LIBRARY OF CONGRESS. 

^ 






'MS 



UNITED STATES OF AMERICA. 



4fl 












I 



H 



HANDBOOK 



OK 



MATERIA MEDICA, PHARMACY, AND 
THERAPEUTICS. 



POTTER 



NOTICES OF THE PRESS 



OF PREVIOUS EDITIONS OF 

DR. POTTER'S HANDBOOK 



From the American Journal of the Medical Sciences. 

" The author has very skilfully steered his course between the pessimism that marks 
a system of therapeutics based solely on the results given by experiments and observations 
in the chemical and physiological laboratories, and the optimism of hasty empirical general- 
izations upon meagre clinical data, and upon this we consider that the greatest claim can 
be made, that this book is a safe one for the junior practitioner. . . . The author, then, 
lias fully attained the purpose which he set before him at the commencement." 

From the Medical Record. 

" This is an old and valued friend which needs no commendation, much less an 
introduction. It ought to be in the library of every physician and student. It is the 
most convenient and most concise work on therapeutics and materia medica in the 
English language, and is at the same time thoroughly reliable. Though necessarily 
largely a compilation, nevertheless there is much that is original, the author being one 
of the most prominent of American therapeutists. The contents embrace the essentials 
of practical materia medica and therapeutics, the amount of pharmacy that every physician 
should possess, one of the best sections on prescription-writing ever written, besides a 
great mass of interesting and valuable material relating to the subject of the work. 
Both diseases and remedies are arranged alphabetically, making the book unusually con- 
venient. The section on applied therapeutics includes, besides the writer's own views, 
the recommendations of fifty authors. All in all, the book is an exceedingly useful one." 

From the New York Medical Journal. 

11 Dr. Potter's Handbook will find a place, and a very important one, in our colleges 
and the libraries of our practitioners. It contains almost everything that can be found in 
the larger works in a more concise form and brought up to a rather more recent date. . . . 
Under the head of prescription writing considerable attention is paid to the subject of in- 
compatibilities, and the student will here find many valuable hints for his guidance in this 
difficult subject. Besides this there are, under the head of special therapeutics, very many 
formulas for the treatment of particular diseases and abnormal conditions, arranged alpha- 
betically for easy reference. This will be especially valuable to young practitioners, and 
will frequently save the trouble of looking through large works and monographs for suit- 
able formulae in the treatment of special cases. This department is fuller in this book 
than in any with which we are acquainted." 

From the Therapeutic Gazette. 

" The author has aimed to embrace in a single volume the essentials of practical 
materia medica and therapeutics, and has produced a book small enough for easy carriage 
and easy reference, large enough to contain a carefully-digested, but full, clear and well- 
arranged mass of information. No new remedy of any acknowledged value is omitted 
from this list. Under each the section on physiological action and therapeutics has been 
written with care. ... In the enumeration of drugs suited to different disorders a very 
successful effort at discrimination has been made, both in the stage of disease and in the 
cases peculiarly suited to the remedy. It is no mere list of diseases followed by a cata- 
logue of drugs, but is a digest of modern therapeutics, and as such will prove of immense 
use to its possessor." 

From the Pacific Medical and Surgical Journal. 

" In looking over the work, we are not surprised that it has taken the author the best 
part of two years in its preparation, for it shows on every page great labor and careful 
research ; and as no good work goes unrewarded, we feel that he will be compensated by 
the favor with which his book will be received by the profession. We have been indeed 
pleased with the examination made, and have already used it for reference." 

\* The price of this book is $4.00 in cloth binding, or $5.00 in full leather. Thumb 
Index in each copy. It may be had through any bookseller, or upon receipt of price will 
be sent, postpaid, to any address by the publishers. 



HANDBOOK 



Materia Medica, Pharmacy, and 
Therapeutics, 



INCLUDING THE 



PHYSIOLOGICAL ACTION OF DRUGS, THE SPECIAL THERA- 
PEUTICS OF DISEASE, OFFICIAL AND PRACTICAL 
PHARMACY, AND MINUTE DIRECTIONS FOR 
PRESCRIPTION WRITING. 



/ 



BY 



SAM'L O. L. POTTER, A.M., M.D., M.R.C.P.Lond., 

PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE IN THE COOPER MEDICAL COLLEGE OF SAN 
FRANCISCO: VISITING PHYSICIAN TO ST. LUKE'S HOSPITAL: AUTHOR OF "QUIZ-COMPENDS" 
OF ANATOMY AND MATERIA MEDICA, U AN INDEX OF COMPARATIVE THERAPEU- 
TICS," AND "A STUDY OF SPEECH AND ITS DEFECTS." FORMERLY 
A. A. SURGEON, U. S. ARMY, AND BRIGADE-SURGEON, 
N. C. OF CALIFORNIA. 



FOURTH EDITION. REVISED. 



PHILADELPHIA: 

P. BLAKISTON, SON & CO., 

1012 Walnut Street. 

1893. 



^ 






Copyright, 1892, 
By P. BLA.KISTON, SON & CO. 



Press of Wm. F„ Fell & Co., 

I220-24 SANSON! ST., 
PHILADELPHIA. 



Olo-SUI 



«] 



^c 






TO MY WIFE 



WHOSE UNFAILING AND 

DEVOTED CARE 

AND PATIENT ENCOURAGEMENT. 

DURING THE PAST FOURTEEN YEARS, 

HAS SUPPORTED THE AUTHOR 

IN EVERY EXIGENCY 

OF HIS 
PROFESSIONAL LIFE. 



PREFACE TO THE FOURTH EDITION 



The exhaustion of the third edition in thirteen months from the date of 
its publication, is ample proof of the continued favor which this book has 
ieceived from teachers, students and practitioners of medicine. For this 
appreciation of his work, by those for whose use he designed it, the author 
returns his sincere thanks, and begs also to hereby express his gratitude 
to the numerous reviewers, whose kind words of commendation have so 
constantly encouraged him. 

In the present edition several new remedies receive such consideration 
as their merits seem to justify ; particularly Aristol, Chloralamid, Diuretin, 
Phenacetine and Piperazine. Briefer mention is made of less important 
agents, such as Antikamnia, Phenolid, Exodyne, Exalgine, Salipyrin, 
Hypnal, etc. Many articles have been re-written, others expanded and 
corrected, and the entire text has received a thorough revision. At the 
same time every care has been taken to preserve intact the characteristic 
features of the book, which have proven so important a factor among the 
elements of its success. 

SAM'L O. L. POTTER. 

330 Sutter St., San Francisco, 
January, 1893. 



PREFACE TO THE FIRST EDITION. 



The book, which this preface completes, has occupied the writer's 
leisure hours during the past two years, and in a measure has grown out 
of some less pretentious volumes previously written by him. The con- 
tinued favor shown by teachers and students, both in this country and 
in England, to his three manuals in the " Quiz-Compend " series for 
students, and particularly to the volume on Materia Medica and Therapeu- 
tics, has encouraged their author to hope that a handbook from him- on 
the same subject, but embracing a wider scope, might meet with a corres- 
ponding degree of appreciation. The fact that quite a number of new 

vii 



Vlll PREFACE. 

manuals on Materia Medica have lately appeared, has not deterred him 
from entering the field, nor diminished his confidence in the approbation 
of his readers ; but has rather seemed a proof that most of the older text- 
books on this branch of medical knowledge are no longer satisfactory, 
even with the regular revisions which they undergo at stated periods. 
Hence he expects for this handbook a position, among the recent manuals 
of its class, as high as its merits and demerits may entitle it to receive in 
the estimation of those for whose use it has been prepared. 

The author's intention has been to produce a book which would 
embrace in a single volume the Essentials of practical Materia Medica 
and Therapeutics, treating of each subject in as concise phraseology as 
possible consistent with the delineation of every important feature. He 
has also endeavored to formulate such minute and definite directions for 
the framing of Prescriptions as might elucidate what to many is a very 
difficult problem. Furthermore, he has tried to present as much infor- 
mation upon the subject of Pharmacy as every physician should possess, 
in order to handle the implements of his profession with confidence, and 
to direct their use by others with pharmaceutical accuracy. 

The complete fulfilment of these aims would be realized if the book 
should take rank as a working companion to the advanced student and 
the junior practitioner ; and be deemed by them a reliable guide through 
the forest of observations and experiments on drug actions and uses, which 
makes progress slow for the already over-burdened mind, when ploughing 
through the more exhaustive and exhausting text-books. 

Although this book is essentially a compilation, as all books of its class 
must be, there will be found in its pages much original matter derived 
from the writer's own experience in professional life. The arrangement 
of the matter will be found to be in some respects unique. After full 
consideration of the many arrangements of the Materia Medica in vogue, 
a modified alphabetical plan was adopted, by which the advantages of the 
alphabetical order might be retained, while permitting the grouping 
together of agents which are clbsely related, physiologically and thera- 
peutically, under the title of the principal member of the class — the 
chief, as it were, of that particular clan. Thus, under the title Amyl 
Nitris (Nitrite of Amyl), will be found mention also of the Nitrites of 
Ethyl, Sodium and Potassium, and their congener Nitro-Glycerin, all of 
which are closely allied to the first-named and to each other, in respect 
of their actions and uses. A very elaborate section on Drug Classifica- 
tion is placed before the Materia Medica, in order to supplement such 
deficiencies in grouping as are inevitable in an alphabetical arrangement. 

In detailing the characteristics of an important drug, its physical pro- 
perties and chemical constituents are first briefly enumerated, then its 
preparations are described in the official language of the pharmacopoeia, 



PREFACE. IX 

usually somewhat abbreviated ; any important unofficial preparations being 
also noted, and all the compounds into which it enters enumerated. 
Next the physiological action is taken up, its characteristic features being 
first described ; then the actions resulting from an ordinary medicinal 
dose, next those produced by small doses continued, and finally those 
from a toxic dose. These are followed by a brief account of its antago- 
nists, antidotes and incompatibles, if any; and a concise summary of its 
therapeutical applications closes the article ; — the whole presenting, it is 
hoped, a clearly defined word-picture of the drug under consideration. 
Every article and preparation comprised in the last edition of the U. S. 
Pharmacopoeia is fully noticed, while all the prominent unofficial agents 
receive such mention as their respective importance seems to demand. 

The second part of the book is devoted to Pharmacy, and has been 
written from the standpoint of a conviction that many young practitioners 
would gladly dispense their own medicines, if provided with a few practi- 
cal directions on the subject ; thereby saving many a dollar from the drug 
store, preventing in their own practices at least the "renewals" which 
constitute so bad a feature of modern pharmaceutics, and gaining for 
themselves a practical acquaintance with their professional weapons which 
cannot but make them better physicians and more accurate prescribers. 
In this section of the book Prescription Writing receives full consideration, 
and many standard formulas are given as samples of prescriptions of each 
kind in extemporaneous use. 

In the third part the subject of Special Therapeutics is treated of elabo- 
rately, and in the form of an alphabetically arranged Index to the treat- 
ment of diseases, as laid down by the most recent authorities. Every 
indication for the use of a drug is referred to its author by his initial, and 
to the most prominent articles are appended a few selected formulae, to 
serve as guides to the neophyte in prescribing. 

The Appendix contains numerous tables, comprising diagnostic hints, 
Latin terms and phrases, formulae for hypodermic use, metric equivalents, 
specific gravities and volumes, and obstetric memoranda; as also Notes 
on temperature in disease, the use of the clinical thermometer, the treat- 
ment of poisoning, and the examination of urine ; also formulae repre- 
senting the most noted patent medicines. 

The Index has received special attention, from a conviction that, if 
well made, it is the best part of a good book. Every title, synonym 
and other reference of importance is included therein, double and 
treble entries being made in every instance which seemed to require such 
repetition. 

Nearly all the regular text-books have been laid under contribution in 
tne preparation of the book, but especial use has been made of the works 
of Bartholow, Ringer, Wood, Phillips, Piffard, Waring and Brunton, in 



X PREFACE. 

their latest editions; as well as of the writer's verbatim notes of two 
courses of didactic and clinical lectures delivered by Professors Bartholow 
and Da Costa in the Jefferson Medical College and Hospital and in the 
auditorium of the Pennsylvania Hospital. On pages 479 and 480 will be 
found a full list of the authorities referred to by initials in the section on 
Special Therapeutics. 

The term "officinal," as applied to drugs recognized by the pharma- 
copoeia, has been discarded, the word "official " being used instead ; for 
the simple reason that the idea to be conveyed is expressed more correctly 
by the latter term than by the former one. When none but official drugs 
and preparations were kept in the officina or drug store, it was eminently 
proper to call them "officinal," but inasmuch as this class does not 
nowadays constitute much over one-fourth part of the officinal stock, it 
is a wilful debasement of our professional weapons, as well as an inexcu- 
sable misnomer, to apply the shop-title to them any longer. 

Cooper Medical College, San Francisco, 
December, 1886. 



TABLE OF CONTENTS 



PAGE 

INTRODUCTION, . . 17 

Materia Medica, 17 

Pharmacy, ' 17 

Empirical Therapeutics, 18 

Rational Therapeutics, ^ 18 

Administration of Medicines, 20 

Classification of Medicines, 23 

Stimulants and Sedatives, 23 

Agents acting chiefly on the Nervous System, 24 

Agents acting on the Organs of Special Sense, 28 

Agents acting on Respiration, 30 

Agents acting on the Circulation, m ^^ 

Agents acting on the Digestive System, 34 

Agents acting on Metabolism, 41 

Agents acting on Excretion, 43 

Agents acting on the Generative Apparatus, 47 

Agents acting on the Cutaneous Surface, 49 

Agents acting on Microbes, Ferments, etc., 51 

Agents acting upon each other, 52 

Dosage of Medicines, 54 

PART I.— MATERIA MEDICA AND THERAPEUTICS, 55 

Abrus to Zingiber 55-414 

PART II.— PHARMACY AND PRESCRIPTION WRITING, ... 415 

Constituents of Vegetable Drugs, 416 

Official Operations, 418 

Official Preparations, 427 

Extemporaneous Pharmacy, 442 

Weights and Measures, 443 

Metric System, 444 

Approximate or Domestic Measures, 446 

Specific Gravity and Specific Volume, 447 

Prescriptions, : . 447 

Analysis of a Prescription, 447 

Principles of Combination, 449 

Prescription Writing, 450 

Abbreviations, 451 

Prescription Blanks, 45 l 

Renewals, 45 2 

Filling a Prescription, 453 

Stock Solutions, 455 

Rules for the Pharmaceutical Student, 455 

xi 



Xll 



TABLE OF CONTENTS. 



Incompatibilty, . . . . 456 

Chemical Incompatibility, 456 

, Pharmaceutical Incompatibility, 458 

Therapeutical Incompatibility, * . 459 

Rules for Avoidance of Dangeis, 460 

Extemporaneous Preparations and Formula, 461 

Excipients for Mixtures, 463 

Excipients fur Emulsions, 466 

Excipients for Pills, 472 

PART III.— SPECIAL THERAPEUTICS 487 

References and Bibliography, 487 

Abdominal Plethora to Yellow Fever, 4S8-702 

APPENDIX, 703 

Latin Terms, Phrases, etc., used in Prescriptions, 703 

Verbs, Participles, Prepositions, etc., 711 

Genitive Case-endings, 712 

Hypodermic Formula, 713 

Chlorodyne, Comparisons of Ten Formulae therefor, 715 

Patent Medicines, 716 

The Treatment of Poisoning, 720 

Tables of Differential Diagnosis, 725 

Notes on Temperature in Disease, 730 

Clinical Thermometry, 730 

Obstetrical Memoranda 732 

Signs of Pregnancy, 732 

Signs of Labor, 732 

Average Pelvic Diameters, 733 

Development of the Foetus, 733 

Diameters of the Foetal Skull at Term, 733 

Asphyxia and Apnxea, 734 

Clinical Examination of the Urine, 735 

Ethics, the Hippocratic Oath, etc., 737 

Table of Specific Gravities and Specific Volumes, 738 

Table of Drops in, and Weights of, a Fluid-drachm of Various 

Liquids, 739 

Table of Weights and Measures, 739 

Table for Converting Apothecaries' Weights and Measures into 

Grams, 740 

Table of Prescription Doses and Quantities, 741 

INDEX, 743 



ERRATA. 



Page 80, 

" 81, 

" 106, 

" 164, 

" 187, 

" 187, 

" 213, 

" 234, 

" 463. 

" 245. 

" 245, 

" 309. 

" 3". 



line 10 from bottom, " Nitrate " should read " Nitrite." 
" 8 " " insert " almost " before " always." 

" 29, " Uvas " should read " Uva." 
running title, " Oxalis " should read " Oxalas." 

" " " Cinchona " should read " Cinnamomum. 

line 11, 

17 from bottom, 

22 

23 from bottom, 



Veloutine " should read " Velatine? 



19 

23 
J 9 



3, «'xx 



" after " Subchloride," insert " of Mercury.' 
" after " Bichloride," insert " of Mercury." 
" should read — " It is said to have broken 

when stirred therein with water, 
should read " xv." 



glass 



INTRODUCTION 



Pharmacology, (pharmakon, a drug, logos, a discourse,) — is a gen- 
eral term which properly includes all matters pertaining to the study of 
medicinal agents in the widest possible sense, embracing all of Materia 
Medica and Pharmacy, with so much of Therapeutics as relates to drugs. 
The term is, however, frequently employed in a more restricted sense, 
including only the physiological action of drugs ; a subject to which the 
title Pharmacodynamics is much more appropriately applied. 

Materia Medica is that branch of medical science which treats of the 
substances used as medicines, their origin, composition, physical char- 
acteristics, chemical properties, modes of preparation and administration, 
physiological and toxicological actions. 

Pharmacodynamics, (pharmakon, a drug, dunamis, power,) — is the proper title for 
that portion of the Materia Medica which relates to the physiological action of drugs, 
that is, the influence of drugs upon the healthy human body to modify its physiological 
activity. 

Toxicology is another subdivision, and includes the effects of drugs when adminis- 
tered in poisonous doses, together with the study of the drug-antagonists for the most 
dangerous symptoms produced, and the appropriate chemical antidotes. 

Pharmacy is the art of preparing medicines for use and dispensing 
them on the order of the therapeutist. It includes a knowledge of the 
Materia Medica, an acquaintance with the theories and manipulations of 
chemistry, and an intimate practical knowledge of many special opera- 
tions peculiar to itself. 

Therapeutics, (therapeuein, to attend upon,) — includes all that re- 
lates to the science and art of healing ; and embraces the application, 
not only of medicines to the alleviation or cure of disease, but of all other 
agents which may aid in the accomplishment of the same result. 

The operations of Nature herself, as well as of the substances described in the Materia 
Medica, and those of all other remedial measures, as food, climate, clothing, heat, cold, 
electricity, etc., are all embraced in a general term Therapeutics, which may be divided 
into two grand divisions, viz. : — 

Natural Therapeutics, including the operations of the Vis Medicatrix Naturae, — 
the modes and processes of healing which occur independently of Art, for the spontaneous 
decline and cure of disease. There is no more completely established dogma in science, 
than that — The Living Organism is in itself adequate to the cure of all its curable dis- 
orders. This Natural Law enables the homoeopath to relate his sugar cures, aids the 
medical skeptic to hold to his infidelity, and helps all physicians out of more close places 
than most of them are willing to acknowledge before their clientele. This part of the 
subject is not taught in the schools except in connection with pathology, and by the chair 
of Theory and Practice of Medicine. It is deserving of a special chair and of more sys- 
tematic treatment than it receives. 

2 I 7 



1 8 INTRODUCTION. 

Applied Therapeutics embraces the application by Art of agents foreign to the living 
organism, for the purpose of aiding Nature to restore the body to a healthy condition. 
This division is the portion of the subject which is taught separately and systematically 
in the schools, and therefore is alone considered in the following pages. 

Other divisions of the general subject of Therapeutics employed in 
professional literature and conversation are those entitled " Empirical" 
and " Rational Therapeutics." 

Empirical Therapeutics is a term applied to the use of medicinal or 
other therapeutical agents for the sole reason that they have been tried 
previously with successful results in cases apparently identical with the one 
under treatment. By those who advocate this method it is styled the 
Therapeutics of Experience, and claimed to be an accumulation of means 
of combating disease simply by observation and experiment, independ- 
ently of physio-pathological reasoning (Hartshorne). It was necessarily 
the original method in Therapeutics, has conferred many rich gifts upon 
medical science, and has been advocated by many great physicians, its 
latest and ablest expounder being the eminent and lamented Niemeyer. 

The use of Opium to relieve pain, — that of Cinchona for malarial fevers, — of Col- 
chicum in gout, — of Potassium Iodide in syphilis, — of trie Bromides in epilepsy, — of 
Cod-liver Oil in phthisis, — are examples of the empirical use of remedies. But, after all 
has been said for it that can be said, the fact remains that it is essentially an unscien- 
tific method, a mere elaboration of the prevailing popular habit of recommending Mrs. A. 
to use pepper tea, because it cured Mrs. B. of " the very same trouble." Permitted to 
reign supreme it would be destructive to all exactness in therapeutical progress. The so- 
called " experience " of one observer is too often overbalanced by the experience of another 
equally competent and trustworthy ; and as few are encouraged to record their failures 
with remedies, there can be no scientific comparison of the failures with the reported suc- 
cesses. For this reason empirical methods would tend to a minimum degree of accuracy in 
a science which, in the very nature of things, can never be an exact one; — though un- 
doubtedly such methods will always prevail to some extent. 

Rational Therapeutics embraces the use of remedies for reasons 
based on a knowledge (i) of the pathological conditions present in the 
subject, and (2) of the physiological action of the agent employed. This 
method is the very antithesis of empiricism, and has been the leading 
idea in every revolt against empirical therapeutics in the past. Humor- 
alism, Chemicism, Solidism, Stimulism, Galenism in the 2d century, Par- 
acelcism in the 16th, and Hahnemannism in the 19th, all originated in 
efforts to find a more rational system of administering medicines than 
the prevailing empiricism of the day. 

The illustrious Albrecht von Haller, the father of Physiology and the 

author of the doctrine of Irritability, was the real originator of modern 

physiological therapeutics. In the preface to his Swiss Pharmacopoeia 

{circa A. D. 1755), occur the following remarkable directions, — the first 

recorded of their kind : — 

" Nempe primum in corpore sano medela tentanda est, sine peregrina ulla miscela : 
odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et ad omnes quae 
inde contingunt affectiones, quis pulsus, quis calor, quae respiratio, quaenam excretiones, 
attendendum. Inde adductum phenominorum in sano obviorum, transeas ad experimenta 
in corpore aegioto." 



INTRODUCTION. I9 

"In the first place the remedy is to be tried on the healthy body, zvithout any foreign 
substance mixed zvith it ; having been examined as to its odor and taste, a small dose is 
to be taken, and the attention directed to all effects zvhich thereupon occur ; such as tipon 
the pulse, the temperature, the respiration, the excretions. Having thereby adduced their 
obvious phenomena in health, you may pass on to experiment upon the sick bodyP 

Forty or more years after these rules were laid down ex cathedra by 
Haller, the central idea contained in them was incorporated as one of the 
main pillars, into a medical edifice then being erected in Germany. In 
the course of construction this pillar became so hidden beneath a super- 
structure of palpable absurdities, that the medical profession, in its anxiety 
to steer clear of the whole mass, almost forgot the corner-stone of truth, 
appropriated from the teachings of one of its own greatest teachers. 
While, however, the masses of the profession, blinded by prejudice, turned 
away from everything which savored of drug-experiment, a few in every 
country were quietly working on the lines of Haller's dogma that Drug- 
proving is the only true basis of Drug-using. As a result of their labor, 
the present generation sees the development of an idea, announced 
130 years ago, but now inspiring the minds of teachers and students all 
over the civilized world. Medical Colleges are recognizing physiological 
drug-experimentation as a part of their regular curricula ; — laboratories 
are fitted up in many of the schools with costly instruments of precision, 
for the more exact prosecution of this study ; and under the direction of 
such men as Wood, Ringer, Murrell, Brunton, Hildebrandt, Lieber- 
meister, Husemann, Schmiedeberg, etc., systematic researches are being 
conducted upon animals to ascertain the physiological action of every 
agent hitherto used in medicine. The alkaloids, and other component 
principles of vegetable drugs, are being subjected to the same rigid obser- 
vation, — as also every new compound which chemistry gives to medicine. 
Journals, in every civilized country, teem with the results of these labors ; 
and no medical student is permitted to pass the graduating ordeal until he 
has mastered the essential characteristics of the physiological action of the 
important medicaments so far as established. What has hitherto been the 
conviction of but a few, is daily growing into a fixed canon of profes- 
sional belief, — that physiological experimentation with drugs must be the 
basis of their therapeutical employment, and that all real advance towards 
the establishment of Therapeutics as a science, must be made upon the 
lines laid down by Haller, i.e., drug-proving upon the healthy human 
organism. Still, in the words of Brown-Sequard, " Therapeutics will 
cease to be empirical, only when this last kind of knowledge shall be 
fully obtained;" — but its fulness will never be fully realized, unless the 
results have been thoroughly considered with full regard to the differences 
due to the action of drugs in different doses on the human organism in 
health and disease. [Compare pages $j, 54, infra.'] 



ADMINISTRATION OF MEDICINES. 



Medicines may be introduced into the circulation by various routes, as 
the gastro-intestinal tract, the rectum, the respiratory tract, the veins and 
arteries, the subcutaneous cellular tissue, and the integument itself. 

The Gastro-intestinal Route is the one most frequently employed, 
being the most convenient. The remedies, after being swallowed, find 
their way into the current of the circulation, through the walls of the 
gastro-intestinal blood-vessels and the lacteals. When the stomach is 
empty and its mucous membrane healthy, crystalloidal substances in solu- 
tion pass through the walls of its vessels with great rapidity. Colloidal 
substances (fats, albumen, gum, gelatin, etc.) require to be digested and 
emulsified before they can be absorbed. 

The Rectum will absorb many substances applied in the form of 
Enemata or Suppositories. Those most suited to this route are the salts 
of the alkaloids in solution, especially those of Morphine, Atropine, and 
Strychnine, the latter being absorbed more rapidly per rectum than by 
the stomach. Acid solutions, if not too frequently repeated, are also well 
administered by this channel. 

The Respiratory Tract admits of the rapid absorption of medicinal 
substances through its extensive blood-supply. The inhalation of vapors 
or atomized fluids, the- insufflation of powders into the nares, fauces, 
larynx, etc., and the use of a medicated nasal douche, are methods 
whereby this channel may be utilized. 

The Veins are only used as a route of medication in emergencies, 
where the other channels are not available, and where immediate action 
is necessary to the preservation of life, the operation being a highly dan- 
gerous one. The injection intravenously of Saline Solutions in the col- 
lapse of cholera, diabetic coma, etc., — Blood or Milk as a last resort in 
excessive hemorrhage, epilepsy, uraemia, the collapse of cholera, etc., — 
and a solution of Ammonia for the bites of venomous reptiles, Hydro- 
cyanic-acid poisoning, Opium narcosis, Chloroform asphyxia, etc., are 
the instances admitted in practice. 

20 



INTRODUCTION. 21 

Arterial Transfusion has also been performed successfully in a 
number of cases, and is considered safer than venous transfusion when 
a large quantity of fluid has to be introduced into the circulation. A 
special apparatus is employed for these purposes, known as Aveling's 
Transfusion Syringe, but the ordinary Dieulafoy's aspirator, slightly 
modified, may be used with safety and convenience. The danger of 
the operation lies in the liability of the introduction of air into the 
circulation, an occurrence which may cause instant death in the human 
subject. 

The Hypodermic Method is the introduction of medicines into 
the organism by injecting them into the subcutaneous areolar tissue, 
from which they are quickly absorbed by the lymphatic and capillary 
vessels. The great advantage of this method is the absolute certainty as 
to the quantity of drug actively affecting the organism, a very essential 
question when using small quantities, as with powerful alkaloids. Another 
is the avoidance of reactions between the drug and the secretions of the 
stomach, which may destroy the activity of the former, or seriously 
change its character. The Medicines must be in solution, of neutral 
reaction and freshly prepared, the usual menstruum being distilled water ; 
though spring water filtered will answer just as well, and much better 
than distilled water which has been standing several days, and exposed 
from time to time to the air. The solution is to be injected beneath the 
skin, by a hypodermic syringe, care being taken to avoid puncturing a 
vein. The most suitable localities for the injection are the external 
aspect of the arms and thighs, the abdomen, the back, and the calves of 
the legs. On the external aspect of the thigh, just in front of the great 
trochanter, there is an area of some two inches square, over which the 
insertion of a fine hypodermic needle is not felt, so barren is the skin 
in that region of the sensitive nerve filaments. 

After nearly filling the syringe with the solution to be used, the needle should be screwed 
on tightly; and with the instrument held in a vertical position, point uppermost, the 
excess of solution over the amount required should be ejected, thus expelling air-bubbles 
and filling the needle itself. A portion of skin should be grasped by the thumb and fore- 
finger at the site selected for the injection, into which the needle should then be quickly 
inserted until its point has passed beneath the skin, when the piston may be pressed down 
slowly, delivering the solution so gradually as to avoid rupturing the tissue. If the solu- 
tions are freshly prepared with clean water, the needles kept clean and sharp, and the- 
injection be made beneath the skin, not into it, there will be no risk of producing abscesses 
with the agents ordinarily employed. Tablets for hypodermic use are prepared by the 
prominent manufacturers, each containing one dose. They may be readily dissolved in a 
teaspoon at the bedside, and are very convenient for the pocket, if put up in a case with 
a good hypodermic syringe, as may be obtained from Parke, Davis and Co., of Detroit. 
Their regular line of Hypodermic Tablets includes the agents named in the following 
list, put up in tubes of 25 each. 



22 



INTRODUCTION. 



List of Hypodermic Tablets. 



Aconitine (crystals), 


. . gr. 


Apomorphine Muriate, 


. . gr. 


Atropine Sulphate, 


■ • gr- 


Atropine Sulphate, 


• • gr- 


Cocaine Hydrochlorate, 


. . gr. 


Conine Hydrobromate, 


• • gr. 


Colchicine, . 


. gr. 


Corrosive Sub. and Urea 


> • • gr- 


Digitalin (soluble), . 


• ■ gr. 


Gelsemine Muriate, . 


• gr. 


Hyoscine Hydrobromate 


> • • gr- 


Hyoscyamine, . 


• • gr. 


Morphine Sulphate, 


. . gr. 



1 

lift' 

1 
To- 

FO"- 

TOT* 



Morphine Sulphate, 
Morphine & Atropine, No. I. 

Morphine Sulph., . 

Atropine Sulph., 

Morphine & Atropine, No. 2. 

Morphine Sulph., . 

Atropine Sulph., . 

Picrotoxin, 

Pilocarpine Hydrochlor., 
Pilocarpine Nitrate, 
Physostigmine Sulph., . 
Sodium Arseniate, . 
Strychnine Sulphate, 
Strychnine Sulphate, 

[For Formulae for Hypodermic Solutions, see Appendix.] 



50- 

__L_ 

100' 

1 

50- 

1 



gr-f 



gr.f 



gr- 5% • 

gr-i- 

gr.|. 

g r - To-0- 

gr-xo- 

g r -5 a o- 

g r -T-oo- 



> 



Parenchymatous Injection is the delivery of a medicine deeply 
into the tissues, either to affect a muscle itself or to locally influence some 
important nerve-trunk. The principal agents used in this manner are 
Strychnine for palsied muscles, Chloroform for sciatic and other neu- 
ralgias, and Salts of Cocaine for local anaesthesia. 

The Skin is an active absorbent of crystalloidal substances when its 
epidermis or cuticle is removed. By this route there are four methods of 
introducing medicaments into the circulation, viz. — the Enepidermic, 
Epidermic, and Endermic Methods, and Inoculation. 

The Enepidermic Method consists in placing the medicine in 
simple contact with the epidermis, no friction being used to hasten its 
penetration. Chloroform and Oleic Acid solutions of the alkaloids pass 
by osmosis in this manner with comparative ease, but aqueous solutions 
act very slowly and alcoholic ones with great difficulty if at all. 

The Epidermic Method consists in the use of friction to promote 
the passage of the medicament between the cells of the epidermis. 
Mercurial Ointment, Cod-liver Oil, and other fats, Oleates, etc., are 
used in this way for their local and systemic effects. 

The Endermic Method obviates the difficulty of absorption through 
the cuticle by removing the latter through the agency of a blister, and 
then powdering the medicament over the surface of the denuded derma. 

An ordinary Cantharides-plaster, followed by a poultice to raise the blister, may be 
employed ; but a quicker method is to place upon the skin a piece of lint soaked in 
Stronger Water of Ammonia, covering it with a watch-glass or a piece of oiled silk to 
prevent evaporation. The blister raises rapidly and should then be removed with scissors. 
Morphine, Atropine, Quinine, and Strychnine are the agents generally used in this man- 
ner, but the method is painful and unpopular. 

Inoculation is the introduction of medicinal agents through the 
scraped or punctured skin by an operation similar to that employed for 
vaccination. 



CLASSIFICATION OF MEDICINES. 



In the present state of knowledge respecting the actions and uses of 
medicinal agents, no really scientific classification of these substances is 
possible. Some writers have adopted a system based on the natural rela- 
tions of the various articles to each other, while many classify them 
according to their effects on the human system, and others make no 
attempt at arrangement but treat of them in alphabetical order. The 
latter method has been followed in this work, from a conviction that 
every medicine should first be studied as an individual, both with respect 
to its physiological actions and its therapeutical applications. When the 
student has thus made himself familiar with the characteristic features of 
each article of the Materia Medica, he may begin, by comparing one 
with another, to seek acquaintance with their more delicate lights and 
shades. Some system of classification then becomes imperative as an 
aid to the memory, and as the titles of the groups to which the various 
agents belong in any physiological classification are also used to express 
their actions and uses, the following synopsis is inserted as an appropriate 
introduction to the section on Materia Medica and Therapeutics. 

Stimulants and Sedatives. 
These are general terms employed in various classifications with very 
little discrimination. 

Stimulant (Stimulus, a goad), — is a term which is used in various 
senses when applied to medicinal agents. Alcoholic preparations, which 
are true narcotics, are commonly termed "stimulants," and the same 
expression is employed to designate any agent which excites the organic 
action of a part of the economy. 

Divisible Stimulants are those which have a prompt but transient effect, such as 
Alcohol, Ammonia, Camphor, etc. Spinal Stimulants exalt the functions of the cord, as 
Strychnine, Picrotoxin, Ergot, Atropine, Phosphorus. Cardiac Stimulants increase the 
action of the heart, as Alcohol, Atropine and Morphine in small doses, Strychnine, etc., 
also Squill, Convallaria, Cimicifuga, and Digitalis, which slow but strengthen the cardiac 
action. Vaso-motor Stimulants, as Alcohol, Chloroform, Ether, Ammonia, Strychnine, 
Digitalis, and Squill, acting on the vaso-motor centre; and the Nitrites, Belladonna, Elec- 
tricity, Volatile Oils, etc., acting as local dilators of the vascular system. Cerebral Stimu- 
lants, as Alcohol, Opium, Belladonna, Caffeine, Cocaine, Theine, Cannabis, Chloroform, 
Ether, Tobacco, etc. Renal Stimulants, as the diuretic group. Stomachic Stimulants, 

2 3 



24 AGENTS ACTING CHIEFLY ON THE NERVOUS SYSTEM. 

as the Aromatics, Volatile Oils, Vegetable Bitters, Mineral Acids, Nux Vomica, Mustard, 
Capsicum, etc. Hepatic Stimulants, as Nitro-muriatic and Nitric Acids, and the chola- 
gogue purgatives, Podophyllum, Jalap, Leptandra, Euonymin, Iridin, etc. Intestinal 
Stimulants, as Mercurials, Elaterium, Colocynth, Jalap, Scammony, Podophyllum, etc., 
which affect the glandular apparatus, — and Belladonna, Physostigma, Nux Vomica, Rhu- 
barb, Senna, Aloes, Frangula, Cascara, etc., which chiefly affect the muscular fibres and 
the intestinal nerves. Ctttaneous Stimulants, as the diaphoretic group, and the rubefa- 
cients, Mustard, Capsicum, Turpentine, Ammonia, etc. All stimulation reacts into 
depression, and most of the agents which stimulate the nerve centres at first soon depress 
and finally paralyze them. 

Sedatives (Sedo, I allay), — are agents which exert a soothing influ- 
ence on the system by lessening functional activity, depressing motility, 
and diminishing pain. 

General Sedatives include the narcotics and anaesthetics. Local Sedatives include Aco- 
nite, Opium, Ice, etc. Pulmonary Sedatives, as Hydrocyanic Acid, Veratrine, and the 
nauseants and emetics. Spinal Sedatives, as Physostigma, Gelsemium, Potassium Bro- 
mide. Stomachic Sedatives include Arsenic, Bismuth, Nitrate of Silver, Bicarbonate of 
Sodium. Vascular Sedatives, as Digitalis, Tobacco, Aconite, Veratrum, and the emetics. 
Nervous Sedatives, among which are Potassium Bromide, Tobacco, Lobelia, and the 
group of spinal depressants. 



Agents Acting Chiefly on the Nervous System. 
Motor-Excitants are agents which increase the functional activity 
of the spinal cord and the motor apparatus, producing disturbances of 
motility, heightened reflex excitability, and tetanic convulsions when 
given in large doses, their ultimate effect being motor paralysis from over- 
stimulation. 

The most important members of this class are Nux Vomica and Ignatia, with their 
alkaloids Strychnine and Brucine, also Thebaine, the tetanizing alkaloid of Opium. It 
also includes Morphine and Atropine, which, though at first sedative, when given in large 
doses produce convulsions. The respiratory centre in the medulla is stimulated by Strych- 
nine, Atropine, Ammonia, and small doses of Alcohol, Ether, and Chloroform. The 
motor convolutions in the brain are stimulated by Alcohol in moderate doses, as also for 
a brief period by Ether and Chloroform. 

The end-organs of the motor nerves are stimulated by the local use of Electricity, 
Strychnine, and friction ; and are irritated by the internal administration of Aconitine, 
Nicotine, Camphor, Pilocarpine, and Pyridine. Other members of this class are embraced 
in the following list : — 



Nux Vomica. 


Alcohol.f 


Ergot. 


Digitalis. 


Tgnatia. 


Ether.f 


Ustilago. 


Convallaria. 


Strychnine. 


Chloroform. f 


Gossypium. 


Cimicimga. 


Brucine. 


Ammonia. 


Picrotoxin. 


Pilocarpine. 


Thebaine. 


Absinthe. 


Aconitine. 


Pyridine. 


Morphine.* 


Buxine. 


Nicotine. 


Rhus Toxicoden. 


Atropine.* 


Calabarine. 


Camphor. 


Electricity. 



Motor-Depressants lower the functional activity of the spinal cord 
and motor apparatus, and in large doses paralyze them. Some act indi- 
rectly by reducing the spinal circulation, as Digitalis, Aconite, and large 

* In large doses. f In small doses. 



AGENTS ACTING ON THE NERVOUS SYSTEM. 



'5 



doses of Quinine ; others by a directly paralyzant action on the centres. 
The principal members of this class may be enumerated as follows, 
viz. : — 



Opium, Morphine. 

Gelsemium. 

Muscarine. 

Pulsatilla. 

Grindelia. 

Phytolacca. 

Physostigma. 

Belladonna. 

Stramonium. 

Hyoscyamus. 

Pilocarpus. 

Quebracho. 

Camphor. 

Aconite. 

Tobacco. 

Lobelia. 



Curare. 

Conium. 

Chloral. 

Ergot (at last). 

Arnica. 

Ailanthus. 

Veratrum. 

Alcohol* 

Ether.* 

Chloroform.* 

Bromides. 

Potassium. 

Lithium. 

Zinc. 

Prussic Acid. 

Potass. Cyanide. 



Amyl Nitrite. 

Sodium Nitrite. 

Methyl Strychnine. 

Ethyl Strychnine. 

Methyl Thebaine. 

Methyl Veratrine. 

Methyl Conine. 

Other Methyl Compounds. 

Ammonium Cyanide. 

Ammonium Iodide. 

Ethyl Ammonium Chloride. 

Amyl Ammonium Chloride. 

Amyl Ammonium Iodide. 

Amyl Ammonium Sulphate. 

Other Compound Ammonias. 

Galvanism. 



The motor centres in the medulla are powerfully depressed by Opium, Morphine, Aco- 
nite, Conium, Chloral, Physostigma, and large doses of Alcohol, Ether, and Chloroform. 
The- three last named are also paralyzers of the motor convolutions in the brain, arresting 
all voluntary movements when administered in sufficient quantity. The anterior cornua 
of the cord are greatly depressed by Physostigma and other agents, and the motor nerves 
by Conium, Methyl-Strychnine, etc., both actions resulting in paralysis of the limbs. Cu- 
rare, even in small doses, paralyzes the end-organs of the motor nerves, and Belladonna, 
the compound Ammonias, Methyl compounds, etc., exercise a similar but less powerful 
influence. Galvanism is also an effective local depressant of motor activity. 

Local Stimulants increase common sensibility to the extent of pro- 
ducing pain, chiefly by direct action upon the end-organs of the sensory 
nerves in the skin, though some act probably by stimulating the local 
circulation, as in inflammation. The principal members of this group 
are : — 



Faradism. 
Heat. 

Cold. 

Alcohol. 

Ether. 



Chloroform. 
Carbolic Acid. ( 
Creasote. 
Mineral Acids. 
Ammonia. 



Volatile Oils. 
Acrid Essential Oils. 
Metallic Salts. 
Veratrine (at first). 
Cantharis (at first). 



Local Anaesthetics and Anodynes {an, without, aistheysis, percep- 
tion, odunay, pain), — reduce the functions of the sensory nerves until 
they lose the power of receiving or conducting sensations. Some act by 
direct depression of the end-organs in the skin, etc., others by impairing 
the conductivity of the sensory nerves, while some act indirectly by 
reducing the local circulation. The Anodynes diminish, and the Anaes- 
thetics destroy, for a time, the sensibility of the skin or mucous mem- 
brane. The chief agents of this class are — 



Local Anodynes. 
Aconite, Aconitine. 
Belladonna, Atropine. 
Opium, Morphine. 



Local An&sthetics. 
Extreme Cold, Ice. 
Ether Spray, 
Carbolic Acid. 



* In large doses. 



26 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Local Anodynes. Local Ancesthetics. 

Carbolic Acid. Erythroxylon. 
Chloroform. Cocaine. 

Chloral Hydrocyanic Acid. 

Veratrum, Veratrine. Creasote. 

Volatile Oils. Oil of Turpentine. 

Galvanism. Iodoform. 

Cerebral Excitants, — are remedies which increase the functional 
activity of the cerebrum, without producing any subsequent depression, or 
any suspension of the cerebral functions. They act partly by increasing 
the action of the heart and consequently the rapidity of the circulation, 
partly by a direct action upon the gray matter of the brain. The chief 
members of this group are — 

Alcohol (at first). Coffee, Caffeine. 

Ammoniac. Tea, Theine. 

Asafetida. Guarana, Guaranine. 

Camphor. Erythroxylon, Cocaine. 

Cannabis. Tobacco. 

Valerian. Strychnine. 

Ammonia (inhaled). Acetic Acid (inhaled). 

Deliriants excite the functions of the higher brain to such a degree 
as to disorder the mental faculties, producing intellectual confusion, loss 
of will-power, delirium and even convulsions. They are all narcotics 
(though all narcotics are not deliriants), and may be listed as follows, 
viz. — 

Alcohol. Cannabis Indica. 

Belladonna. Chloral. 

Stramonium. Lupulus (at first). 

Hyoscyamus. Opium (at first). 

Cerebral Depressants lower or suspend the functions of the higher 
cerebrum after a preliminary stage of excitement. Under this head may 
be included the Narcotics, General Anaesthetics, and several of the Anti- 
spasmodics, all acting on the cells of the convolutions,' at first stimu- 
lating the brain functions, they produce after a time stupor, coma and 
insensibility. 

The most useful of this class are the Bromides, Zinc and Caffeine, as they also diminish 
reflex excitability and thus secure rest of the nervous system. Some of them are decidedly 
dangerous, as they may paralyze the heart or the medulla and its centres of organic life 
before the consciousness is much disturbed; such being Chloroform, Aconite, Opium, and 
the irritant poisons. 

Narcotics (iiarkay, stupor), are agents which, at first excitant to the 
higher brain, produce profound sleep, characterized by. stupor, and if the 
dose be sufficient, coma, insensibility and death by paralysis of the 
medullary centres governing respiration and other functions of organic 
life. They are closely related to stimulants, Opium and Alcohol being 



AGENTS ACTING ON THE NERVOUS SYSTEM. 2J 

good illustrations, in the different stages of their action, of both stimulant 
and narcotic effects. They give us the power of lowering perception, 
inducing sleep and soothing the vital functions by rest, all of which are 
means of great therapeutical value. The chief narcotics are — 

Alcohol. Cannabis Indica. 

Opium, Morphine. Humulus. 

Belladonna, Atropine. Chloroform, Ether, etc. 

Hyoscyamus. Chloral-hydrate. 

Stramonium. Croton-chloral. 

Hypnotics (Jienpnos, sleep), — are remedies which produce sleep, and 
in this wide sense of the term the class would include the Narcotics and 
the Anaesthetics, as well as those agents which may be termed Pure 
Hyp?iotics, which induce sleep by bringing the brain into a favorable 
condition therefor, rather than by direct soporific action. In this sense 
the purest hypnotics are the Bromides, but artificial sleep may be pro- 
duced by many other agents. The principal members of this class are 
the following : — 

Opium, Morphine, Narceine. Urethane. 

Chloral-hydrate. Sodium Bromide. 

Croton-chloral. Calcium Bromide. 

Cannabis. Lithium Bromide. 

Cannabin Tannate. Zinc Bromide. 

Hyoscyamus. Potassium Bromide. 

Paraldehyde. Monobromated Camphor. 

Hops. Lettuce. 

Sulphonal. Lactic Acid. 

Chloralamid. Amylene Hydrate. 

Methylal. Piscidia Erythrina. 
General Anaesthetics. 

Analgesics (an, without, algos, pain), or Anodynes (an, without, 
odunay, pain), — are remedies which relieve pain either by direct depres- 
sion of the centres of perception and sensation in the cerebrum, or by 
impairing the conductivity of the sensory nerve fibres. Opium is the 
most efficient of all analgesics, because it arrests the afferent impressions 
at every step of their track — at their formation, along the course of their 
conduction, and at the point where they impinge on the sensorium. The 
Local Anodynes have been described, and the list of General Anodynes 
includes the following-named agents, viz. — 

Opium, Morphine. Aconite. 

Belladonna, Atropine. Chloroform, Ether, etc. 

Cannabis Indica. Conium. 

Stramonium. Chloral-hydrate. 

Hyoscyamus. Croton-chloral. 

Gelsemium. Lupulus. 

Antipyrine. Acetanilide. 

Anaesthetics {an, without, aisthaysis, perception), — are agents which 
destroy sensation. Local Ancestlietics have been described. General 
Ancesthetics are certain volatile substances, mostly belonging to the class 



2<8 AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 

of alcohols and ethers, which when inhaled produce complete uncon- 
sciousness and loss of sensation (anaesthesia), with lessened motor power. 

Narcotics also produce anaesthesia, but the term is usually restricted to the effects of the 
volatile agents referred to. The principal members of this group are — 

Ether (Oxide of Ethyl). Nitrous Oxide. 

Chloroform. Bromide of Ethyl. 

Bichloride of Methylene. Bichloride of Ethylene. 

Antispasmodics {anti, against spasmos, a spasm), — are agents which 
prevent or allay spasm of voluntary or involuntary muscles in any portion 
of the organism. Some of the agents belonging to this class act by 
stimulation of the higher nervous centres, the coordinating power, and 
the circulation, as Alcohol and Ether in small doses, Camphor, Musk, 
Valerian, etc. ; others by a depressant influence on the motor centres, as 
the Bromides ; and still others by paralysis of the end organs of the vaso- 
motor nerves, as Amyl Nitrite. A few depress all the vital functions, as 
Aconite, Tobacco, Lobelia, Hellebore, and Prussic Acid ; and a long list 
stimulate the bowels to expel gaseous accumulations, namely, Asafetida, 
Cajuput, Valerian, Musk, Aromatic Oils, etc. They are used in convul- 
sive affections, especially asthma and other spasmodic diseases of the 
respiratory organs, hysteria, chorea, angina pectoris, epilepsy, etc. The 
principal antispasmodics are as follows, viz. — 



Alcohol. 


Aconite. 


Ammoniac. 


Ether. 


Lobelia. 


Castor. 


Chloroform. 


Tobacco. 


Musk. 


Amyl Nitrite. 


Hellebore. 


Galbanum. 


Nitrites. 


Opium. 


Sumbul. 


Bromides. 


Belladonna. 


Ipecac. 


Potassium Iodide. 


Stramonium. 


Senega. 


Potassium Nitrate. 


Hyoscyamus. 


Silver Salts. 


Arsenic. 


Prussic Acid. 


Zinc Salts. 


Valerian. 


Physostigma. 


Copper Salts 


Conium. 


Curare. 


Asafetida. 



The Cerebellum is affected by a few drugs, their action upon its 
several lobes producing various disturbances of equilibrium. 

Alcohol 'is the principal agent acting upon this portion of the brain, and different pro- 
ducts of the still seem to affect different portions of the cerebellum. For instance, intoxi- 
cation by wine or beer is said to cause lateral falling, that by whiskey an inclination to fall 
face downwards, cider a backward tendency (Brunton). Apomorphine in large doses 
produces a tendency to move in a circle, and therefore probably affects the cerebellum or 
the corpora quadrigemina. 



Agents Acting on the Organs of Special Sense. 

Mydriatics (nieudos, moisture), — are agents which produce dilatation 

of the pupil of the eye (mydriasis). Some act locally, others when given 

internally, and the principal ones (Atropine and its congeners) act both 

locally and internally, producing at the same time paralysis of the ciliary 



AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 29 

muscle resulting in temporary loss of accommodation, the eye remaining 
focussed for distant objects, and the intra-ocular tension being increased. 

The dilating action of Atropine and its congeners is due to stimulation of the end- 
organs of the sympathetic nerve, increasing the power of the radiating muscular fibres of 
the iris, and also to paralysis of the end-organs of the motor oculi (3d cranial] nerve, 
lessening the power of the circular fibres or sphincter iridis. When administered inter- 
nally the drug is carried by the circulation to the eye, acting thereon locally as if instilled 
directly upon the conjunctiva. The principal mydriatics are those named in the follow- 
ing list, viz. : 

Belladonna, Atropine. Belladonnine (internally only). 

Hyoscyamus, Hyoscyamine. Homatropine. 

Stramonium, Daturine. Gelsemine (locally only). 

Duboisia, Duboisine. Anaesthetics (at last). 

Cocaine. 
Atropine, Duboisine and Homatropine are the mydriatics used by ophthalmologists. 

Myotics (jneno, I close), — are agents which produce contraction of 
the pupil. The alkaloid of Physostigma, Eserine, is the chief local 
myotic, and the only one used in ophthalmic practice. It acts by stimu- 
lating the circular muscular fibres of the iris, at the same time contracting 
the ciliary muscle so that the eye is accommodated for near objects only, 
and diminishing intra-ocular tension ; in all of which it exactly antago- 
nizes the action of Atropine. 

Muscarine, Pilocarpine and A T icotine are also local myotics, acting upon the end- 
organs of the oculo-motor nerve. Anaesthetics in the early stage of their action cause 
contraction of the pupil by lessening reflex action ; later, when they begin to paralyze 
respiration the accumulation of venous blood irritates the centres and produces dilatation, 
which is a sign of failing respiratory power during anaesthesia. The myotic action of 
Opium is of central origin, probably the paralysis of the local reflex excitability. The 
chief myotics are as follows : — 

Physostigma, Eserine. Gelsemine (internally). 

Opium, Morphine. Lobeline (internally). 

Pilocarpus, Pilocarpine. Nicotine (locally). 

Muscarine. Anaesthetics (at .first). 

The Sensibility of the Eye is increased by Strychnine, the field of 
vision becoming extended, and the vision rendered more acute. If the 
drug be administered hypodermically the improvement will be more 
marked in the eye corresponding to the side of the body where the injec- 
tion was made. 

The sensibility for color is affected by drugs, Strychnine increasing the field for blue, 
Eserine diminishing it for red and green, and Santonin causing objects to appear at first 
of a violet and afterwards of a greenish-yellow color. 

Visions are produced by several drugs, their action being probably 
on the cerebral sight-centres (angular gyrus and occipital lobes) rather 
than on the eye. Alcoholic delirium is a familiar instance, while Canna- 
bis Indica often causes pleasant visions, and Sodium Salicylate in some 
persons produces very disagreeable ones. Digitalis may produce subjec- 
tive sensations of the continued presence of light. Bromides in excess 



30 AGENTS ACTING ON RESPIRATION. 

may produce visions of such intensity that their subject remembers them 
distinctly for years afterwards. 

Amblyopia, or impairment of vision from nerve-changes, is produced 
temporarily by Quinine, and may be permanently induced by Tobacco, 
Alcohol, Lead and Urea. 

The Ear is affected by several drugs. Strychnine and Morphine 
increase the excitability of either the auditory nerve or the centre for 
hearing (superior temporo-sphenoidal convolution), making that faculty 
much more acute. Quinine, Antipyrine and Salicylates produce hyperae- 
mia of the auditory apparatus, causing subjective noises, as humming, 
buzzing or ringing, which are very unpleasant. Hydrobromic Acid and 
the Bromides, also Ergot, will diminish the congestion and to a great 
extent will neutralize or prevent these noises. 

Quinine in large doses is believed by some to have produced permanent injury of the 
sight and the hearing, but authentic cases of such action are extremely rare, if indeed 
they can be found at all. Temporary deafness is often caused by Quinine, but it usually 
disappears soon after the administration of the drug is stopped. 

The Sense of Smell is also increased by Strychnine, and decreased 
by all cerebral depressants and by those agents which produce changes 
in the nasal mucous membrane, e. g. , Potassium Iodide. 

The cerebral centre for this faculty is situated at the tip of the temporo-sphenoidal 
lobe, and the terminal branches of the olfactory nerve are distributed upon the mucous 
lining of the upper portion of the nasal fossae. Strychnine probably stimulates the 
former, and all drugs acting upon the latter region would have more or less effect upon 
the power of distinguishing smells. 

The Taste is not much affected by drugs except as each makes its 
peculiar impression on the nerves of taste, and may overcome that of 
another agent. Smell has much to do with taste in many instances, the 
expedient of holding the nose while swallowing Castor Oil being familiar 
•to every one. 

The " after- taste " of drugs is often different to their original taste; thus Bitters are 
said to leave a sweet " after-taste, and the same is claimed for Quinine if given in acid 
solution so as to be entirely dissolved, and if washed out of the mouth with water 
immediately after swallowing. Substances which are excreted from the system in the 
saliva (as Iodides) leave a very persistent after-taste. 



Agents Acting on Respiration. 
The Respiratory Centre is situated in the medulla oblongata, close to 
the termination of the calamus scriptorius. It probably consists of tho- 
racic and diaphragmatic Inspiratory centres, the act of expiration being 
considered normally a passive one, due to the natural contraction of 
the walls of the air-vesicles, and the return of the diaphragm and thoracic 



AGENTS ACTING ON RESPIRATION. 3 I 

walls to the position from which they were moved by the inspiratory effort. 
An Expiratory Centre must also exist for the initiation of forced expiration, 
as in the production of voice, cough, sneezing, etc. The chief Inspira- 
tory Nerves are the pulmonary branches of the vagus. The Expiratory 
Nerves are the nasal branches of the fifth, the superior and inferior laryn- 
geal, and the cutaneous nerves of the chest and abdomen. 

Respiratory Stimulants exalt the function of the respiratory centre, 
quickening and deepening the breathing. Such agents, besides Opium 
in small doses, are — 

Chloralamid. Brucine. Digitalis. Quebracho. 

Strychnine. Thebaine. Zinc salts. Tobacco (briefly). 

Atropine. Apomorphine. Copper salts. Alcohol (briefly). 

Duboisine. Emetine. Ammonia. Ether (briefly). 

Strychnine also stimulates the vagus tract. Electricity applied to the nerve-trunks or 
to the inspiratory muscles, is a direct respiratory stimulant. Veratrine, Eserine, and Mus- 
carine stimulate the vagus terminations, quickening the respiration, but afterwards slow it 
by depressing the respiratory centre. Aconite stimulates the end-organs of the vagus 
when given in small doses. 

Respiratory Depressants lower the activity of the respiratory 
centre, rendering the respirations slow and shallow. The chief agents of 
this class are — 



Cold. 


Gelsemium. 


Alcohol. 


Caffeine. 


Opium, 


Aconite. 


Ei her. 


Colchicine. 


Physostigma. 


Veratrine. 


Chloroform. 


Nicotine. 


Muscarine. 


Prussic Acid. 


Chloral. 


Quinine. 


Lobeline. 


Conium. 


Saponine. 


Camphor. 


The ten last named first excite the centre for a brief period 


and then depress it 



Pulmonary Sedatives diminish cough and dyspnoea by lessening 
the irritability of the respiratory centre or the nerves of respiration. 
Some act by directly depressing the respiratory centre, as those enumera- 
ted under the preceding head ; others by removing some irritant from 
the passage, or by lessening local congestion, as the expectorant group ; 
and others by lowering the excitability of the vagus end-organs in the 
lungs, and other afferent filaments throughout the respiratory tract. 

Opium has the most powerful influence as a sedative to the respiratory centre, and muci- 
laginous or saccharine substances soothe the local irritation, hence the latter are so fre- 
quently used as vehicles for the former in cough mixtures. Hydrocyanic Acid has a 
similar sedative action, hence the use in coughs of Primus Virginiana and other substances 
containing it. Belladonna stimulates the respiratory centre, but at the same time lessens 
the excitability of the vagus terminations in the lungs, and completely arrests secretion 
from the bronchi. Stramonium acts similarly. The principal pulmonary sedatives may 
be enumerated as follows : — 

Opium. Prussic Acid. Turpentine. 

Belladonna. Amyl Nitrite. Ethyl Iodide. 

Stramonium. Quebracho. Conium. 

Hyoscyamus. Cannabis. Tobacco. 



32 AGENTS ACTING ON RESPIRATION. 

Errhines and Sternutatories (en, in, rhin, the nose; sternuto, I 
sneeze), — are agents which produce increased nasal secretion and sneezing, 
when locally applied to the mucous membrane of the nose. The first term 
is usually applied to substances which cause increase of the mucus without 
sneezing, the latter to those which invariably produce sneezing. The drugs 
should be in powder for application. The stimulus produced by these 
agents is transmitted by the nasal branches of the fifth nerve to the respi- 
ratory centre, exciting the sudden and forcible expiratory effort called 
sneezing ; also to the vaso-motor centre, contracting the smaller vessels 
throughout the body and producing a general rise in the blood-pressure. 
The principal agents of this class are — 

Tobacco, as snuff. Euphorbium. Capsicum. 

Ipecacuanha. Sassy Bark. Hellebore. 

Sanguinaria. Saponine. . Ammonia. 

Veratrum Album. Ginger. Cubebs. 

The last two named may be used as simple Errhines, as the vapor of dilute Ammonia- 
water or the smoke of burning Cubebs do not excite sneezing generally. 

Expectorants (ex, out of, pectus, the breast), — are remedies which 
modify the secretion of the broncho-pulmonary mucous membrane, and 
promote its expulsion. They may be divided into — 

Nauseating Expectorants, — in large doses act mechanically by expelling 
the mucus in the act of vomiting, in small doses by increasing osmosis 
from the inflamed mucous membrane. The members of this subdivision 
generally increase secretion and tend to lower the blood-pressure. The 
chief of them are the following named : — 

Antimony, Tartar Emetic. Apomorphine. 

Ipecacuanha, Emetine. Quebracho. 

Lobelia, Lobeline. Potassium Iodide. 

Pilocarpus (Jaborandi). Alkalies. 

Stimulant Expectorants, — are largely eliminated by the bronchial 
mucous membrane which they stimulate, altering the secretion and facili- 
tating expectoration. These remedies generally diminish secretion and 
increase blood-pressure. They are — 

Acids. Squill. 

Ammonium Chloride, and Carbonate. Garlic. 

Ammoniac. Onion. 

Benzoin and Benzoic Acid. Nux Vomica, Strychnine. 

Balsams of Peru and Tolu. Senega, Saponin. 

Wood Tar, and Tar. Sulphur. 

Oleum Pini Sylvestris. Liquorice. 

Turpentine. Saccharine Substances. 

Besides the above many other remedies may act as expectorants, some by relieving 
bronchial spasm, as Opium, Stramonium, and Tobacco, — others by soothing the irritable 
respiratory centre, as Opium and Chloral, — and the ciliary excitants by reflex action 
through their impression on the nerves of the mouth. 



AGENTS ACTING ON THE CIRCULATION. 33 

Ciliary Excitants, — promote the expectoration of bronchial mucus 
by their reflex excitation of the tracheal and bronchial cilia, when dis- 
solved in the mouth. Gum Acacia, Ammonium Chloride, Potassium 
Chlorate, and native Chloride of Sodium have this action. 



Agents Acting on the Circulation. 

Cardiac Stimulants rapidly increase the force and frequency of the 

pulse in depressed conditions of the cardiac apparatus. One of the most 

useful agents of this class is Alcohol in some form, its action being largely 

due to a reflex influence excited through the nerves of the mouth and 

stomach. It should therefore be given in but slightly diluted form, and 

in small quantities frequently. Ether is next in value and still more rapid 

in action, and Heat is one of the most powerful and available of the class. 

Ammonia has an energetic action as a stimulant to the vaso-motor centre, 

as well as a reflex one upon the heart similar to that of Alcohol. The list 

of cardiac stimulants includes the following, viz. : — 

Alcohol. Cocaine. Sparteine. 

Ammonia. Ether. Camphor. 

Atropine. Chloroform. Aromatic Oil. 

Nitroglycerin. Heat. Turpentine. 

Counter-irritation. Continuous Galvanic Current. Opium, and Morphine, in 

small doses. 

Cardiac Tonics, when given in moderate doses, stimulate the cardiac 
muscle, slowing and strengthening its contractions. In large doses they 
are apt to produce irregular action of the heart, and some of them have 
more or less of a tendency to cause sudden death by syncope if pushed to 
any great extent. The most important of these agents are — 

Digitalis. Squill. Strophanthus. 

Convallaria. Erythrophlceum. Strychnine. 

Cimicifuga. Caffeine. Helleborein. 

Adonis vernalis. 

Digitalis acts partly by stimulation of the vagus end-organs in the heart, thus increasing 
cardiac inhibition, and partly by direct stimulation of the cardiac centre in the medulla, as 
well as by a direct influence on the heart muscle itself. Convallaria, Erythrophlceum, 
Sqziill, and Cimicifuga act similarly but less powerfully, and are correspondingly safer. 
Strophanthus is still better, as it does not affect the vessels, and therefore does not raise 
the blood- pressure. 

Cardiac Sedatives lessen the force and the frequency of the heart's 
action and are used to control palpitation of that organ, and to slow the 
pulse in febrile conditions in sthenic subjects, especially when local inflam- 
mation is the exciting cause. The chief cardiac sedatives are — 

Aconite. Digitalis. 

Antimony. Senega, Saponin. 

Veratrum Viride. Prussic Acid. 

Muscarine. Potassium Salts. 

Pilocarpine. Cold. . 



> 



34 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

Aconite, Veratrum, Muscarine, Pilocarpine, Saponin and Prussic Acid are direct 
cardiac poisons, depressing the heart muscle and the cardiac motor ganglia ; Muscarine 
and Pilocarpine also stimulate the inhibitory ganglia; Digitalis stimulates the vagus 
centre and the cardiac muscle, and acts as a sedative in many cases by slowing the rate 
and giving it a regular rhythm. Aconite is said by some authorities to relax inhibition, 
by others to stimulate the vagus centre. Antimony depresses the motor ganglia. Potassium 
the cardiac muscle. 

Vascular Stimulants produce dilatation of the peripheral vessels, 
and increase the rapidity of the circulation, thus equalizing the blood- 
pressure and preventing internal congestions. The most useful are 
Alcohol 'and Ether, as they stimulate the action of the heart simultaneously 
with the vascular dilatation. The chief members of this group are : — 

Alcohol. Amyl Nitrite. 

Ether. Liq. Ammonii Acetatis. 

Nitrous Ether. Opium, as Dover's Powder. 

Nitroglycerin. Heat, as Poultices, etc. 

The dilating action of Amyl Nitrite and other Nitrites is due to weakening either of 
the muscular walls of the arterioles or to paralysis of the vaso-motor ganglia in them. 
Alcohol, Ether and Opium probably depress the vaso-motor centre. 

Vascular Tonics produce increased contraction of the arterioles and 
consequently increased blood-pressure. The most important are — 

Digitalis. Iron. Strychnine. 

Squill. Ergot. Lead and Silver. 

Opium, in small doses. 

These agents act upon the local vaso-motor mechanism in the walls of the vessels, which 
are also directly stimulated by cold produced in any way, as by Ether spray, or evaporat- 
ing lotions containing Alcohol, Vinegar or Ammonium Chloride. 

Vascular Sedatives increase the contraction of the vessels and lessen 
the circulation through them. They are employed to check hemorrhage 
and to cut short a local inflammation. The chief agents belonging to 
this group are — 

Cold. Hamamelis. Opium. 

Ergot. Digitalis. Acetate of Lead. 

Agents Acting on the Digestive System. 
Dentifrices (dens, a tooth, frico, I rub), — are medicated powders or 
pastes employed to cleanse the teeth and gums. Chalk is the basis gener- 
ally used, for its mechanical action and its alkaline quality. Antiseptics, 
as Borax, Quinine, Carbolic Acid, etc., should also be employed so as to 
prevent the acid fermentation of food products between the teeth and the 
consequent decay of the dentine. Tincture of Myrrh is an excellent 
ingredient, being an aromatic local stimulant and disinfectant. 

Many drugs affect the teeth injuriously, such being the Mineral Acids, Persalts of Iron 
and Alum. The first two should be taken through a glass tube, and the mouth should 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 35 

be afterwards rinsed with a weak alkaline wash. Opium, Chloral, Cocaine, Carbolic Acid, 
Creasote, Chlorate of Potassium and Aconite are the agents used as local anodynes in 
toothache from caries exposing a nerve filament. Chloral should never be used for this 
purpose, as in solution sufficiently strong to be of any service, it will cause sloughing of the 
gum, especially if injected thereinto with a hypodermic syringe, as is frequently done by 
ignorant dentists. 

Sialogogues {seealon, saliva, ago, I carry off), — are agents which in- 
crease the secretion and flow of saliva and buccal mucus, either by reflex 
action from the local irritation produced when anything is taken into the 
mouth, or by stimulating the glands during their elimination. The prin- 
cipal sialogogues are divided into two classes, the first (topical) acting by 
reflex stimulation, the second (general) acting through their systemic 
influence on the glands or their secretory nerves. They are as follows : — 

Topical Sialogogues. General Sialogogues. 

Acids and Alkalies. Pilocarpus (Jaborandi). 

Ether, Chloroform, etc. Muscarine. 

Mustard, Ginger. Physostigma. 

Pyrethrum, Mezereon. Mercurials. 

Tobacco, Cubebs. Iodine compounds. 

Capsicum, Rhubarb. Antimonials. 

Horse-radish. Tobacco, Ipecac. 

Antisialics (anti, against, seeaton, saliva), — are remedies which dimin- 
ish the secretions of the salivary glands. Atropine is the principal agent 
of this group, acting by paralyzing the terminations of the nerves of secre- 
tion. Physostigma counteracts this paralysis, but in large doses acts as 
an antisialic by lessening the blood supply to the glands. Opium dimin- 
ishes the reflex excitability of the reflex centre and also diminishes the 
secretion. Others acting locally are — 

Borax. Soda. Lithia. 

Potassium Chlorate. Lime. Magnesia. 

Insipid or nauseous articles of food or medicine. 

Refrigerants {refrigero, I cool), — are remedies which allay thirst and 
impart a sensation of coolness. They include the Vegetable Acids, the 
Mineral Acids (greatly diluted), Ice, Water, if cold, Effervescing drinks, 
Fruit juices, and many diaphoretics. 

Gastric Tonics or Stomachics, — are agents which increase the 
appetite and promote gastric digestion. They include a number of sub- 
stances, dietetic and medicinal, some acting by stimulation of the produc- 
tion of gastric juice, others by stimulating the local circulation, and several 
by exciting the activity of the nervo-muscular apparatus of the stomach. 

The first indication is met by the use of dilute alkaline solutions before meals, — the 
second by administering any of the pungent carminatives, as the Aromatic Oils, Pepper, 
Mustard, etc., or by Alcohol and Ether in small doses, or by the Aromatic Bitters, as Gen- 
tian, Orange, etc., or the simple bitters, as Calumba; — while the third desideratum is 



36 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

secured by the use of such agents as Nux Vomica, Hydrastis, Arsenic, the dilute Mineral 
Acids, and the Volatile Oils. Adjuvants to gastric digestion are the various digestion- 
ferments, Pepsin, Ingluvin and dilute HC1 Acid, which may be used to supplement the 
gastric juice when deficient in quantity or quality. 

Acids, — considered therapeutically and physiologically, are medicines 
which in concentrated form act usually as caustics, and when given in 
medicinal doses internally check the secretions of organs producing acid 
secretions with which they come in contact, and increase those of organs 
producing alkaline secretions. Thus a dilute acid given before meals will 
check the production of the acid gastric juice, but will stimulate that of 
the alkaline pancreatic juice. 

The chief members of this group are the following, which should be given in very 
dilute form : — 

Acidum Aceticum. Acidum Nitricum. 

Acidum Citricum. Acidum PhosphOricum. 

Acidum Benzoicum. Acidum Sulphuricum. 

Acidum Hydrochloricum. Acidum Nitro-hydrochloricum. 

Ant-acids or Alkalies, — from the same stand-point, are remedies 
which neutralize acids, check alkaline secretions and stimulate acid secre- 
tions, when in contact with the ducts of the organs producing them. Thus 
a dilute alkali given before meals will stimulate the production of the acid 
gastric juice and if applied to the mouth of the pancreatic duct will 
check the secretion of the alkaline pancreatic juice. The principal 
articles which belong to this group are the following, which should always 
be administered in dilute solution : — 

Liquor Potassae, Liquor Sodse. Potassium Acetate. 

Carbonates and Bicarbonates of Potassium, Potassium Citrate. 

Sodium, Lithium, Magnesium and Am- Potassium Tartrate. 

monium. Potassium Bitartrate. 

Calcined Magnesia (Magnesia). Sodium Acetate. 

Lime-water, Chalk. Sodium Citrate. 

Aromatic Spirit of Ammonia. Lithium Citrate. 

The substances in the first list are direct antacids, lessening the acidity in the stomach, 
and many of them also acting as remote antacids, lessening the acidity of the urine, as 
Potash and Soda, and their Carbonates and Bicarbonates. Ammonia and its Carbonates 
after absorption are eliminated as urea, and do not lessen the acidity of the urine. The 
salts in the second list are remote antacids, do not lessen acidity in the stomach, but do 
that of the urine, being oxidized in the blood and excreted as Carbonates. 

Emetics (eemeo, I vomit), — are agents which produce vomiting. 
They may be subdivided into two groups, (1) Local Emetics, or those 
which act by irritating the end-organs of the gastric, pharyngeal or oeso- 
phageal nerves, and (2) General or Systemic Emetics, which act through 
the medium of the circulation. Both these classes produce the emetic 
action by irritation of the vomiting centre in the medulla, the first by 
reflex, the second by direct stimulation. The principal emetics are the 
following named : — 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 2)7 

Local Emetics. General Emetics. 

Alum, Mustard, Salt. Ipecacuanha. 
Ammonium Carbonate. Emetine. 

Zinc and Copper Sulphates. Apomorphine. 

Subsulphate of Mercury. Tartar Emetic. 

Tepid Water, in quantity. Veratrine. 

Vegetable Bitters, as Quassia, Senega. 

in strong infusions. Squill. 

Tartar Evietic, Ipecacuanha and probably Apomorphine, act locally as well as systemi- 
cally, for if injected subcutaneously they are excreted by the stomach in part, thus irritat- 
ing the gastric nerves as well as the vomiting centre. Pilocarpus is a local emetic, and 
Digitalis and its congeners, also Muscarine, are systemic emetics, but none of these 
agents are used medicinally for that purpose. Opium, Morphine and Codeine usually 
produce emesis as one of their after effects. 

Anti-emetics, — are agents which diminish nausea and vomiting, some 
by a local sedative action upon the end-organs of the gastric nerves, 
others by reducing the irritability of the vomiting centre in the medulla. 
The most efficient of the local sedatives is Ice, swallowed in small pieces. 
'Astringents are very useful when there is congestion of the gastric mucous 
membrane, as in the vomiting of alcoholism and phthisis, where Silver 
Nitrate and Alum are respectively effective. The most important anti- 
emetics are the following, viz.: — 

Local Gastric Sedatives. General Sedatives. 

Alcohol. Creasote. Opium. 

Alum. Ether. Morphine. 

Arsenic. Ice. Prussic Acid. 

Belladonna. Opium. Bromides. 

Bismuth. Prussic Acid. Chloral. 

Carbonic Acid, Silver Nitrate. Nitro-glycerin. 

Cerium Oxalate. Calomel "I small Food. 

Chloroform. Ipecac, j doses. Alcohol. 

Carbolic Acid. Hot Water. ■ Amyl Nitrite. 

Potassium Nitrate. Cocaine. 

Vomiting being set up by irritation of many afferent nerves from various regions of the 
body, or by impulses from the brain excited through impressions on the nerves of special 
sense, the measures for combating it are very diversified. (Compare the title Vomiting 
in Part III.) 

Gastric Pain is best treated by such local sedatives as Bismuth, Hydrocyanic Acid, or 
small doses of Morphine, Arsenic and Belladonna. Cocaine is one of the most efficient 
agents of this class, in 5 to 6 minim doses of a 4 per cent, solution, every hour. As its 
general action is opposed to that of Opium, Bromides, etc., it must act locally, and 
therefore should be given by the mouth. 

Carminatives {Carmino y I soothe), — aid the expulsion of gas from 

the stomach and intestines, by increasing peristalsis, stimulating the 

circulation, and relaxing the cardiac and pyloric orifices of the stomach. 

They also act as diffusible stimulants, both of the bodily and mental 

faculties. The principal carminatives belong to the aromatic oils, 

alcohols or ethers, and are embraced in the following list ; — 

Oil of Eucalyptus. 
Oil of Fennel. 
Oil of Peppermint. 
Oil of Spearmint. 



Asafetida. 


Mustard. 


Capsicum. 


Pepper. 


Cardamom. 


Spirits. 


Chloroform. 


Oil of Anise 



38 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



Ether. 


Oil of Cajuput. 


Oil of Nutmeg. 


Fennel. 


Oil of Caraway. 


Oil of Pimento. 


Ginger. 


Oil of Cinnamon. 


Oil of Valerian 


Horse-radish. 


Oil of Cloves. 


Camphor. 


Mace. 


Oil of Coriander. 


Serpentaria. 



Cathartics or Purgatives {kathairo, purgo, I cleanse), — are agents 
which increase or hasten the intestinal evacuations. According to their 
respective degrees and direction of action they are subdivided into several 
groups, as follows : — 

Laxatives {Jaxo, I loose), or Aperients (aperio, I open), — include those 
which excite moderate peristalsis, and produce softened motions without 
irritation. Sulphur is the typical laxative. 

Simple Purgatives, — increase peristalsis actively, and stimulate the 
secretions of the intestinal glands, producing one or more copious and 
semifluid motions with some irritation and griping. Senna is the type of 
this group. 

Drastic Purgatives (drao, I act) r — act still more intensely, producing 
violent peristalsis and watery stools, with much griping pain, tenesmus, and 
borborygmi. They irritate the intestinal mucous membrane, cause exos- 
mosis of serum from its vessels, and in large dose set up inflammation and 
symptoms of irritant poisoning. Jalap is a typical drastic. 

Saline Purgatives, — consist of the neutral salts of metals of the alkalies 
or alkaline earths. They stimulate the glands, increase peristalsis, promote 
osmosis and cause free watery evacuations. Magnesium Sulphate is a 
typical saline. 

Hydragogue Purgatives (keudore,water, ago, I bring away), — include the 
most active of the drastic and saline groups, those which remove a large 
quantity of water from the vessels. Elaterium is a typical hydragogue. 

Cholagogue Purgatives {kohlay, bile, ago, I bring away), — are those 
agents which stimulate the flow of bile and produce free purgation at the 
same time, the stools being green-colored, or "bilious," and liquid. 
Podophyllin is the type of this group. 

The principal Cathartics are the following named: — 



Laxatives. 


Laxatives. 


Simple Purgatives. 


Sulphur. 


Hyoscyamus. 


Rhamnus Frangula. 


Magnesia. 


Soap. 


Ox-gall. 


Cassia. 


Almond Oil. 


Calomel. 


Manna. 


Taraxacum. 


Small doses of drastics, sa- 


Figs. 


Glycerin. 


lines or cholagogues. 


Prunes. 


Oatmeal. 




Tamarinds. 


Bran Biscuit. 


Saline Purgatives. , 


Honey. 


Brown Bread. 


Magnesium Sulphate. 


Olive Oil. 




Magnesium Citrate. 


Cascara Sagrada. 


Simple Purgatives. 


Potassium Sulphate. 


Physostigma. 


Senna. 


Potassium Tartrate. 


Ergot. 


Aloes. 


Potassium Bitartrate. 


Belladonna. 


Rhubarb. 


Sodium Sulphate. 


Stramonium. 


Castor Oil. 


Sodium Phosphate. 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



39 



Saline Purgatives. 


Drastics. 


Hydragogues. 


Sodium Chloride. 


Gamboge. 


Croton Oil. 


Pot. et Sodium Tartrate. 


Croton Oil. 


Salines in large doses 


Manganese Sulphate. 


Cathartic Acid, hypodermi- 






cally. 


Cholagogues. 


Drastics. 




Mercurials. 


Jalap. 


Hydragogues. 


Aloes. 


Colocynth. 


Elaterium. 


Rhubarb. 


Elaterium. 


Gamboge. 


Euonymin. 


Scammony. 


Potas, Bitartrate. 


Podophyllum 
Iridin. 



Intestinal Astringents, contract the walls of the intestinal vessels, 
diminishing the exudation therefrom, and lessening the fluidity of the 
faecal discharges. The more powerful members of this group have also a 
constringing action on the intestinal mucous membrane. The principal 
agents of this class are the following : — 

Conslringents. 
Tannic Acid. 
Vegetable Astringents. 



Astringents. 
Phosphoric Acid. 
Nitric Acid. 
Sulphuric Acid. 
Acetic Acid. 
Acetate of Lead. 
Nitrate of Silver. 



Diluted. 



Alum. 

Oxide of Zinc. 
Sulphate of Copper. 
Persalts of Iron. 



Hepatic Stimulants and Cholagogues (Jzohlay, bile, ago, I bring 
away), — are two groups of agents acting upon the biliary secretion, the 
first-named increasing the functional activity of the liver and the amount 
of bile formed, the second removing the bile from the duodenum and 
preventing its reabsorption into the portal circulation. Some hepatic 
stimulants are also cholagogues, others are not, while cholagogues proper 
generally act as hepatic stimulants by carrying off the bile and so indirectly 
urging the liver to secrete more. The discovery of the entero-hepatic 
circulation of bile has cleared up many of the discrepancies formerly 
existing with regard to the action of drugs upon this gland and its secre- 
tion. The following list includes the principal drugs belonging to both 
groups : — 

Hepatic Stimulants. 



Aloes. 

Podophyllin. 
Mercuric Chloride. 
Sodium Benzoate. 

Phosphate. 

Salicylate. 
Nitro-hydrochloric Acid. 
Euonymin. 
Iridin. 
Phytolaccin. 
Sanguinarin. 
Antimony. 
Arsenic. 
Ipecacuanha. 
Colchicine. 
Colocynth. 
Rhubarb. 



Potassium Sulphate. 
Sodium Sulphate. 

Bicarbonate. 
Ammonium Benzoate. 
Chloride. 
Nitric Acid (dilute). 
Benzoic Acid. 
Baptisin. 
Hydrastin. 
Tuglandin. 
Leptandrin. 
Jalapin. 
Scammony. 
Guaiac. 
Sarsaparilla. 
Phvsostigma. 
Rochelle Salt. 



Cholagogues. 
Aloes. 

Podophyllin. 
Mercurous Chloride. 
Pil. Hydrargyri. 
Mercury with Chalk. 
Sodium Phosphate. 

Sulphate. 
Potassium Sulphate. 
Colchicum. 
Colocynth. 
Rhubarb. 
Arsenic. 
Euonymin. 
Scammony. 
Baptisin. 
Jalapin. « 

Iridin. 



i 

40 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

Those in the first column are the most powerful of the stimulant group, the second 
column including the less efficient agents. To secure the best cholagogue effect it is 
advisable to combine an hepatic stimulant with an intestinal stimulant which shall pro- 
duce increased secretion from the intestinal mucous membrane and excite peristalsis. 

The Glycogenic Function of the liver, and the production of urea are 
stimulated by the following-named drugs : — 

Increasing Glycogen. Increasing Urea. 

Nitrite of Amyl. Arsenic. Iron. 

Sodium Bicarbonate. Antimony. Phosphorus. 

Nitro-hydrochloric Acid. Ammonium Chloride. 

Hepatic Depressants are agents which lower the functional activity 
of the liver, reducing the quantity of bile secreted, and lessening the 
production of glycogen and urea. They are as follows, viz. : — 

Lessening Bile. Diminishing Glycogen. Lessening Urea. 
Opium. Morphine. Opium. Opium. 

Many Purgatives. Morphine. Codeine. Morphine. 

Acetate of Lead. Phosphorus. Colchicum. 

Quinine (?) Arsenic. Alcohol. 

Alcohol (?) Antimony. Quinine. 

Many purgatives act as hepatic depressants and diminish the secretion of bile by lower- 
ing the blood pressure in the liver, and by carrying off the materials from which bile 
might be formed. 

Pancreatic Stimulation may be obtained by the administration of 
Ether, or by Galvanism of the gland itself. The secretion is depressed 
by Atropine and by inducing nausea and vomiting. 

Anthelmintics (anti, against, helmins, a worm), — are agents which 
destroy (vermicides) or cause the expulsion of intestinal worms (vermi- 
fuges). The chief vermifuges are Castor Oil, Jalap and Scammony, 
while the vermicides may be enumerated as follows, viz : — 

Thread Worms Round Worms Tape Worms 
(Oxyuris Vermicular is.) (Ascaris Lumbricoides.) {Tcenia, etc.) t 

Alum. Santonica. Filix Mas. 

Sulphate of Iron. Santonin. Kamala. 

Lime Water. Spigelia. Kousso. 

Quassia. Chenopodium. Granatum. 

Eucalyptol. Azedarach. Pelletierine. 

Sodium Chloride. Senna. ") with the Pepo. 

Tannin. Calomel, j above. Turpentine. 

Veg. Astringents. Chloroform. 

The substances enumerated in the first column are all used locally by enema. Adjuncts 
to these remedies are such agents as prevent the excessive secretion of intestinal mucus, 
which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, 
also Ammonium Chloride and Sodium Chloride. 



AGENTS ACTING ON METABOLISM. 41 



Agents Acting on Metabolism. 

Restoratives, — are agents which promote constructive metamorpho- 
sis, including the Foods, Haematics, and Tonics, as well as many agents 
called Stimulants in other classifications. 

Foods, — are substances which, when introduced into the body, supply 
material to renew some structure or to maintain some vital process; being 
distinguished from medicines in that the latter modify some vital action 
but supply no material to sustain such. 

The food of man is derived from all three of the kingdoms of nature, viz., the mineral, 
vegetable and animal, and includes many substances treated of in the Materia Medica, 
as Oils and Fats, Sugar, Starch, Gum, Alcohol, Beverages like Coffee and Tea, Water, 
Phosphate of Lime, Chloride of Sodium, etc. 

Hcematics {Jiaima, the blood), — are medicines which augment the quan- 
tity of hsematin in the blood, and thus restore the quality of that tissue 
by enriching its red corpuscles. They consist chiefly of Iron and Man- 
ganese and their compounds. 

Tonics (tonnos, tension), — are agents which improve the tone of the 
tissues on which they have specific action, restoring energy and strength 
to debilitated subjects, by a scarcely perceptible stimulation of all the 
vital functions, their effects being apparent in an increased vigor of the 
entire system. The chief tonics are enumerated in the foregoing lists 
under the heads of the organs, or tissues particularly affected by them. 
(Compare the titles Stimulants, Respiratory Stimulants, Cardiac 
Tonics, Vascular Tonics, Gastric Tonics, etc.) 

The most typical medicinal agents which impart a general sense of tone and strength 
are Strychnine, Quinine, Iron and Vegetable Bitters. Those especially acting upon the 
stomach, are Arsenic, Bismuth, Cinchona, Hydrastis and Nux Vomica, — on the spinal cord 
and general circulation. Strychnine, — on the heart, Digitalis, Squill, Convallaria and Ciini- 
cifuga, — on the nervous system, Phosphorus, Quinine and the Valerianates, — on muscular 
tissue, Tannin, — on the blood, Iron, Manganese, Cod-liver Oil, and other fats. 

Alteratives, — are certain remedies which alter the course of morbid 
conditions in some way not yet understood, perhaps by promoting meta- 
bolism. They certainly modify the nutritive processes and thereby cure 
many diseases of chronic type. Mercury and Iodine are the most promi- 
nent agents of this class, the former being endowed with the power of 
breaking up newly deposited fibrin, and disorganizing syphilitic deposits, 
while the latter acts energetically upon the lymphatic system and promotes 
absorption. Arsenic also is almost specific in many chronic skin affec- 
tions, and has remarkable power over chronic pulmonary consolidations, 
probably producing fatty degeneration and softening of the effusion, so 
that it may be absorbed or expectorated. The principal alteratives are : — 



42 ' AGENTS ACTING ON METABOLISM. 



Arsenic. 


Mercury. 


Iodine. 


Antimony. 


Colchicum. 


Iodides. 


Aurum. 


Guaiacum. 


Stillingia. 


Mezereum. 


Sanguinaria. 


Sarsaparilla. 


Sulphur. 


Xanthoxylum. 


Cod-liver Oil. 


Sulphides. 


Calcium Chloride. 


Phosphorus. 



Certain therapeutists of laboratory type have, of late years, seen fit to denounce the 
term Alterative as " a cloak for ignorance," but have never been able to present a better 
designation for a class of agents whose effects are among the most thoroughly established 
of clinical facts. 

A subdivision may be made of the Resolvents or Discutients (Resolvo, 
I unbind, Disculio, I dissipate), — agents which promote the absorption 
of inflammatory products or other materials of morbid origin, apparently 
by stimulation of the lymphatic system. They include Mercury, Arsenic, 
Iodine, and Cadmium, as well as such local measures as Poulticing and 
Counter-irritation. 

The Destructive Metamorphosis of the tissues is promoted by 
a number of agents, most of which are classed as Alteratives or as Astrin- 
gents, the most important of which are the following-named : — 

Alkalies. Sulphides and Iodides. 

Vegetable Acids. Sarsaparilla. 

Metals and their salts. Stillingia. 

Colchicum. Xanthoxylum. 

Tannic and Gallic Acids, and substances containing them. 

On the other hand, Metabolism may be diminished by many substances, 
the following-named being the chief ones : — 

Alcohol. Salicin. Resorcin. 

Glycerin. Salicylates. Chinoline. 

Oils and Fats. Quinine. Kairine. 

Antipyretics (anti, against, peuretos, fever), are agents or measures 
which reduce the body-temperature when abnormally high. This may.be 
done by two principal methods, and the agents doing either accomplish 
the result by different actions, as follows, viz. : — 

By Lessening the Production of Heat, by {£ ^^^^^t 

or by C 3. Dilating cutaneous vessels, and producing increased 

romo ing j > " j 4. Producing perspiration, and its evaporation. 

[ 5. Abstracting heat from the body. 

The following list contains nearly all the antipyretics, the number 
following each referring to its proper method of action, as enumerated 
above : — 

Quinine. 1 Chinoline. 1 Phenacetine. 1 - 4 

Quinidine. 1 Resorcin. 1 Aconite. 2 

Cinchonine. 1 Kairine. 1 - 4 Antimonials. 2 ' 4 

Cinchonidine. 1 Kairoline. 1 . 4 Veratrine. 2 

Berberine. x Antipyrine. 1 - 4 Colchicum. 2 



AGENTS ACTING UPON EXCRETION. 43 

Benzoic Acid. 1 Hydroquinone. 1 Leeching. 2 

Carbolic Acid. 1 Thallin. 1 ' 4 Cupping. 2 

Picric Acid. 1 Pyrocatechin. 1 Blistering. 2 

Salicin. 1 Pheno-resorcin. 1 Poulticing. 2 

Salicylic Acid. 1 Camphor. 1 Nitrous Ether. 3 > 4 

Sodium Salicylate. 1 , 4 Eucalyptol. 1 Dover's Powder. 4 

Quinine Salicylate. 1 Thymol. 1 Cold Bath. 5 

Methyl Salicylate. 1 Other Essential Oils. 1 Cold Drinks. 5 

(Oil of Gaultheria.) Alcohol. 1 * 3 Ice to Surface. 5 

Trimethylamine. 2 ,' Digitalis. 2 Cold Sponging. 5 

Acetanilide. 1 * 4 Salol. 1 Wet Packing. 5 

Purgation and Venesection produce antipyretic results, but their mode of action is 
doubtful (Brunton). 

Antiphlogistics (anti, against, pfleggo, I burn), — are measures and 
medicines which are supposed to have some specific power in reducing 
inflammation. The term is becoming obsolete, but frequent references 
are seen yet to the influence of Mercury and Opium in inflammations of 
serous membranes, Antimony and Aconite in inflammations of the 
respiratory tract and organs, and to the power of Veratrum Viride over 
puerperal metritis. The chief antiphlogistics are the following : — 

Aconite. Digitalis. Venesection. 

Veratrum Viride. Ergot. Local Depletion. 

Tartar Emetic. Ipecacuanha. Purgation. 

Mercury. Potassium Nitrate. Counter-irritation. 

Opium. Rest, recumbent position. Cold. 
Gelsemium. 

Antiperiodics are remedies which affect certain periodical febrile 
diseases, lessening the severity of their paroxysms or preventing their 
return. They act probably by arresting the development in the blood of 
successive crops of pathogenic organisms, upon which the disorders are 
supposed to depend. The principal antiperiodics are : — 

Cinchona Bark and its Alkaloids. Arsenic. 

Bebeeru Bark and its Alkaloid. Eucalyptol. 

Salicin, Salicylic Acid, Salicylates. Iodine. 

Agents Acting upon Excretion. 
Diuretics (deeouraysis, urination), — are remedies which increase the 
renal secretion. They may act in several ways, namely : — 

1. By raising the general blood-pressure by contraction of efferent vessels or vessels in 

other. regions of the body. 

2. By dilating the renal arteries and increasing the renal blood-supply, raising the pres- 

sure in the glomeruli. 

3. By stimulating the secreting nerves or cells of the kidney. 

4. By simply washing out the kidneys, as by IVate?- in quantity. 

The following list contains the most important agents of this class, 
which are usually subdivided into the two groups indicated by the sub- 
titles. The numbers refer to the modes of action of the drug in the 
above synopsis : — , 



44 



AGENTS ACTING UPON EXCRETION. 



Refrigerant Diuretics. 


Stimulant Diuretics. 


Potassium Acetate 3 


Alcohol. 2 


Gin. 2 


Potassium Bitartrate. 3 


Cantharides. 3 


Carrot. 3 


Potassium Citrate. 3 


Turpentine. 3 


Fennel. 3 


Potassium Chlorate. 3 


Juniper. 3 


Mustard. 3 


Potassium Nitrate. 3 


Savine. 3 


Asparagus. 3 


Sodium Acetate. 3 


Copaiba. 3 


Uva Ursi. 3 


Calomel. 1 


Cubebs. 3 


Buchu. 3 


Digitalis. 1 


Pepper. 3 


Sarsaparilla. 3 


Erythrophloeum. x 


Matico. 3 


Pareira. 3 


Caffeine. 3 


Kava. 3 


Chimaphila. 3 


Broom. 3 


Guaiac. 3 


Santonica. 3 


Squill. 1 , 2 


Parsley. 3 


Lobelia. 3 


Nitrites. 2 


Taraxacum. 3 


Aconite. 3 


Colchicum. 3 


Jaborandi. 3 


Tobacco. 1 , 3 


Strychnine. 1 


Dulcamara. 3 


Volatile Oils. 


Stigmata Maidis. 1 , 2 


Bryonia. 3 


Oleo-resins. 3 



Diuretics are employed for the following purposes, namely, (i) to 
remove the excess of fluid in dropsies, — (2) to hasten the elimination of 
waste products and other poisonous substances from the blood, — (3) to 
dilute the urine. In — 

Cardiac Dropsy, — or other dropsies due to venous congestion, the best diuretics are 
those which act on the general vascular system, as Digitalis, Squill, etc. Calomel is very 
efficient here. 

Dropsy from Renal Disease, — Broom, Nitrous Ether, Oil of Juniper, Digitalis and 
Squill are the most reliable diuretics in the order named. 

Hepatic Dropsy, — Copaiba is considered especially suitable. In this and the previous 
form a little Pil. Hydrargyri occasionally often aids the diuretic action of other agents. 

To Eliminate Solids, — Potassium Nitrate arid Bitartrate, Turpentine, Juniper, Caffeine, 
etc., are the most efficient. [Compare Antilithics.] 

To Dilute the Urine, — Water is the best diuretic, and the most efficient form is Dis- 
tilled Water acidified with Carbonic Acid Gas. 



Renal Depressants, — are such agents as directly diminish the 
activity of the renal cells, and lessen or suspend the secretion of urine. 
Morphine, Quinine and Ergot act in this way through the circulation, 
and Digitalis, instead of acting as a diuretic, may arrest the renal circu- 
lation by stimulating the vaso-motor centre and thus by contracting the 
vessels may stop the secretion altogether (Brunton). The same is true of 
Caffeine and Strychnine, hence it is well to combine these with other 
diuretics (Nitrous Ether, Alcohol), which dilate the renal arteries. 

Alkalinizers of the Urine, — are agents which produce an'alkaline 
reaction to the urine when taken internally. They include the alkalies, 
particularly Potassium and Lithium salts, but excepting Ammonia, which 
is broken up in the organism. Sodium salts, being partly excreted by 
the bile and the bronchial mucus, and partly locked up in the system as 
the neutral chloride, while the Urate of Sodium is insoluble, are not as 
efficient in this regard as are other alkalies. Fruits, milk and fish also 
act in the same manner by means of the salts which they convey into the 
economy. * 



AGENTS ACTING UPON EXCRETION. 45 

Acidifiers of the Urine, — are Benzoic and Salicylic Acids, and 
Vegetable Acids in excess, also excess of proteids, sugar and starch in 
the food, and certain wines and spirits. The Mineral Acids have little 
or no influence on the acidity of the Urine, being excreted as neutral 
sulphates, chlorides, phosphates, etc. 

Vesical Sedatives, — are substances which lessen irritability of the 
bladder, relieving pain and decreasing the desire to micturate. Opium, 
Belladonna, Hyoscyamus, Stigmata Maidis, Cannabis, etc., lessen the 
irritability of the nerves, Carbonate of lime that due to the presence of 
calculi, — and mucilaginous drinks, such as Barley-water or Linseed tea, 
also astringents like Buchu, Uva Ursi, Pareira, etc., diminish the irrita- 
tion due to chronic cystitis, and antiseptics, as Copaiba, and Cubebs, also 
act in like manner. 

Vesical Tonics, — increase the contractile power of the muscular 
fibres in the wall of the bladder. Cantharides, Potassium Bromide, 
Strychnine and Belladonna are the most prominent members of this class. 

Urinary Sedatives and Astringents, — act sedatively upon the 
whole extent of the urinary tract through the medium of the urine charged 
with them when administered internally. Some of the members of this 
class may be administered locally, but only to the urethral and vesical 
mucous membranes, which are accessible to direct local medication. 

Instances of the application of these agents are in the use of Potassium and Lithium 
Salts to diminish the acidity of the secretion, — Cubebs, Copaiba and Sandal-wood Oil as 
antiseptics and astringents, — and urethral injections of Alum, Acetates of Zinc and Lead, 
Boracic Acid, Chloral and Zinc Chlorides, etc., for a simple purpose. Copaiba is one of 
the most efficient agents for rendering the urine antiseptic, and should be more employed 
in cystitis and urethritis than it is. Oil of Eucalyptus is nearly as efficient, and Stigmata 
Maidis (Corn Silk), in tincFure,is beginning to be well thought of for a general alterative 
influence on the urinary tract. 

Antilithics or Lithontriptics {anti, against, leethos a stone, treebo, I 
wear down), — are agents supposed to prevent the formation of concretions 
in the excretory passages (antilithics) or to dissolve them when formed 
(lithontriptics.) The terms are generally restricted to remedies affecting 
the urinary calculi, but those directed against the biliary form are in- 
cluded in this arrangement for the sake of consistent classification. The 
chief agents coming under this title are — 

Biliary Caladi, Uric Acid or Urates. 

Ether and Turpentine. Distilled Water. 

(Durande's Solvent.) Alkalies, Potash or Lithia. 

Sodium Bicarbonate. Potassium Salts. 

Sodium Salicylate. Lithium Salts. 

Sodium Phosphate. Potassium Tartraborate. 

Castile Soap. Magnesium Citroborate. 
Alkaline Waters, especially Vichy. 



46 AGENTS ACTING UPON EXCRETION. 

Oxalate of Calcium. Phosphatic Calculi. 

Dilute Nitro-Hydrochloric Acid. Ammonium Benzoate. 

Carbonated Water. Benzoic Acid. 

Lactic Acid (for digestion). Dilute Nitric Acid. 

There is probably little or no solvent value to the agents recommended for biliary 
calculi. In the case of Uric Acid the administration of Potash or Lithia is based on 
their combining with the acid forming the calculus, and forming Urate of Potassium or 
Lithium, which salts are more soluble than the Uric Acid itself. 

Diluents (Diluo, I dilute), — are agents which, after their absorption 
dilute the excretory fluids and enable the latter to hold more solid ma- 
terial in suspension. Water is the one true diluent, whatever form it may 
be disguised in, as teas, weak fluid foods, acid drinks, etc. 

Diaphoretics and Sudorifics (deeaphorheeo, I carry through ; sudor, 
sweat, facio, I make), — are remedies which increase the action of the 
skin and promote the secretion of sweat. When they act energetically, 
so that the perspiration stands in beads upon the surface they are known 
as Sudorifics. They may be subdivided into the following groups, viz. — 

1. Simple Diaphoretics, which enter the circulation and are eliminated by the sudori- 
ferous glands, which they stimulate to increased action. 

2. Nauseating Diaphoretics, which produce relaxation and the dilatation of the super- 
ficial capillaries. 

3. Refrigerant Diaphoretics, which reduce the circulation, at the same time acting 
directly on the sweat centres in the spinal cord and medulla. 

The principal diaphoretics are enumerated as follows, the figures refer- 
ring to their respective supposed modes of action as indicated above, viz. : — 

Jaborandi. 1 . 3 Ether. 2 , 3 Lobelia. 2 , 3 

Pilocarpine. 1 , 3 Alcohol. 2 . 3 Sarsaparilla. 1 

Salicylic Acid. 1 Nitrous Ether. 2 , 3 Guaiacum. 1 

Salicylates. 1 Ammonium Acetate. 1 Serpentaria. 1 

Ipecacuanha. 2 Ammonium Citrate. 1 Sassafras. 1 

Tartar Emetic. 2 Dover's Powder. 2 Senega. 1 

Sulphur. 1 Aconite. 3 Vapor Bath. 2 

Opium. 2 - 3 (large doses) Veratrum Viride. 3 Turkish Bath. 2 

Camphor. 1 Potassium Salts. 3 Wet Pack. 2 

Tobacco. 2 , 3 Mezereon. 1 Warm Drinks. 2 
Cocaine. 3 

Anhidrotics {an, without, heedroce, sweat), — are agents which check 
perspiration. They may act — 

1. By depressing the action of the sweat-glands. 

2. By depressing the excitability of the sweat-centres. 

3. By reducing the circulation in the skin. 

The most important agents of this class are the following-named, the 

figures indicating their mode of action as above arranged, viz. : — 

Belladonna. 1 Acids, locally. 3 Chloralamid. 

Atropine. 1 Jaborandi. Quinine? 

Hyoscyamus. x Pilocarpine. Picrotoxin. 

Stramonium. 1 Nux Vomica. Dover's Powder. 

Muscarine. 2 Strychnine. Opium. 2 (small doses.) 

Agaricus Albus. 2 Ergot. 3 Zinc Salts. 3 

Salvia (Sage). Sulphuric Acid. Local Cold. 3 



AGENTS ACTING ON THE GENERATIVE APPARATUS. 47 

Strychnine, Atropine, Dover's Powder, Jaborandi, Picrotoxin and Zinc Salts are all 
respiratory stimulants, and very efficient against the sweating of phthisis, though most of 
them are classed as diaphoretics. This is explained on the theory of accumulation of 
Carbonic Acid in the blood by depressed respiration caused by severe coughing, this 
stimulating the sweat centres, and being opposed by agents which stimulate the respiratory 
centre. 

Agents Acting on the Generative Apparatus. 

Aphrodisiacs (Aphrohdeetay, Venus), — are medicines which stimulate 
the sexual appetite and power. They act by reflex or central action upon 
either the cerebral or the spinal genital centre. Tonics are indirectly 
aphrodisiac, as are all measures which promote the general bodily nutri- 
tion. The chief agents used as direct aphrodisiacs may be enumerated 
as follows, viz. : — 



Nux Vomica. 


Cimicifuga. 


Ergot. 


Strychnine. 
Cannabis. 


Serpentaria. 
Sanguinaria. 


Iron. 
Alcohol. 


Cantharis. 


Opium (at first). 


Bitter Tonics 


Phosphorus. 
Aurum. 


Camphor (at first). 
Damiana (?). 


Flagellation. 
Meat Diet. 



Strychnine acts by increasing general nutrition and exalting the reflex excitability of the 
genital centres. Hemp probably only causes a mild delirium which may or may not take 
a sexual direction. Cantharides acts by direct irritation of the mucous lining of the 
urethra, and is dangerous in aphrodisiac doses. Alcohol in small doses excites the genital 
centre in the brain ; so, also Opium and Camphor, the latter being decidedly anaphro- 
disiac after a time. The power of Damiana is doubtful. Urtication and Flagellation of 
the nates produce priapism by irritation of the genital centre in the cord through the 
sensory nerves of the part. Ergot is considered useful by contracting the dorsal vein of 
the penis, preventing its emptying too rapidly. 

Anaphrodisiacs {an, without, Aphrohdeetay, Venus), — are medicines 
and measures which lower the sexual function and diminish the sexual 
appetite. They act by lessening the excitability of the nerves of the 
genital organs, by depressing the genital centres in the brain and cord, 
or by decreasing the local circulation. The principal anaphrodisiacs are 
enumerated as follows, viz.: — 

Potassium Bromide. Tobacco. Nauseants. 

Ammonium Bromide. Digitalis. Purgation. 

Potassium Iodide. Conium. Venesection. 

Camphor (at last). Belladonna. Ice, locally. 

Opium (at last). Stramonium. Cold Baths. 

Lupulin. Gelsemium. Vegetable Diet. 
Cocaine. 

Emmenagogues (emmayneeah, the menses, ago, I move), — are reme- 
dies which restore the menstrual function, either directly by stimulation 
of the uterine muscular fibre, or indirectly by improving the blood and 
toning up the nervous system. The direct emmenagogues are ecbolic in 
large doses. The principal members of this class are enumerated in the 
following list, viz. : — 



48 AGENTS ACTING ON THE GENERATIVE APPARATUS. 

Direct Emmenagognes. Indirect Emmenagogues. 



Ergot. 


Rue. 


Iron. 


Quinine. 


Apiol. 


Manganese. 


Savine. 


Borax. 


Cinnamon. 


Digitalis. 


Myrrh. 


Strychnine. 


Cantharis. 


Guaiacum. 


Aloetic Purgatives. 


Pulsatilla. 


Polygonum Hydrop. 


Cod-liver Oil. 


Asafetida. 


Potass. Permang. 


Hot Hip-baths. 


Alcohol. 


Cimicifuga. 


Leeching the genitals. 


Indigo. 


Oxalic Acid. 


Rubefacients to thighs 


Hydr. Biniod. 


Hedeoma. 


Tonic Remedies. 


Caulophyllum. 


Origanum. 




Tansy. 


Viscum Flavescens. 





Oxytocics or Acholics (ockseus, quick, tokos, childbirth; ekbolay, 
abortion), — are agents which stimulate the muscular fibres of the gravid 
uterus to contraction, and may produce abortion. In small doses the same 
remedies are emmenagogue as a rule. Their mode of action has not been 
clearly made known, but it is generally believed to be due in some cases 
to direct stimulation of the uterine centre in the cord, in others to con- 
gestion of the uterus producing reflex stimulation. The principal oxytocics 
are those enumerated in the following list, viz. : — 

Ergot. Quinine. Oil of Rue. 

Ustilago. Borax. Pilocarpine. 

Savine. Cotton-root Bark. Viscum Flavescens. 

Any drastic purgative, or gastro-intestinal irritant, may produce abortion by reflex 
action. The Volatile Oils act in this manner, also Colocynth and many other agents used 
by women to produce abortion, as Tansy, Pennyroyal, etc., all of which are dangerous to 
life in doses sufficient to excite the action of the gravid uterus. 

Uterine Depressants lower the activity of the nervo-muscular appa- 
ratus which controls the uterine contractions. The most important of 
these agents are : — 

Opium. Chloral. Tobacco. 

Bromides. Chloroform. Sulphate of Copper. 

Cannabis. Tartar Emetic. Emetics. 

Viburnum Prunifolium. Piscidia Erythrina. 

Uterine Tonics and Alteratives, — are medicines which are con- 
sidered to have such specific influence over the uterus. Authorities differ 
very much regarding the value of these agents, but those enumerated in 
the following list are generally considered to have considerable value in 
uterine therapeutics, viz.: — 

Uterine Tonics. Uterine Alteratives. 

Potassium Bromide. Iodine. 

Potassium Chlorate. Iodoform. 

Pulsatilla. Iodized Phenol. 

Helonias Dioica. Glycerin. 

Cimicifuga. Hydrastis. 

Savine. Silver Nitrate. 

Astringents (locally). Galvanism. 

Those in the first list, except Astringents, are used internally; those in the second col- 
umn as topical applications to the uterine cavity or cervix. 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 



49 



Galactagogues (galla, milk, ago, I bring away), — are medicines 
which increase the lacteal secretion, as Ricinus, Tea, Anise, Fennel, 
Potassium Chlorate, etc. The value of many so-called galactagogues is 
extremely doubtful, the best being the local application of the leaves of 
the Castor-oil plant (Ricinus communis), and a good black Tea internally, 
with Milk, Beer or Porter as a beverage. Pilocarpus comes the nearest 
to being a true galactagogue, but its influence is very transient. (Com- 
pare Lactation in Part III.) 



Agents Acting on the Cutaneous Surface. 

Irritants are substances which, when applied to the skin, produce a 
greater or less degree of vascular excitement. When used to produce a 
reflex influence on a part remote from their site, they are termed Coun- 
ter-Irritants, and may be subdivided into the following groups, viz. : — 

Rubefacients (Pubefacio, I make red), — produce temporary redness and 
congestion of the skin, unless left too long in contact with the surface, 
when they may cause exudation between the cuticle and the true skin 
(vesicants), or may destroy the tissue and form a slough (escharotics). 
They may induce muscular atrophy. 

Vesicants, Epispastics or Blisters, — produce decided inflammation of 
the skin, and outpouring of serum between the epidermis and derma. 
Cantharides is the agent generally used for this purpose. 

Pustulants, — affect isolated parts of the skin, as the orifices of the 
sudoriferous glands, giving rise to pustules. 

The following list embraces the principal agents and measures belong- 
ing to these groups, viz. : — 



Rubefacients. 


Rubefacients. 


Vesicants. 


Mustard. 


Oil of Cajuput. 


Cantharides. 


Capsicum. 
Camphor. 


Oil of Turpentine. 
Volatile Oils. 


Euphorbium. 
Mezereon. 


Ammonia. 


Pitch. 


Iodine. 


Mezereon. 


P'riction. 


Rhus Toxicodendron. 


Arnica. 


Hot Water. 


Ammonia (the confined vapor) 


Alcohol. 




Glacial Acetic Acid. 


Ether.' 


Pustulants. 


Volatile Oil of Mustard. 


Chloroform. 

Iodine. 

Menthol. 


Croton Oil. 
Tartar Emetic. 
Ipecacuanha. 

Silver Nitrate. 


u j Boiling Water. 

\ Corrigan's Hammer. 



Escharotics or Caustics {eskahrah, a slough or scab ; kaioh, I 
burn), are agents which destroy a tissue to which they are applied, and 
produce a slough. They act usually in one of three modes, viz. : — 



1. By abstracting the water of the tissue. 

2. By combining with the albumen of the part. 

3. By corrosive oxidation. 

4 



5<D AGENTS ACTING ON THE CUTANEOUS SURFACE. 

The principal escharotics are enumerated in the following list, the 
numbers affixed to each pointing out its mode of action as stated above. 

Mineral Acids. 1 Caustic Potash. 1 Mercuric Chloride. 2 

Glacial Acetic Acid. 1 Caustic Soda. 1 Mercuric Oxide. 2 

Carbolic Acid. 1 Lime. 1 Mercuric Nitrate. 2 

Chromic Acid. 3 Dried Alum. 2 Zinc Sulphate. 2 

Arsenious Acid. 1 Silver Nitrate. 2 Zinc Chloride. 2 

Antimony Chloride. 1 Copper Sulphate. 2 Bromine. 3 

Astringents (ad, to, stringo, I bind), — are agents which produce 
contraction of muscular fibre and condensation of other tissues, the first 
probably by direct irritation, the second by precipitating its albumen 
and gelatin. They also lessen secretion from mucous membranes. The 
principal astringents may be enumerated as follows, viz. : — 



Acids. 


Tannic Acid. 


Bismuth Subnitrate, etc 


Alcohol. 


Gallic Acid. 


Cadmium Sulphate. 


Alum. 


Catechu. 


Copper Sulphate. 


Chalk. 


Galls. 


Ferric Chloride. 


Lime. 


Kino. 


Lead Acetate. 


Creasote. 


Oak-bark. 


Silver Nitrate. 


Carbolic Acid. 


Uva-Ursi. 


Zinc Sulphate. 



Sulphuric Acid, Gallic Acid and Acetate of Lead are examples of Remote Astringents, 
acting on internal organs through the blood. Those which affect the part to which they 
are applied are Local Astringents, and include most of those enumerated above. 

Styptics and Hemostatics {stenphoh, I contract ; haimah, blood ; 
stahsis, a standing), — are agents which arrest hemorrhage, Styptics being 
those which are applied locally, and Hemostatics those which are admin- 
istered internally. Some of the former act mechanically, by promoting 
the formation of a clot in the mouths of the bleeding vessels ; others 
cause the vessels themselves to contract, checking the flow of blood. The 
principal members of this class are the following-named : — 

Styptics. Hemostatics. 

Acids. Cold. Ergot. 

Alum. Matico. Digitalis. 

Cautery. Spider's-web. Gallic Acid. 

Collodion. Tannic Acid. Lead Acetate. 

Ferric Chloride. Lead Acetate. Dilute Sulphuric Acid. 

Ferric Sulphate. Zinc Sulphate. Ipecacuanha. 

Silver Nitrate. Vegetable Astringents. Hamamelis. 

Oil of Turpentine. 

Emollients (Emollio, I soften), — are substances which soften and relax 

the tissues to which they are applied. They relieve tension, dilate 

vessels, diminish pressure on the nerves, and protect inflamed surfaces 

from the air and from friction. The principal articles which may be 

classed under this heading are the following : — 

Hot Fomentations. Linseed Oil. Petroleum. 

Poultices. Olive Oil. Soap Liniment. 

Glycerin. Spermaceti. Starch. 

Lard. Almond Oil. Cacao Butter. 



AGENTS ACTING ON MICROBES, GASES, FERMENTS. 51 

Demulcents (JDemulceo, I soothe), — are substances generally of a 
mucilaginous nature, which soothe and protect the parts to which they 
are applied. This term is generally used for substances employed for 
mucous membranes, and the term Emollients for similar agents used on 
the skin. The chief agents belonging to this class are : — 



Acacia. 


Starch. 


Honey. 


Olive Oil. 


Cetraria. 


Glycerin. 


Marsh-mallow. 


Isinglass. 


Barley. 


Flaxseed. 


White of Egg. 


Tragacanth. 


Liquorice. 


Gelatin. 


Almond. 


Bland Oils. 



Protectives, — are agents of a mechanical nature employed to cover 
and protect an injured part from the air, water, etc. Collodion and 
Gutta-percha are those in general use, but certain plasters, as the Adhe- 
sive, the Lead or the Soap Plaster, may be employed for this purpose, 
also Cotton Wool. 

Agents Acting on Microbes, Gases, Ferments, etc. 

Antizymotics (anti, against, zeumohsis, fermentation), — are agents 
which arrest fermentative processes, which may depend upon the action 
of organic ferments (enzymes), as diastase, ptyalin, pepsin, etc., or upon 
that of organized ferments, as the yeast-plant, bacteria, etc. The Anti- 
zymotics may be subdivided into two groups, Antiseptics and Disinfectants. 

Antiseptics (anti, against, sayptekos, putrefaction), — prevent or retard 
septic decomposition, by destroying the bacilli which produce it, or by 
arresting their development. The chief antiseptics are : — 



Mercuric Chloride. 


Potassium- Chlorate. 


Quinine. 


Mercuric Iodide. 


Zinc Chloride. 


Salicin. 


Mercuric Oxide. 


Carbolic Acid. 


Thymol. 


Potassium Permanganate. 


Creasote. 


Borax. 


Sulphurous Acid. 


Alcohol. 


Chlorine. 


Sulphites and Hyposulphites. 


Eucalyptol. 


Hydronaphthol, 


Sulpho-carbolates. 




etc. 



Disinfectants destroy the specific germs of communicable diseases, 

many of which belong to the microbe class, hence many antiseptics are 

also disinfectants. They act in several modes, some as oxidizants, others 

by combining with albumen, others by chemical combination forming 

substitution-compounds, others by arresting molecular changes, and still 

others by altering the reaction of the media containing the germs. The 

principal disinfectants are : — 

Heat, 230°-25o° F. Zinc Chloride. Bromine. 

Sulphurous Acid Gas. Carbolic Acid. Lime. 

Nitrous Acid Gas. Potass. Bichromate. Osmic Acid. 

Chloride of Lime. Potass. Permanganate. Ferrous Sulphate. 

Mercuric Chloride. Iodine. Zinc Sulphate. 

Aluminium Chloride. Chlorine. 

Candy's Fluid is an aqueous solution of Potassium Permanganate, 2 parts in 100, or 
gr. 176 in ^ xx. Burnett's Fluid is a solution of Zinc Chloride, containing about 50 per 
cent, of the salt, and equivalent to the official Liquor Zinci Chloridi. Labarraque 1 s 
Solution is the official Liquor Sodas Chloratae. 



52 AGENTS ACTING UPON EACH OTHER. 

Deodorants, — are agents which destroy foul odors. The Volatile 

Deodorants are chiefly oxidizing and deoxidizing substances, acting 

chemically on the obnoxious gases ; while the Non-volatile ones are 

mainly absorbents, which condense and decompose the effluvia. The 

deodorants in general use are the following named : — 

Chlorine Gas. Peroxide of Hydrogen. Charcoal. 

Sulphurous Acid Gas. Potassium Permanganate. Earth, Lime. 

Nitrous Acid Gas. Ozone. Ferrous Sulphate. 

Parasiticides (ftarrahseetos, a parasite, ccedo, I kill), — are agents 

which destroy the animal and vegetable parasites found upon the human 

body. They are generally applied in the form of lotions, ointments or 

oleates, and include the following substances, viz.: — 

Sulphur. Mercury. Carbolic Acid. 

Sulphides. Ammonialed Mercury. Petroleum. 

Sulphurous Acid. Mercuric Chloride. Storax. 

Iodide of Sulphur. Mercuric Nitrate. Staphisagria. 

Iodine. Mercuric Oxide. Balsam of Peru. 

Agents Acting upon Each Other. 
Antidotes and Antagonists are terms frequently confounded with 
each other, and rarely defined with sufficient lucidity to enable a clear 
distinction to be drawn between them. An A?itidote is a substance which 
affects a poison either physically or chemically, or both, and in such a 
manner as to remove the poison from the body or to form with it an 
insoluble salt or an inert compound, with the object of preventing its 
toxic action upon the organism. 

Thus, Tannic Acid'is an antidote to Digitalis, as it forms therewith a compound (tan- 
nate), which is soluble with difficulty and therefore comparatively innocuous. But as 
this tannate is not wholly inert, another antidotal measure must be employed, viz.: — 
evacuation of the stomach, which may be accomplished by the administration of Zinc 
Sulphate or any other emetic, or by the use of a stomach pump. 

Antagonists, on the other hand, are agents which directly oppose each 
other in some or all of tteir physiological actions, and may be used 
against each other to counteract their effects on the system. Antidotal 
action takes place in the alimentary canal, and is applicable to vegetable 
as well as mineral poisons. Antagonism takes place in the blood and 
tissues, and so far as antagonistic drugs are concerned, is applicable 
almost wholly to vegetable poisons, as these produce their effects after 
absorption. The heart and respiratory apparatus are the principal object- 
ive points for the antagonism of drugs, but the spinal cord, the cerebrum, 
muscular tissue and the glandular system are also affected by most of 
them. 

Antagonistic Measures are such proceedings as may tend to antagonize 
certain effects of- poisons, and include Artificial Respiration, — Faradism 
of the respiratory muscles, — Constant motion, — Douching, — Rest, etc. 



AGENTS ACTING UPON EACH OTHER. 53 

Thus, to refer to the case of Digitalis again, Saponin and Senegin are its most complete 
physiological antagonists, their counteraction extending throughout the whole range of its 
effects. Aconite and Morphine antagonize its cardiac action, the former being considered 
the best antagonist to the effects of large doses, and the latter to those of its long-con- 
tinued use. Alcohol is also indicated in Digitalis-poisoning, and absolute Rest in the 
recumbent posture is an antagonistic measure of great importance, by reason of the lia- 
bility of the heart to cease its action on assuming the erect position, when much lowered 
by the drug. 

In the treatment of poisoning, whether from mineral or vegetable sub- 
stances, the first indication is to administer the appropriate chemical anti- 
dote, so as to render the poison harmless or comparatively so. Next, the 
stomach should be emptied and washed out, lest the newly-formed com- 
pound be absorbed after a time, and to remove any of the poison which 
may have escaped the action of the antidote. Next, the antagonist should 
be administered, in order to counteract the effects of such portion of the 
poison as may have been absorbed. Lastly, the appropriate antagonistic 
measures should be employed to sustain the action of any organic function 
which may show signs of failure. In most cases of alkaloidal poisoning 
absorption has proceeded so far before assistance is obtained that antidotes 
are of no value, and reliance can only be placed upon the physiological 
antagonist and such supporting measures as will tend to maintain vitality 
until the poison has been eliminated by the natural channels. 

In the following pages the antidotes and antagonists for each poisonous 
substance in the Materia Medica are enumerated under their proper titles, 
and in the Appendix the same agents are tabulated in a suitable form for 
reference. A few examples are appended below, to illustrate the princi- 
ples above stated, and to point out some of the most prominent instances 
of physiological antagonism at present known. 

Atropine, Belladonna, etc. 

Antidotes, — Tannic Acid, to form an insoluble tannate. Zinc Sulphate, as an emetic, 
or Apomorphine hypodermically, or the stomach-pump. Purgation. Antagonists, — 
Muscarine. Physostigmine. Pilocarpine Morphine. Quinine. Aconite. Antagonistic 
Measures, — Artificial respiration. Faradism of respiratory muscles. 

Strychnine, Nux Vomica and Ignatia. 

Antidotes, — Animal Charcoal suspended in water. Emesis, as above-mentioned. An- 
tagonists, — Chloral, or 'Chloroform, to muscular relaxation. Curare. Nitrite of Amyl. 
Bromide of Potassium. Antagonistic Measures, — Artificial respiration. Perfect quiet. 

Morphine and Opium. 

Antidotes, — Emesis or stomach-pump. Antagonists,— Atropine. Strychnine. Black 
Coffee. Caffeine. Ammonia, inhaled. Amyl Nitrite. Antagonistic Measures, — Cold 
douche. Artificial respiration. Continued movement. 

Potassiutn Cyanide. 

Antidotes, — Sulphate of Iron, to form Prussian Blue. Emesis. Antagonists, — Atro- 
pine. Ammonia. Alcohol. Antagonistic Measures, — Artificial respiration. Faradism. 

Arsenic and its Compounds. 

Antidotes, — Hydrated Oxide of Iron. Dialyzed Iron. Magnesia. Chalk. Lime-water. 
Emetics, or stomach-pump. Oil or Mucilage to protect the mucous membranes. Diluents. 
Iodide of Potassium, to promote elimination. Antagonists, — none. 



DOSAGE OF MEDICINES. 



> 



The Doses given throughout this book are for adults ; for children the 
following rule (Young's) will be found the most convenient. Add 12 to 
the age and divide by the age, to get the denominator of a fraction, the 
numerator of which is 1. Thus, for a child two years old, 2+ 2 12 = 7, 
and the dose is one-seventh of that for an adult. Of powerful narcotics 
scarcely more than one-half of this proportion should be used. Of mild 
cathartics, two or even three times the proportion may be employed. 

Children bear Opiates badly: — but on the other hand they stand comparatively large 
doses of several other drugs; such being Arsenic, Belladonna, Calomel, Ipecacuanha, 
Squills, Rhubarb, and several other purgatives. 

For Hypodermic Injection, the dose should be two-thirds or three-fourths of that 
used by the mouth; by rectum five-fourths of the same. Strychnine acts more actively 
when given per rectum than by the stomach. 

Conditions which modify the action of medicines, and therefore 
affect their dosage, are — age, body -weight, temperament and idiosyncrasy, 
drug-habits, intervals between doses, time of administration, condition of 
the stomach, temperature of the body, cumulative drug-action, mode and 
form of drug-administration, disease, climate, race, etc. 

The Dosage of Medicines is the weakest part of the therapeutic armament, the flaw in 
our weapons which may be the cause of their failure at any moment, perhaps the most 
critical one for a life. If the accumulated rubbish of ages, which has been called thera- 
peutical knowledge, is ever to be given scientific shape, ever placed in process of becoming 
a science, the question of dosage must form one of the principal corner-stones in the 
foundation. Drugs have widely differing actions on the human organism in health and 
in disease, according as they are administered in different doses, in different menstrua, and 
during different conditions of the subject's health. This difference, when between 
extremes of dosage, is often so wide as to separate actions directly contrary to each other, — 
that of the very large one opposing the action of the very small dose: — a truth hidden by 
one set of dogmatists under their former "doctrine," now "rule," of "similars," and 
avoided by the great mass of the medical profession, through dread of the bogy-name, 
"irregular." 

A thoroughly-prepared materia medica of half-a-dozen standard drugs, such as Aconite, 
Arsenic, Belladonna, Mercury, Opium and Quinine, — based upon their actions and uses 
in different doses and under different states of the organism, — would be of more real 
value to the physician, who wishes to do his work accurately and with his eyes open, than 
all the contents of the dispensatories, plus the entire literature of the " new remedies," 
and every symptom in the ten quarto volumes of the largely discredited and partly 
repudiated homoeopathic Materia Medica. 

If our medical students would each devote but one month, of his annual college 
vacation, to the personal investigation of some one feature of the action of some one 
drug, under such safe -guards against error as would secure the acceptance of the resulting 
observations, — what a mine of therapeutic gold would soon yield its solid truth to eager 
eyes! Formally laid down by Haller (see ante, page 18) in 1755, cultivated to some 
extent by Alexander in 1 768, Crumpe in 1793, Thommassini, Curtis, etc., — urged by 
John Hunter, Sir Thomas Watson, Dr. King Chambers, and many other luminaries of 
the medical profession, — the scientifically guarded proving of drugs on the human 
organism has lain, like the similar work of Jenner, neglected all these years, waiting for 
another Koch, to re-inaugurate the work. 

' 54 



PART I 



MATERIA MEDICA AND THERAPEUTICS. 



ABRUS, Jequirity (Unofficial), — is the seed of Abrus precatorius, or 
Wild Liquorice, a plant of the nat. ord. Leguminosae, indigenous in 
India, but growing wild in most tropical countries. The seeds are small, 
hard, of a bright scarlet color, with a black spot around the hilum, and 
contain an alkaloid, some fixed oil, sugar, a principle resembling Gly- 
cyrrhizin, and Abric Acid, C 12 H 24 N 3 ; but neither of these is believed 
to be the active principle. 

Preparation. 

Infusiim Abri, Infusion of Jequirity (Unofficial), — prepared by macerating three pow- 
dered seeds in ^ ss of cold water for twelve hours, adding ^ss.of boiling water, and 
filtering when cold. It should be used while fresh, as after two or three days it is 
worthless. 

Another formula contains gr. ix of Jequirity to the ^ , with gr. iv of Boric Acid to 
prevent decomposition. 



Physiological Action and Therapeutics. 

Jequirity seeds, when moistened with water, become highly poisonous. 
If applied to the conjunctiva, a severe inflammation is set up, with oedema 
and false membrane, ulceration of the cornea, and extension to the lids, 
face, neck and submaxillary glands. Inserted into a wound in cattle, 
they cause death in a few hours. The irritant action is believed to result 
from the presence in the seeds of some ferment, or perhaps great numbers 
of gonidia, which develop rapidly on a suitable tissue. The infusion, in 
a short time, swarms with bacteria. 

Jequirity is used for the purpose of producing a purulent or croupous 
conjunctivitis, by which to destroy old granulations (trachoma) and pan- 
nus. A mild infusion is applied to the eye two or three times a day for 
two days, and followed by weak solutions of Alum or Borax. This should 
be repeated after three weeks if necessary. An emulsion of the seeds in 
water is a useful application to unhealthy ulcers and lupus. 

55 



$6 ABSINTHIUM ACETANILIDE. 

ABSINTHIUM, Wormwood, — the leaves and tops of Artemisia 
Absinthium, a perennial garden herb of the nat. ord. Compositae, 
indigenous in Europe, but cultivated in the United States. The leaves 
are about 2 inches long, hoary, silky-pubescent, petiolate, pinnately two 
or three-cleft ; heads numerous, with small, pale-yellow florets, odor 
aromatic, taste persistently bitter. It contains a volatile oil and a bitter 
principle, Absinthin. Dose, gr. xx-xl, in infusion. There are no official 
preparations, except Vinum Aromaticum (see Alcohol), of which Absin- 
thium constitutes one per cent. 

Absinthe, the French liqueur, is an alcoholic solution of the oil, containing also extracts 
of Anise, Marjoram, and Angelica. Its continued use produces various nervous symp- 
toms, morning nausea and vomiting, also a tendency to epileptiform convulsions. 

The bitter constituent of Absinthium is stimulant to the digestive 
organs, but the oil is a narcotic poison, increases the cardiac action, and 
produces tremor, stupor, epileptiform convulsions, involuntary evacuations, 
and stertorous breathing. It is but little used in medicine, and only as a 
stomachic tonic in dyspepsia. 



ACACIA, Gum Arabic, — is a gummy exudation from Acacia Verek, 
a small tree of the nat. ord. Leguminosae, indigenous in Africa — also from 
other species of Acacia. It occurs in spheroidal tears of various sizes, 
breaking with a glassy, sometimes iridescent fracture; insoluble in alcohol, 
but soluble in water, forming a thick and mucilaginous liquid. It consists 
of Arabin or Arabic Acid, C 12 H 22 O n , combined with calcium, potassium, 
and magnesium. 

Preparations. 

Mucilago Acacice, — has of Acacia 34, Water to 100 parts. It should not be prescribed 
with tinctures or spirits except in very small quantity. Dose, indefinite. 

Syrupus Acacice, — has of the Mucilage 25, Syrup 75. Should be freshly made. Dose, 
indefinite. 

Acacia enters into the composition of Mistura Amygdalae, Mistura Glycyrrhizae Com- 
posita, Pulvis Cretae Compositus, Trochisci Cretae, Trochisci Cubebae, and Trochisci 
Glycyrrhizae et Opii. 

Gum Arabic has no activity except the negative one of a demulcent, 
and is chiefly used in coughs, sore throats, catarrhal inflammation of the 
stomach and intestines, and irritant poisoning. It is much employed in 
pharmacy to suspend insoluble powders in mixtures, for which purpose 
the mucilage is generally used. 



ACETANILIDUM, Acetanilide,— Antifebrin. Like the major 
number of the newest antipyretics, which are related either to Chinoline 
or to Phenol, Acetanilide is a derivative of Anilin, from which it is ob- 
tained by the action thereon of glacial acetic acid, substituting the organic 



ACETANILIDE. 57 

radical Acetyle for an atom of hydrogen. Chemically, it has the name 
Acetanilide or Phenyl-aceta??iide, and the formula C 6 H 3 .C 2 H 8 O.NH. 

The name Antifebrin is copyrighted by its original promoters for trade purposes, and 
therefore should be dropped from professional usage. 

It is a pure white and crystalline powder, of neutral reaction, odorless, 
but of slightly burning taste. It melts at 235 F., and distils at 55 7 F., 
— is soluble freely in alcohol, wine, etc., — but very sparingly (1 in 200) 
in cold water, and more readily in hot water. It is a neutral substance, 
being unaffected by hydrochloric or sulphuric acids, and ordinarily so 
by alkalies. 

The dose ranges from gr. ij to gr. x, repeated twice, and not exceeding gr. xlv in the 
24 hours. As much as gj has been swallowed without ill effects supervening. It may 
be administered in the very convenient form of compressed tablets; — also in powders, or 
in dilute alcoholic solution, ^j may be dissolved in Jivss of brandy, to which, if we 
add 3 vj each of simple syrup and water, we get a six-ounce mixture, of which a table- 
spoonful (^ss) contains 5 grains of Acetanilide, a fair adult dose. As an antipyretic, 
gr. iij may be administered every % to yi hour, until 12 or 15 grains have been given, 
which will usually be a sufficient quantity, especially if given at the acme of the febrile 
movement. 

Unofficial Derivatives and Allied Compounds. 

Antikamnia is a proprietary preparation widely advertised as an antipyretic and anal- 
gesic, of equal power in the latter respect with morphine. Analyses of several samples 
have been made by different chemists, all of which agree in finding the chief ingredients 
to be Acetanilide and Sodium Bicarbonate in varying proportions. By some observers 
Caffeine was detected, also Tartaric Acid, etc. The preparation is formulated by the 
earliest analysis as a mixture of Acetanilide 70, Sodium Bicarbonate 20, and Caffeine 10 
parts. Dose, gr. v-xv. 

Antinervine is a mixture of Acetanilide, 2 parts, with I each of Ammonium Bromide 
and Salicylic Acid (Ritsert). It is also called by the names Salbromalide and Salicylbro- 
manilide. 

Phenolid is a preparation consisting of a mixture of Acetanilide 58, and Sodium Sali- 
cylate 43. It competes with Antikamnia as a universal panacea against pain. 

Exodyne is a mixture of Acetanilide 90, Sodium Salicylate 5, and Sodium Bicarbonate 
5. The name (from 'ef, out of, odvvrj, pain) sufficiently states its claims to medicinal virtue. 

Exalgine, Methyl-acetanilide, — is a crystalline compound allied to Acetanilide, occur- 
ring in acicular needles, readily soluble in dilute alcohol, less so in warm water, and 
with difficulty in cold water. Dose, gr. j-v, in wine, or other dilute alcoholic mixture. 
Alcohol gss, and Water 5J form a permanent solution with gr. xvj. 

Exalgine resembles Acetanilide and Antipyrine in its antipyretic and analgesic powers. 
Compared with the latter it is less efficiently antipyretic, but more powerful as an anal- 
gesic and antiseptic. In overdose it is highly dangerous, having produced symptoms 
resembling those of angina pectoris, also toxic effects resembling those of carbolic acid, 
with delirium, dyspnoea, cyanosis and renal disturbances. It has been used with most 
excellent results in neuralgias; also in chorea. In the latter affection daily doses of 3 
grains were sufficient. Its name, derived from e£, out of, atyog, pain, denotes its princi- 
pal therapeutic action. 

Physiological Action. 
Acetanilide is a very efficient antipyretic, besides being strongly anal- 
gesic and antispasmodic, lessening the reflex action of the spinal cord, and 
inhibiting the sensibility of sensory nerves. It raises the arterial tension 
somewhat, and slows the heart in a corresponding degree. 



58 ACETANILIDE. 

Compared with the action of Antipyrine, the effect of Acetanilide on 
the body-temperature is manifested more slowly (i hour against ^ hour), 
— but lasts a longer time (6 against 2 hours). It is markedly diuretic, 
somewhat diaphoretic; is a cerebral, muscular and vaso-motor stimulant, 
and leaves no ill after-effects; — while Antipyrine is powerfully diaphoretic, 
a cerebral sedative, and produces great depression. Furthermore, Ace- 
tanilide produces the same degree of reduction of body-temperature as 
Antipyrine, with the ingestion of but i^th the dose; and, like the latter 
agent, it has little or no effect on the normal temperature, and its con- 
tinued use begets tolerance of its action. 

Its Antipyretic action corresponds, in degree and in duration, to the 
size of the dose, — the pulse is slowed, and quiet sleep often follows. There 
is neither vomiting nor diarrhoea afterwards, but there is a tendency, in 
some few cases, to collapse, with chills and cyanosis, especially the latter, 
during the period of depressed temperature. 

A toxic dose destroys the ozonizing function of the blood, decolorizing 
it, and forming methyl-haemoglobin. The heart, liver and kidneys are 
found in a state of acute fatty degeneration, in animals poisoned thereby. 
Its continued use in large doses is highly injurious to the blood, especially 
in diseases (as typhoid fever) which are themselves destructive to the 
blood-elements. 

Therapeutics. 

Besides being one of the most efficient antipyretics, this drug has 
marked analgesic and antispasmodic powers ; and these, together with its 
great advantages of a small dose, efficiency and safety, and the absence of 
the severe rigors and cardiac depression which mark the chinoline deriva- 
tives, — combine to make it one of a wider therapeutical range than most 
of its analogues. It is especially useful in phthisis and typhoid fever, for 
the hyperpyrexia, thereby relieving wakefulness, lessening delirium, and 
upholding a failing heart ; but if long used in large doses" in the latter 
disease it may increase the liability to serious sequelse, especially periostitis 
of the ribs, gangrene of tissues, etc. For the pains of locomotor ataxia, 
and in those of rheumatic origin, sciatica, lumbago, etc., it is a most 
efficient remedy. In acute rheumatism, it is highly praised ; and in acute 
bronchitis doses of four grains every two hours have often arrested the 
attacks within twenty-four hours. In epilepsy, it is being tried, with the 
view of moderating reflex excitability. Added in minute proportion to 
aqueous solutions for hypodermic use it is said to preserve them from 
decomposition more efficiently than any other agent hitherto employed 
for that purpose. 



ACIDUM ACETICUM ACIDUM BORICUM. 59 

ACIDUM ACETICUM, Acetic Acid,— is a liquid composed of 
36 per cent, of absolute Acetic Acid, HC 2 H 3 2 , and 64 per cent, of water. 
It is a clear, colorless liquid, of a distinctly vinegar odor, a purely acid 
taste, and a strongly acid reaction; sp.gr. 1.048 at 59 F.; miscible in 
all proportions with water and alcohol, and wholly volatilized by heat. 
It is prepared from wood by destructive distillation and purification. 
Acetic Acid is also official in two other degrees of concentration, viz.: — 

Acidum Aceticum Glaciale, Glacial Acetic Acid, HC 2 H 3 2 , — is nearly or quite abso- 
lute Acetic Acid, solid below 59 F., above that temperature a colorless liquid of sp. gr. 
1.056 to 1.058. Is strongly escharotic and only used locally. 

Acidum Aceticum Dilulum, Diluted Acetic Acid, — consists of Acetic Acid 17, Dis- 
tilled Water 83 parts, contains 6 per cent, of absolute Acetic Acid, and has a sp. gr. of 
1.0083. Dose, 3J-1J. 

Acetzim, Vinegar (Unofficial). — is an impure diluted Acetic Acid, produced by the 
acetous fermentation of any liquid susceptible of the vinous fermentation. 

Diluted Acetic Acid is used in the preparation of the four official Aceta (Vinegars). 

Physiological Action. 
Acetic Acid, like the other vegetable acids, in concentrated form is 
escharotic and produces gastro-enteritis if swallowed. In dilute form it 
acts as a refrigerant, diminishing thirst and allaying restlessness. It 
forms salts in the stomach, thus enters the blood, and is there oxidized, 
producing carbonic acid, and thereby increasing the acidity of the urine. 
It is also diuretic. Long used, it causes emaciation and poverty of the 
blood, producing a general scorbutic condition. It is hemostatic and 
anthelmintic, and the vapor inhaled causes reflex contraction of the vessels 
and raises the blood-pressure. 

Therapeutics. 
The glacial acid is used as a caustic in many skin affections, as warts, 
condylomata, etc., and to destroy the parasite in ringworm and pityriasis. 
It has been employed locally in carcinoma, with the view of dissolving 
the supposed cancer-cells. The dilute acid is used locally in superficial 
inflammations of the skin, and may be sponged over the body to check 
perspiration and reduce the surface temperature in fevers. It is often 
administered internally to reduce obesity, which it does by impairing 
digestion. Locally, it may be employed to arrest slight hemorrhages, 
as epistaxis ; and is occasionally used by enema for the destruction of 
ascarides. 

ACIDUM BORICUM, Boric or Boracic Acid, H 2 Bo 3 ,— is a 
weak acid occurring in transparent, colorless, six-sided plates, of unctuous 
touch, odorless, of a cooling and slightly bitter taste, soluble in 25 of 
water and in 15 of alcohol at 59 F., in 3 of boiling water and in 5 of 
boiling alcohol. It is produced from Borax by the action of Sulphuric 
Acid. Dose, gr. v-xx. There is only one official Borate, viz.: — 



> 



6<D ACIDUM BORICUM. 

Sodii Boras, Borate of Sodium, Borax, Na 2 B i 7 , ioH. 2 0, — colorless, 
transparent prisms, of cooling and sweetish, afterwards alkaline taste and 
alkaline reaction, soluble in 16 of water at 59 F., and in 0.5 of boiling 
water ; insoluble in alcohol. Occurs native in ancient lake beds in 
various parts of the world. Dose, gr. v-xl. 

Unofficial Preparations. 

Boro-glyceride, — is a solid chemical compound, prepared by heating together Boracic 
Acid and Glycerin. It is soluble in water, but is generally used in solution of equal parts 
of pure Glycerin and Boro-glyceride. It combines readily with Chrysarobin, Carbolic 
Acid, Atropine and Morphine, and is used as a local application in eye diseases and skin 
affections. 

Boracic Ointment, — has of Boracic Acid 1, White Wax 1, Paraffin 2, Almond Oil 2, 
thoroughly mixed together. 

Boracic Lotion, — is a saturated solution of the acid in water. 

Boracic Lint, — prepared by steeping lint in a boiling saturated solution and drying. 
It contains nearly one-half its weight of the acid. 

Magnesii Boro-cilras, Borocitrate of Magnesium, — prepared extemporaneously thus, — 
R. Magnesii Carbonatis ^j, Acidi Citrici gij, Sodii Biborat. gij, Aquae Bullientis % viij. 
A tablespoonful three or four times daily as a solvent of acid calculi. 

Potassii Tart ra- boras, Tartraborate of Potassium, — is a better solvent of uric acid 
calculi than the Magnesium salt, and is soluble in 2 parts of cold water. Prepared by 
heating together Boracic Acid I, Potassii Bitartras 4, Water 10 parts. Dose, gr. xx, 
largely diluted with water, three or four times a day. 

Physiological Action and Therapeutics. 

Boracic Acid is an efficient antiseptic, disinfectant and deodorant, 
arresting fermentation and putrefaction, and very destructive to low 
organisms. A solution of 1 in 133 arrests the activity of bacteria. It is 
feebly acid and but slightly irritant, and is used as a surgical dressing for 
its antiseptic and unirritating qualities. Its lotion and ointment have 
been successfully employed in ulcers, eczema, burns and scalds, pruritus 
ani, fetid perspiration, wounds, tinea tonsurans, and tinea circinata. 

The Borate of Sodium is antiseptic and disinfectant, as it also destroys 
low vegetable organisms. It removes the epidermis when locally applied, 
has power to increase uterine contraction, and aids the solution of Benzoic 
Acid. It is employed as a wash to remove the epidermis from the skin, 
and as a lotion in acne, freckles, chloasma, leucorrhcea, aphthae, etc., and 
to allay itching in urticaria, psoriasis, impetigo, and in pruritus pudendi, 
scroti et ani. It has been used internally in amenorrhcea, dysmenorrhcea, 
puerperal fever and puerperal convulsions, for its supposed specific action 
on the uterus. 

Boro-glyceride in solution (1 to 40) is also a powerful antiseptic, and 
is used as a lotion in purulent ophthalmia and in the treatment of wounds, 
also as a local application to diphtheritic membranes. It is an efficient 
preservative of milk and food against putrefactive changes, and is entirely 
harmless. 

An elegant cosmetic cream may be made by dissolving Boracic Acid in 
Glycerin, and then incorporating it with White Wax and Almond Oil. 



ACIDUM CAKBOLICUM. 6l 

ACIDUM CARBOLICUM, Carbolic Acid, Oxy-benzene, 
Phenic Acid, Phenylic Alcohol, Phenol, C 6 H 5 HO, — is an alcoholic 
product of the distillation of coal-tar between the temperature of 356 
and 374 F. It occurs in needle-shaped crystals of tarry odor and burn- 
ing taste, is liquefied by about 5 per cent, of water, soluble in 20 of water at 
59 F., and very soluble in alcohol, ether, chloroform, glycerin, oils, etc. 

Peculiarities about Carbolic Acid are that about 5 per cent, of water liquefies it, a further 
addition of water renders it turbid, until 2000 parts of water to 100 of the acid have been 
added, when a stable and clear solution is formed. One volume of liquefied Carbolic 
Acid containing 5 per cent, of water forms with one volume of Glycerin a clear mixture 
which is not rendered turbid by the addition of three volumes of water (absence of Crea- 
sote and Cresylic Acid). It does not redden blue litmus paper, but combines freely with 
alkalies and other salifiable bases, the products having an alkaline reaction and being' 
decomposed by the feeblest acids (carbonic, etc.) Dose, gr. %-')■ 

Acidum Carbolicum Crudum, Impure Carbolic Acid, — is obtained as 
above stated, but at a lower heat (338 to 374 ), and contains Carbolic, 
Xylic and Cresylic Acids in varying proportions, together with other 
impurities. It is used as a disinfectant. 

Preparations. 

Unguentum Acidi Carbolici,— strength 10 per cent., Ointment 90. 
Glyceritum Acidi Carbolici (Unofficial), — Carbolic Acid I, Glycerin 4. 
Aqtia Acidi Carbolici (Unofficial), — has of the Glycerite 3 x to Aqure Oj. Dose gj— 5j ss. 
Carbolic Acid Gauze (Unofficial), — medicated with Ac. Carbol. 1, Resin 5, Paraffin 7. 
Carbolic Acid Plaster (Unofficial), — has of Carbolic Acid 25, Shellac 75, coated with 
Gutta-Percha dissolved in Carbon Disulphide. 

Carbolic Acid Solutions, for antiseptic surgery, are : — 
5 per cent, in Water, as a spray or wash. 
2J4. per cent, in Water, for sponges, hands, or as a lotion. 
5 per cent, or less in Olive Oil, as a special dressing. 
Phenol Sodique is composed of Carbolic Acid gr. 188, Caustic Soda gr. 31, Distilled 
Water ^iv. 

Official Derivative Salts. 

Sodii Sulpho-Carbolas, Sulpho-Carbolate of Sodium, NaC 6 H 5 S0 4 .2H 2 0, — prepared 
by dissolving Carbolic Acid I, in strong Sulphuric Acid I, thus forming a Sulpho-carbolic 
Acid, which is then neutralized with Carbonate of Sodium. Transparent, rhombic prisms, 
soluble in 5 of water at 59 F., less freely in alcohol and glycerin. Dose, gr. x-xxx. 

Analogues. 

Creasotum, Creasote, — is a similar product, obtained from wood-tar, but by the action 
of Nitric Acid it is converted into Oxalic Acid chiefly, while by the same reagent Car- 
bolic is converted into Picric Acid. Creasote does not coagulate albumen (?) or collodion, 
Carbolic Acid does. Creasote is described under its own title. 

Resorcin (Unofficial), C 6 H 6 2 , — is also a phenol, obtained from certain resins by the 
action of fusing alkalies. [Described under its own title.] 

Physiological Action. 
Carbolic Acid is a powerful antiseptic and antiferment, being destruc- 
tive to all low forms of life. It is a local anaesthetic and a superficial 
escharotic, coagulating albumen and also the blood when out of the body. 
Taken internally undiluted it produces violent gastritis, ttt, vj of the pure 
acid having caused dangerous symptoms. It stimulates the cardiac inhibi- 



62 ACIDUM CARBOLICUM ACIDUM CHROM1CUM. 

tion, first slowing, then depressing, and finally paralyzing the heart. Respi- 
ration, at first increased, is soon depressed, the pupils are contracted, and 
both brain and spinal cord are directly affected ; stupor, coma, suspended 
reflexes, impaired motility and sensibility being produced. It is rapidly 
absorbed and diffused, many fatal cases having occurred from its external 
use. It is partly oxidized in the blood, and partly eliminated by the 
lungs and kidneys, imparting to the urine a peculiar olive-green or smoky 
color. 

Locally applied Carbolic Acid produces on the skin or mucous membrane 
a white superficial eschar which succeeds to burning pain of short duration. 

Antidotes and Antagonists. 

Liquor Calcis Saccharatus, or the official Syrupus Calcis, given freely ; or Sulphate of 
Sodium or Magnesium to form a Sulpho-carbolate, or the chemical antidotes. Vegetable 
demulcents (but no oils or glycerin) to protect the mucous surfaces. Atropine is a very 
complete physiological antagonist to the systemic symptoms, maintaining the heart and 
respiration until elimination occurs. Of Magnesium Sulphate nearly 3 ozs. were used in 
a case where l / z oz. of 95 per cent, acid had been taken, resulting in full recovery from 
an apparently hopeless condition. Cider Vinegar may prove to be an antidote, as it 
removes the effects of the local application of the strong acid. Soap, in strong watery 
mixture (suds), is said to be almost a perfect antidote. 

Therapeutics. 
Carbolic Acid owes its prominence to its having been the principal 
agent used in the antiseptic method of treating wounds ; but lately its 
employment in that connection has become much restricted, and many 
of the most prominent surgeons have abandoned it altogether in favor of 
other germicides. For nausea and vomiting it is an excellent remedy in 
i^-grain doses, and in many chronic pulmonary affections it is used with 
benefit by spray. It may be employed locally in acute and chronic 
catarrhs, parasitic skin diseases, uterine and other ulcers, abscesses, boils, 
and carbuncles, endo-metritis, and perhaps in pulmonary phthisis. It has 
proven of temporary benefit in diabetes of hepatic origin. It has been 
injected parenchymatously (2 per cent, solution) in erysipelas, pleuro- 
pneumonia, intermittents, synovitis, lupus, chancroid, hydrocele, etc. 

The Sulpho-carbolates of Sodium, Potassium, Calcium, and Magnesium have been 
employed advantageously in the septic diseases (as the exanthemata, diphtheria, puerperal 
fever), the object being to obtain the antiseptic and antipyretic actions of Carbolic Acid 
without its dangers. They may be used locally with good results in aphthae, tonsillitis, 
otorrhcea, gonorrhoea, and inflamed mucous membranes generally. 



ACIDUM CHROMICUM, Chromic Acid, Cr0 3 — is obtained 
by the action of Sulphuric Acid upon Potassium Chromate, and occurs in 
small crimson needle-shaped crystals, deliquescent and very soluble in 
water. Brought in contact with alcohol mutual decomposition takes place. 
A similar result and perhaps sudden combustion results when it is placed 



ACIDUM CHROMICUM. 63 

in contact with other easily oxidizable substances, such as Glycerin, Spirit 
of Nitrous Ether, etc. It is not used internally. 

Pofassii Bickro?nas, Bichromate of Potassium, K 2 Cr 2 7 , — large, orange-red prisms of 
disagreeable, metallic taste and acid reaction, soluble in 10 of water at 59° F., and in \]/ z 
of boiling water, insoluble in alcohol. Used locally in aqueous solution (gr. v-^j to the 
^), and internally in doses of gr. T T Q-ij in trituration. 



Physiological Action and Therapeutics. 

Chromic Acid is a powerful escharotic, penetrating deeply, but slow 
of action and not very painful. It coagulates albumen and parts readily 
with its oxygen, oxidizing organic matter and decomposing ammonia and 
sulphuretted hydrogen. It is therefore an energetic disinfectant and 
deodorizer. When used as a caustic it is mixed with sufficient water to 
make a paste, which may be employed for the destruction of warts, hem- 
orrhoids and other superficial growths, the neighboring parts being pro- 
tected by cotton soaked in a strong alkaline solution. For syphilitic warts 
and condylomata, lupus, tinea tonsurans, etc., a solution of 100 grains to 
the § of distilled water is generally used. A solution of 1 in 40 is an 
excellent and inexpensive antiseptic lotion for putrid sores and wounds, 
syphilitic affections of the tongue, mouth and throat, ozaena, leucorrhcea, 
and gonorrhoea. In uterine catarrh and hemorrhages a solution of 120 
grains to the g has been injected into the uterine cavity with good results. 

Bichromate of Potassium is a good antiseptic and an escharotic of 
milder action than the acid. In doses of ^ij-iv it has proved fatal to life 
in adults, with symptoms of gastro-enteritis, suppression of urine, and 
cardiac paralysis. It is chiefly employed as a local application in satu- 
rated solution to warts and venereal condylomata ; and in dilute solution 
(gr j-x to the ]§) for catarrhal conditions of the nasal, buccal or vaginal 
mucous membrane. Internally it has been employed with benefit in loco- 
motor ataxia and in dyspepsia simulating gastric cancer; also in chronic 
gastric catarrh, the tongue having a thick yellow coat, in chronic diarrhoea 
from intestinal ulceration, and in chronic ulcers of the pharynx and mouth. 
It is a good remedy in syphilitic sore throat, local rheumatism of the 
fibrous tissues, periosteal and syphilitic rheumatism, and acute catarrh and 
influenza, chronic nasal catarrh, chronic laryngitis, and chronic catarrhal 
affections of the bronchial mucous membrane, especially when the expecto- 
ration is tough and stringy. It has also been used with some success in 
membranous croup and diphtheria. In pharmacy it is employed in the 
preparation of Chromic Acid and Valerianic Acid, and as a test solution. 
Most of the medical galvanic and faradic batteries are run by a mixture 
of this salt with Sulphuric Acid. Poisoning by it should be treated as 
directed for that by mineral acids. 



64 ACIDUM FLUORICUM ACIDUM GALLICUM. 

ACIDUM FLUORICUM, Fluoric Acid, HF (Unofficial),— is a 
strong escharotic, acting deeply and leaving a dry and painful slough. 
The dilute acid (1 in 200) is prepared by acting on fluorspar by Sulphuric 
Acid, the resulting gas being dissolved in water. Its dose is n^xx-xxx, 
well diluted. 

Dilute Fluoric Acid has been successfully used as an internal remedy in 
goitre, and the gas has been inhaled with benefit in diphtheria and mem- 
branous croup. 



ACIDUM GALLICUM, Gallic Acid, HC 7 H 5 5 .H 2 0— is a 

nearly colorless solid in long needles or triclinic prisms, having a slightly 
acid and astringent taste, soluble in 100 of water and in 4^ of alcohol 
at 59 F. , and in 3 of boiling water. It is prepared from a paste of pow- 
dered galls (see Galla), by fermenting for six weeks, boiling and reboil- 
ing in water, filtering and crystallizing. According to some authorities 
the Tannic Acid of the galls is split up into Gallic Acid and glucose by fer- 
mentation ; but according to others the glucose is an impurity and the 
Tannic Acid is simply converted into two parts of Gallic Acid, C 14 H 10 O 9 
-f- H 2 = (HQH 5 5 ) 2 . Dose, gr. v-xv, in solution, pill or powder. 

Acidum Pyrogallicum, Pyrogallic Acid, Pyrogallol, Tri-hydroxy- 
benzene, C 6 H 3 (HO) 3 (Unofficial), — is obtained from Gallic or Tannic 
Acid by careful heating. Dose gr. j-ij. 

Preparations. 

Unguentum Acidi Gallici, — is a 10 per cent, ointment, with a basis of Benzoinated 
Lard. 

Vegetable Astringents depend for their medicinal value upon the Gallic and Tannic 
Acids contained in them. Such are — 

Alnus, Alder Bark. Heuchera, Alum Root. 

Castanea, Chestnut Leaves. Kino, Kino. 

Catechu, Catechu. Krameria, Rhatany. 

Diospyros, Persimmon. Myrica, Wax Myrtle. 

Galla, Nut Galls. Nymphaea, Pond Lily. 

Geranium, Cranesbill. Quercus Alba, Oak Bark. 

Granatum, Pomegranate. Rosa Gallica, Red Rose. 

Hamamelis, Witch Hazel. Rubus, Blackberry. 

Haematoxylon, Logwood. Statice, Marsh Rosemary. 

Physiological Action. 
Gallic Acid, and its congener Tannic Acid, are astringents, the former 
being the more feeble of the two. They differ in that Tannic Acid coagu- 
lates albumen and gelatin, while Gallic does not. Tannic Acid is con- 
verted by the organism into Gallic and Pyrogallic Acids, in which forms 
it is absorbed and excreted. According to some authorities the difference 
between Gallic and Tannic Acids is one of oxidation, according to others 
of hydration \ the latter assuming Tannic Acid to be simply Gallic Acid 



ACIDUM HYDROBROMICUM DILUTUM. 65 

Anhydride. They constringe the muscular tissue in the walls of the 
minute vessels, thus checking secretion and hemorrhages and cutting 
short local inflammations. Except in enormous doses they are harmless. 
[Compare Acidum Tannicum.] 

Pyrogallic Acid may act as an intense poison, having been absorbed 
from the surface with fatal results, preceded by vomiting and diarrhoea, 
rigors, and fever, black urine full of globulin, and disorganization of the 
blood-corpuscles. It has great affinity for oxygen and may be used as an 
antiseptic and disinfectant in 1 to 2*^ per cent, solutions. 

Antagonists and Incompatibles. 

Mineral acids, alkalies, per-salts of iron, and salts of antimony, lead, and silver are 
chemically incompatible. 

Therapeutics. 

Gallic Acid is preferred to Tannic Acid when an astringent action is 
desired upon remote parts, as the lungs, kidneys, etc., which can only be 
reached through the circulation. In hematuria, distant passive hemor- 
rhages, albuminuria, diabetes insipidus, bronchorrhcea, night-sweats, 
chronic diarrhoea, and chronic cystitis, it is a most useful remedy. 

Pyrogallic Acid has been used internally in two-grain doses for inter- 
nal hemorrhages. As an ointment (j5J-^j) it is next to Chrysarobin as 
an efficient palliative in psoriasis, and has been used with good results in 
lupus and epithelioma, being supposed to attack the diseased nodules 
only, leaving the adjacent skin uninjured. 



ACIDUM HYDROBROMICUM DILUTUM, Diluted Hy- 
drobromic Acid, — is composed of 10 per cent, of absolute Hydro- 
bromic Acid (HBr), and 90 per cent, of water. It is a clear, colorless, 
and odorless liquid, of a pungent acid taste, produced by decomposing 
Potassium Bromide by Sulphuric Acid and distilling. Dose, ttLxx-^ij, 
every three hours. 

Hydrobromic Acid has identical action on the nervous system and cir- 
culation with that of the Bromides. Added to a mixture of Quinine and 
water (niij to each grain of Quinine) it will produce a clear solution. 

In hysteria, congestive headaches, neuralgia, and nervous exhaustion, 
Hydrobromic Acid has been found useful. Used as a solvent of Quinine 
it retards cinchonism, and prevents the headache resulting from the full 
action of Quinine and Iron. As a substitute for the Bromides of Sodium 
and Potassium it is highly recommended, being much less depressant. 
It has been especially recommended in tinnitus aurium. Fothergill uses 
it for coughs of reflex or spasmodic nature, also for simple continued fever 
where there is cerebral disturbance. 
5 



66 ACIDUM HYDROCHLORICUM. 

ACIDUM HYDROCHLORICUM, Hydrochloric Acid, 
Muriatic Acid, — is a liquid composed of about 32 per cent, of absolute 
Hydrochloric Acid Gas, HC1, and 68 per cent, of water. It is colorless 
and fuming, of specific gravity 1.160, pungent odor, intensely acid 
reaction and taste, and is obtained by the action of Sulphuric Acid upon 
Sodium Chloride, the resulting gas being carried through water which 
dissolves it. It is sometimes used as a caustic. Its union with basic 
substances forms salts, called Hydrochlorates (Muriates), of which four 
are official, viz. : the Hydrochlorates of Apomorphine, Morphine, Pilo- 
carpine, and Quinine, described under the titles of their respective bases. 

Preparations. 

Acidum Hydrochloricum Dilutum, — is a 10 per cent, solution of the absolute acid m 
water. Dose, mjij-x. 

Acidum Niiro-hydrochloricum, — see under Acidum Nitricum. 

Physiological Action of the Mineral Acids. 

The mineral acids (Hydrochloric, Sulphuric, Nitric, Nitro-hydrochloric, 
and Phosphoric) resemble each other in general action so closely that they 
may all be described in this place. 

The strong acids are escharotic, abstracting the water of the tissues, 
combining with the albumen and other bases, and destroying the proto- 
plasm. They are very diffusible, redissolving the albumen after precipi- 
tating it (except Nitric Acid). Sulphuric and Phosphoric have a strong 
affinity for water, completely decomposing tissues to which they are 
applied, and are therefore the most powerfully escharotic. Nitric Acid 
does not readily redissolve the albumen precipitated by it, which thus 
forms a barrier against the deep action of the acid. Sulphuric Acid 
chars or carbonizes the tissues black, while Nitric and Hydrochloric tan 
them yellow. 
I The dilute acids produce a peculiar taste in the mouth and a sensation 

of roughness on the teeth. They stimulate the flow of saliva from the 
parotid and submaxillary glands, but have no action on the sympathetic 
saliva. They promote the alkaline intestinal secretions and excite the 
flow from ducts having an alkaline secretion (bile, etc.), but check that 
from those whose secretion is acid (gastric, etc.). Secretion generally is 
promoted by Nitric Acid, and lessened by Sulphuric, Hydrochloric 
acting between the other two. Given before meals, in small doses, they 
relieve acidity of the stomach by checking the production of the acid 
gastric juice. At first they aid digestion, being synergistic to the action 
of pepsin, but if continued they impair digestion by lessening the pro- 
duction of the gastric juice. They check fermentation and constipate the 
bowels, except Nitric Acid, which relaxes them. They render the urine 
slightly more acid than its normal reaction, but do not acidify alkaline 



ACIDUM HYDROCYANICUM DILUTUM. 6j 

urine as the vegetable acids do. They are all astringent to the tissues, 
Hydrochloric being weakest and Sulphuric the strongest in this respect. 

Antagonists and Incompatibles. 

Alkalies to neutralize the acid; oil, albumen, or milk, to protect the mucous mem- 
brane ; stimulants, Opium, Ammonia (intravenously) to combat the resulting depression 
of the vital powers. 

Therapeutics of the Mineral Acids. 

All the members of this group are useful in fevers, if well diluted, 
Hydrochloric being usually preferred, especially in typhoid. In atonic 
dyspepsia, acidity of the stomach, and locally in ulcerations of the throat, 
Hydrochloric Acid is best used. Nitric is the acid generally preferred as 
a caustic, its action being effectual and superficial. As such it is applied 
undiluted to phagedenic ulcers and sloughs, warty growths, and to the 
cavity of the womb in chronic inflammation thereof. Dilute Nitric Acid 
is used internally in oxaluria and lithemia, intermittent and remittent 
fevers, and aphonia of singers. Dilute Nitro-hydrochloric is more suitable 
in chronic hepatic disorders due to malaria ; Sulphuric in hemorrhages, 
diarrhoeas, colliquative sweating, and as a prophylactic against lead- 
poisoning. Dilute Sulphuric Acid is used as an acid drink in fevers, and 
before meals in acidity of the stomach. It is very doubtful whether the 
latter has any special influence on the nervous or osseous systems. 

All these acids act injuriously on the teeth, by attacking the enamel. 
They should always be administered largely diluted, taken through a straw 
or glass tube, and the mouth should at once be thoroughly rinsed with an 
alkaline solution. 



ACIDUM HYDROCYANICUM DILUTUM, Diluted Hy- 
drocyanic Acid, Prussic Acid, — is a liquid composed of 2 per cent, 
of absolute Hydrocyanic Acid, H-CN, and 98 per cent, of alcohol and 
water. It is colorless, faintly acid, of peculiar odor, and is prepared 
by distilling solutions of Potassium Ferrocyanide and Sulphuric Acid 
together, or extemporaneously by adding 6 parts of Cyanide of Silver to 
a solution of 5 parts of Hydrochloric Acid in 55 of distilled water, shak- 
ing together and pouring off the supernatant liquid, rr^xl have proved 
fatal. Dose, wtj-v. 

Preparations containing Hydrocyanic Acid. 

Aqua Laurocerasi, Cherry-laurel Water (Unofficial), — is a water distilled from the 
fresh leaves of Prunus laurocerasus, the common Laurel or Cherry Laurel, a small tree 
of the nat. ord. Rosaceae, sub-order Amygdaleae. The leaves contain a variable amount 
of Hydrocyanic Acid and a volatile oil. Dose, TTL v-xxx, cautiously. 

Scheele's Dilute Hydrocyanic Acid (Unofficial), — is a 4 or 5 per cent, solution, and is 
highly dangerous even by inhalation. 



68 ACIDUM HYDROCYANICUM DILUTUM. 

Amygdala Amara, Bitter Almond (see its title) and its essential oil; also, various 
other members of the sub-order Amygdalese, including the official Prunus Virginians, 
perhaps the unofficial Prunus laurocerasus, and the leaves and kernels of the peach and 
cherry trees, contain a proximate principle Amygdalin, and a ferment Emulsin, which in 
. the presence of water react with each other, forming Hydrocyanic Acid, a volatile oil, 
and glucose. C M H w NO u (Amygdalin) -j- 2H 2 = C 7 H 6 (Oil of Bitter Almond) -f 
HCN (Hydrocyanic Acid) -j- 2C 6 H 12 6 (Glucose). 

Other Cyanogen Compounds. 

Potassii Cyanidum, Cyanide of Potassium, KCN, — a white, opaque salt, of alkaline 
reaction, bitter-almond taste and a peculiar odor when moist; soluble in 2 of water at 
59 F., sparingly soluble in alcohol. Dose, gr. fo-$. Locally a solution of gr. j-v to 
the I. 

Potassii Ferro cyanidum, Ferrocyanide of Potassium, K 4 Fe(CN 6 ) 6 3H 2 0, — large, 
lemon-yellow prisms or tablets, efflorescent, odorless, of sweetish taste and neutral reac- 
tion, soluble in 4 of water, insoluble in alcohol. Employed in pharmacy as a test solu- 
tion, and in the preparation of Ferrocyanide of Iron, Diluted Hydrocyanic Acid and the 
Cyanides of Potassium and Silver. Rarely used medicinally. Dose, gr. v-xv. 

Physiological Action. 
Prussic Acid is one of the most powerful and rapid poisons known, 
half a grain having proved fatal. Its action on the organism is one 
peculiar to itself, the inhalation of a strong preparation producing rapid 
insensibility and almost immediate exhaustion ; — death from a full dose 
occurring by sudden paralysis of the heart, from a less but still a fatal 
dose, by paralysis of respiration. The symptoms are those of sudden 
and complete asphyxia, and some volitional movements may be made 
before death, unless the dose be very large. In cases in which the dose, 
though fatal, permitted of the observance of its effects, they were usually 
divisible into two marked stages, viz.: (1) Dyspncea, slow and full pulse, 
giddiness, loss of muscular power. (2) Vomiting, dilated pupiis, uncon- 
sciousness, spasms, muscular rigidity, and cessation of the heart's action. 
In poisonous, but not fatal doses, the following effects have been observed : 
feeble pulse, dilated pupils, turgid and dusky face, insensibility, convul- 
! sions or rigidity, but no paralysis. Large medicinal doses may produce 

salivation, irritation of the throat, dizziness, buzzing in the ears, head- 
ache, numbness, dusky countenance, staggering gait, sense of constriction 
of the chest, palpitation of the heart, a frequent or an abnormally slow 
pulse, a sense of great weariness and drowsiness. Post-mortem examina- 
tion shows usually dilated pupils, the eyes having a marked glassy lustre, 
the cadaveric rigidity very great. The blood, in cases which have been 
rapidly fatal, may show the arterial color in both the arterial and the 
venous systems ; but in slower cases it is dark and fluid, engorging both 
sides of the heart, the venous trunks, and the cerebral sinuses. The par- 
alyzant action of the drug is chiefly exercised on the nerve-centres in the 
medulla; next on the peripheral afferent nerves, the spinal cord, the 
motor nerves, and finally on the muscular tissue. It stops the heart by 
irritation of the vagus-roots in the medulla, as well as by paralyzing the 



ACIDUM HYDROCYANICUM DILUTUM. 69 

cardiac motor ganglia. It is said to form with haemoglobin a compound 
(cyan-haemoglobin), which does not readily give up oxygen. The odor 
of the acid is fragrant, resembling that of bitter almonds or peaches, and 
may be detected in the lungs shortly after death. /The effects of a medi- 
cinal dose pass off in an hour at farthest. 

Locally applied to the skin, Hydrocyanic Acid penetrates the epider- 
mis and paralyzes the end-organs of the sensory nerves in the derma. It 
is rapidly absorbed from mucous surfaces. 

Cyanide of Potassium has similar action, but ih addition has some 
few peculiar to itself. Locally used it produces dermatitis, with an ecze- 
matous eruption, and if applied to an abraded surface freely may cause 
fatal effects. Internally it has proved fatal in doses of 3 to 5 grains, with 
all the symptoms of Prussic Acid poisoning, but its action is less rapid. 
It is much used in photography, and many cases of poisoning by it have 
occurred in persons employed in that art. 

Antagonists and Antidotes. 

Atropine has antagonistic action, but is too slowly diffused to be of any value. Ammonia 
by inhalation, by the stomach, and by intra- venous injection, with cold affusion to the 
spine, and artificial respiration, are the measures most likely to avail in cases of poisoning 
where there is time to do anything. In poisoning by Potassium Cyanide give the Sulphate 
of Iron, producing Ferrocyanide of Iron (Prussian Blue). Then evacuation of the 
stomach, artifical respiration, and Ammonia by intra-venous injection. 

Therapeutics. 

Hydrocyanic Acid is used for its antispasmodic and sedative effects. 
In vomiting, whooping-cough, and coughs of spasmodic character, in 
asthma and other neuroses of the respiratory organs, in affections involving 
the pneumogastric nerve, vertigo and headache from stomachal derange- 
ments, gastralgia, painful dyspepsia, vomiting, etc., it is very efficient as 
a palliative. In acute mania and melancholia it has been used with 
advantage; and in various skin diseases, accompanied by itching, tingling, 
etc., its use as a lotion (ttlxxx-^j ad 3J Aquae Rosas) to the unbroken 
surface is prompt in relieving the pruritus and other distressing sensations. 

Cyanide of Potassium in ointment (gr. v ad §j) is used to allay 
pruritus, and in solution (gr. iij-v ad §j) is applied locally with benefit 
in reflex headaches, and is used as a wash to remove nitrate of silver stains. 
It has been used internally in doses of gr. j for acute articular rheumatism, 
but such employment of it is highly dangerous. 

Ferrocyanide of Potassium has been used in doses of 8 to 15 grains 
as an astringent and anodyne, but it is seldom employed in medicine. 

Cherry-laurel Water has been extensively used as a flavoring agent, 
having a very agreeable taste. It is official in the British Pharmacopoeia, 
and is supposed to be a rather elegant mode of administering Prussic Acid ; 
but the uncertainty of its strength is such that it should never be used 



JO ACIDUM LACTICUM ACIDUM NITRICUM. 

internally, except in very small quantities. It has been employed as an 
anaesthetic injection into the urethra prior to catheterization, and was 
formerly employed by ophthalmologists a*s an eye-wash in painful affec- 
tions of that organ. 

ACIDUM LACTICUM, Lactic Acid,— is a liquid composed of 
75 per cent, of absolute Lactic Acid (HC 3 H 5 3 ) and 25 per cent, of 
water ; nearly colorless, syrupy, odorless, of acid taste and reaction, freely 
miscible with water, alcohol and ether, but nearly insoluble in chloroform. 
It is produced by the fermentation of sugar of milk, has a sp. gr. of 1.212, 
and is difficult to obtain pure. It enters into Syrupus Calcii Lactophos- 
phatis. Dose, ^ss-gss, well diluted. 

Physiological Action and Therapeutics. 

Lactic Acid is found in the stomach as a product of the food, and com- 
bines with bases in the blood, forming lactates, which, being oxidized, 
are converted into carbonates. It aids digestion and promotes the appe- 
tite, but, in large doses, causes flatulence and much epigastric pain. 
Injected into the peritoneal cavity of animals, it excites endocarditis, and 
given in diabetes, it has produced acute rheumatism and rheumatic endo- 
carditis. Hence its supposed causation of acute rheumatism when in 
excess and free in the blood. It dissolves false membranes and the 
phosphate of calcium. 

It is used with benefit in diabetes, atonic dyspepsia, oxaluria, and in 
the lithic and phosphatic diatheses when due to imperfect digestion and 
assimilation. As a solvent of false membrane in croup and diphtheria it 
is unquestionably of great service. In chronic cystitis it arrests the 
ammoniacal decomposition of the urine. As the acid found in the shops 
is generally of poor quality, disappointment in its use may be expected. 

ACIDUM NITRICUM, Nitric Acid,— is a liquid composed of 
69.4 per cent, of absolute Nitric Acid, HN0 3 , and 30.6 per cent, of water. 
It is colorless, fuming, very caustic and corrosive, of sp. gr. 1.420, strongly 
acid in reaction, and is obtained by the action of Sulphuric Acid on Nitrate 
of Potassium. Is only used externally as a caustic. 

Preparations. 

Acidum Nitricum Dilutum, Diluted Nitric Acid, — has of the above 1 part in 6 of 
Distilled Water, and contains 10 per cent, of absolute Nitric Acid. Dose nL iij-xv, well 
diluted. 

Acidum Nitrohydrochloricum, Nitrohydrochloric Acid, Nitromuriatic Acid, Aqua 
Regia, — a golden-yellow, fuming, corrosive liquid, composed of Nitric Acid 4 parts, 
Hydrochloric Acid 15 parts. Is wholly volatilized by heat, readily dissolves gold-leaf, 
and a drop added to test-solution of Potassium Iodide liberates Iodine in abundance. 
Dose, n\j-viij, well diluted. 



ACIDUM OLEICUM. 7 I 

Acidum Nitrohydrochloricum Dilutum, Diluted Nitrohydrochloric Acid, — consists of 
Nitric Acid 4, Hydrochloric Acid 15, Water 76 parts. Dose, rt\ v-xx, well diluted. 

Physiological Action and Therapeutics. 

The action and uses of these agents are herein described with those of 
the other mineral acids, under the title Acidum Hydrochloricum (see 
ante, page 66). Some special properties are as follows : — 

Nitric Acid is an exceedingly powerful escharotic, but, as it coagulates 
and does not redissolve the albumen of the tissues, it forms a barrier to 
its own excessive action. The vapor may cause oedema of the glottis, 
intense bronchitis, etc., and death from suffocation. It is used for the 
destruction of chancres, warts, hemorrhoids, phagedenic ulcers, etc. ; and 
internally in dilute form for bilious affections, as it is supposed to have a 
selective action on the liver. It also lessens phosphatic deposits in the 
urine, and acts as an astringent in the system, diminishing profuse secre- 
tion in bronchorrhcea and phthisis. 

Nitrohydrochloric Acid is also supposed to specially affect the liver. 
It is usefully employed in jaundice, dyspepsia, and the so-called bilious 
condition ; also in frontal headache, situated just above the eyebrows, 
when unaccompanied by constipation, and in acidity of the stomach. 
In hepatic disorders it may be used in dilute form as baths, or applied to 
the hepatic region on compresses. The official dilute acid is of little use 
therapeutically, as it rapidly deteriorates, and the same may be said of the 
strong acid when standing long enough for the color to change to a lemon- 
yellow. The most efficient preparation is the strong acid freshly prepared 
when it is of an orange-red color. This should be properly diluted when 
required for use, and should be constantly protected from light. 



ACIDUM OLEICUM, Oleic Acid, HC 18 H M 0.., is one of the 

constituent acids of oils and fats, obtained commercially as a secondary 
product in the manufacture of stearin candles. It is a yellowish oily liquid, 
semi-solid at 57 F., odorless, tasteless, and of neutral reaction, insoluble 
in water but soluble in alcohol, chloroform, benzol, benzin, turpentine, 
and the fixed oils. It dissolves most of the metallic oxides and the un- 
combined alkaloids, forming the so-called Oleates, which, however, are 
not pure chemical compounds, but merely compounds of the oxides or 
alkaloids, as the case may be, with oleic acid, dissolved in great excess 
of the latter. Two of these are official, viz. — 

Preparations. 

Oleatum Hydrargyria Oleate of Mercury — has 10 per cent, of the Yellow Oxide of 
Mercury, with 90 of Oleic Acid. 

Oleatuiti Veratrina:, Oleate of Veratrine — has 2 per cent, of Veratrine in 90 of Oleic 
Acid. 



72 ACIDUM PHOSPHORICUM. 

Unofficial Preparations. 

Oleaies (Oleata) of Aconitine (2 per cent.), Atropine (2 per cent.), Morphine (10 per 
cent.), Morphine and Mercury (2 per cent, morphine and 20 per cent, mercuric oxide), 
Quinine (25 per cent.), Strychnine (2 per cent.), Arsenic (gr. xx of oleate of arsenic to 
the £), Aluminium, Bismuth, Copper, Iron, Lead, Silver, Zinc etc., are prepared by 
the manufacturing pharmacists, and are to be obtained in the shops. Most of them answer 
to the description given above, but several are Oleo-palmitates, or double salts of Oleic 
and Palmitic Acids, being prepared from oils which yield the latter acid in considerable 
quantity. Drs. Shoemaker and Wolff, of Philadelphia, have introduced, under the above 
names, several solid or semi-solid preparations, which they claim to be chemically true 
oleates, salts having no excess of either their acid or basic radicals. They are produced 
by the double decomposition of sodium oleate with solutions of neutral salts, the precipi- 
tates, washed and dried, being the oleates required. These oleates are claimed to be more 
stable than the official oleic solutions, and using less oleic acid are much less costly. 
Many of them may be used as dusting powders, or mixed with oil or lard to form ointments. 

Physiological Action and Therapeutics. 
Oleic Acid is only used in making the Oleates, which were introduced 
by Marshall, in 1872, as substitutes for ointments, being cleaner, more 
elegant, and more penetrating, but decidedly more irritating if applied 
with friction. Their medicinal properties depend upon the bases em- 
ployed, hence their actions and uses will be described under the corre- 
sponding basic heads. They should usually be diluted with an equal bulk 
of vaseline or olive oil before being rubbed into the skin, or they may 
produce a cutaneous eruption or even pustulation. As a rule, they should 
be lightly spread over the surface with the finger or a brush. As parasiti- 
cides, the Oleates of Copper and Mercury are most efficient, and in skin 
diseases generally these preparations are rapidly coming into favor. 

ACIDUM PHOSPHORICUM, Phosphoric Acid,— is a liquid 
composed of 50 per cent, of Orthophosphoric Acid, H 3 P0 4 , and 50 per 
cent, of water, and is obtained by oxidizing Phosphorus by Nitric Acid. 
It is strongly acid, odorless, colorless, and of sp. gr. 1.347. 

Preparations. 

Acidum Phosphoricum Dilutum, Diluted Phosphoric Acid, has of Phosphoric Acid 
20 parts in 80 of Distilled Water, sp. gr. 1.057, and contains 10 per cent, of Orthophos- 
phoric Acid. Dose, nr, v-xxx, in sufficient water. 

Phosphates of Ammonium, Ferrum, and Sodium, and the Syrupus Ferri, Quininas et 
Strychninse Phosphatum, are described under Phosphorus. 

Physiological Action and Therapeutics. 
The action and uses of Phosphoric Acid are described with those of 
the other Mineral Acids under Acidum Hydrochloricum (see ante, page 
66). It may be given in larger doses than the other acids without derang- 
ing digestion, and is therefore preferred in cases requiring acid treatment 
for a long period, as in diabetes, etc. It is considered of especial value 
in strumous affections, and it is thought to diminish the growth of osseous 
tumors, and to dissolve phosphatic deposits. As it contains no free phos- 
phorus, it cannot be used to obtain the effects of that drug. 



ACIDUM PICRICUM ACIDUM SULPHURICUM. 73 

ACIDUM PICRICUM, Picric Acid, Carbazotic Acid, Trini- 
trophenol, C 6 H 3 (N0 2 ) 3 (Unofficial), — is obtained by the action of 
Nitric Acid on Carbolic Acid, or many other substances. It has recently 
been introduced as a test for albumen and sugar in the urine. A saturated 
aqueous solution has been used locally in erysipelas with some advantage. 
Some of its salts (Picrates of Ammonium, Iron, etc.) have been tried 
therapeutically, without any particular results. Powers as an antiperiodic 
and anthelmintic and against trichinae have been urged for it, but expe- 
rience has not supported these claims. Dose, gr. v-xv per diem. 

Ammonium Picrate, in doses of gr. yfa to gr.jss, in pill, four times daily, has been used 
in the malarial fevers of India, in over 10,000 cases with most effective results. 



ACIDUM SULPHURICUM, Sulphuric Acid —is a strongly 
caustic and corrosive liquid, oily, inodorous, of a strong acid reaction, 
composed of not less than 96 per cent, of absolute Sulphuric Acid 
(H 2 S0 4 ) and 4 per cent, of water. It is obtained by the combustion of 
Sulphur and its oxidation by nitrous fumes. Its specific gravity should 
not be below 1.840, and it is miscible in all proportions with water and 
alcohol, with evolution of heat. Occasionally used as a caustic. 

Preparations. 

Acidum Sulpkuricum Dilutum, Diluted Sulphuric Acid, — has of the strong acid 1 part 
to 9 of distilled water. Dose, n\ v-xv, well diluted. 

Acidum Sulphuricum Aromaticum, Aromatic Sulphuric Acid, Elixir of Vitriol, — is 
Sulphuric Acid 20 per cent., diluted with Alcohol and flavored with Cinnamon and 
Ginger. It is not an acid, but rather an ether formed by reaction between the acid and 
the alcohol. Dose, n\, v-xv, well diluted. 

Physiological Action and Therapeutics. 

The action and uses of Sulphuric Acid generally are described with 
those of the other Mineral Acids under Acidum Hydrochloricum (see 
ante, page 66). Its chief use internally is in lead-poisoning, to form the 
insoluble sulphate, and as a remote astringent in diarrhoea, hemorrhoids, 
hemorrhages, night-sweats, and mucous discharges. In choleraic diar- 
rhoea and lead poisoning it is generally administered in combination with 
Opium. The hemorrhages in which it is efficient are only those from 
mucous surfaces. It is exerted chiefly by the kidneys, part escaping by the 
bowels as sulphates, part also by the skin. Like the other mineral acids, 
it does not increase the acidity of the urine to any considerable extent. 
Its principal actions are those of an astringent, an anhydrotic and a 
hemostatic. 



74 ACIDUM SULPHUROSUM. 

ACIDUM SULPHUROSUM, Sulphurous Acid —is a color- 
less liquid, of sulphurous taste and very acid reaction, composed of about 
3)^ per cent, of Sulphurous Acid Gas (S0 2 ) and 96^ per cent, of water. 
It is prepared by heating Sulphuric Acid with charcoal and dissolving the 
gas produced in distilled water. Dose, n^ V-3J, largely diluted with water. 

Preparations. 

Potassii Sulpkis, Sulphite of Potassium, K 2 S0 3 .2PI 2 0. — white, opaque, octahedral 
crystals, or a crystalline powder, somewhat deliquescent, of bitter, saline, and sulphurous 
taste, and a neutral or feebly alkaline reaction ; soluble in 4 of water at 59 F., and in 5 
of boiling water; sparingly soluble in alcohol. Dose, gr. iij -x. 

Sodii Sulphis, Sulphite of Sodium, Na 2 S0 3 .7H 2 0, colorless, transparent, monoclinic 
prisms, efflorescent in dry air, of cooling, saline, and sulphurous taste, and neutral or 
feebly alkaline reaction ; soluble in 4 of water at 59 F., and in 0.9 of boiling water, 
very slightly soluble in alcohol. Dose, gr. v-xx. 

Sodii Bisulpkis, Bisulphite of Sodium, NaHS0 3 , — opaque prismatic crystals, or a 
crystalline or granular powder, slowly oxidized in the air; of faint, sulphurous odor, a 
disagreeable taste, and an acid reaction; soluble in 4 of water and in 72 of alcohol at 
50 F., in 2 of boiling water, and in 49 of boiling alcohol. By strong heat it is con- 
verted into sulphur and sulphate of sodium. Dose, gr. iij-x. 

Sodii Hyposulphisy Hyposulphite of Sodium, Na 2 S 2 3 .5H 2 0, — large,' colorless, mono- 
clinic prisms or plates, efflorescent in dry air, of cooling and bitter taste, and neutral or 
faintly alkaline reaction; soluble in 1.5 of water at 59 F., and in 0.5 of boiling water, 
which partly decomposes it; insoluble in alcohol. Dose, gr. v-xx. 

Magnesii Snlpkis, Sulphite of Magnesium, Mg,S0 3 .6H 2 0, — a white, crystalline pow- 
der, gradually oxidized in the air, of bitter and sulphurous taste, and neutral or slightly 
alkaline reaction; soluble in 20 of water at 59 F., and in 19 of boiling water; insolu- 
ble in alcohol. Dose, gr. v-xxx. 

Antagonists and Incojnpatibles. 

All oxidizing substances change the Sulphites into Sulphates, and the mineral acids 
decompose them. 

Physiological Action. 

Sulphurous Acid has great affinity for oxygen, and is a powerful dis- 
infectant and deodorizer, and very destructive to all plant life. The gas 
inhaled is irritant to the glottis, and may produce dangerous inflammation 
of the respiratory passages. 

The Sulphites and Hyposulphites are partly decomposed by the acid 
of the stomach, sulphurous acid being given off, and the balance being 
converted into sulphates act as purgatives, and are absorbed, undergoing 
elimination as sulphates by the kidneys and bowels. They were formerly 
supposed to enter the blood and tissues as sulphites, and to arrest morbid 
processes of the zymotic character, but both these assumptions have 
proven erroneous. 

Therapeutics. 

Sulphurous Acid Gas (Sulphurous Anhydride) is extensively used as a 
disinfectant, being the most powerful and convenient agent for this pur- 
pose. Sulphur is burned on a shovel or plate in the room to be fumigated, 
all outlets having been carefully closed. It is injurious to many fabrics. 

Sulphurous Acid is used locally in many throat § affections as a spray 



ACIDUM TANNICUM. 75 

or by a mop. In diphtheria, stomatitis, aphthae, ulcers of the tonsils, 
syphilitic and tuberculous laryngitis, chronic bronchitis, etc., it maybe 
thus applied with great benefit. Morbid fermentation in the stomach with 
growth of penicillium and sarcinae is quickly stopped by 5 to 60-minim 
doses in water, or by the sulphites in 20-grain doses. In parasitic skin 
diseases and foul wounds these agents are extremely useful as local appli- 
cations. 

The Sulphites were used in zymotic and septic fevers as internal 
antiseptics on theoretical grounds, but their supposed value has not been 
realized. 

ACIDUM TANNICUM, Tannic Acid, Tannin, C 14 H 10 O 9 ,— 

is a solid body in light-yellowish scales, of strongly astringent taste and 
acid reaction, obtained from powdered galls (see Galla), by exposure for 
three days in a damp atmosphere, then macerating with ether, pressing, 
and drying the liquid portion. It is soluble in 6 parts of water, in 0.6 
of alcohol, and in 6 of glycerin at 59 F. Dose, gr. j-xx in water, pill 
or capsule. 

Preparations. 

Unguentum Acidi Tannici, — is a 10 per cent, ointment made with Benzoinated Lard. 

Trochisci Acidi Tannici, — each troche contains one grain of Tannic Acid. 

Collodium Stypticum — ^-Styptic Collodion, — has of Tannin 20, Alcohol 5, Ether 20, 
Collodion 55 parts. 

Suppositoria Acidi Tannici (Unofficial), — have Tannin I part to 5 of Cacao Butter. 

Glyceritum Acidi Tannici (Unofficial), — has Tannin 1 part in 4 of Glycerin. 

Vegetable Astringents contain some form of tannic acid, as Quercitanic Acid from 
Oak-bark, Khatania-tannic Acid in Rhatany, etc. (For list, see page 64.) The official 
acid is Gallo-tannic Acid, being that produced from Galls. 

Antagonists and Incompatibles. 

Mineral acids, alkalies, persalts of iron, and salts of antimony, lead and silver, are 
chemically incompatible. Vegetable alkaloids and gelatin form insoluble precipitates 
with Tannic Acid. 

Physiological Action. 
Tannic Acid is a powerful astringent. It precipitates pepsin and 
coagulates albumen, impairs digestion, stops peristalsis, and causes con- 
stipation. A part of that taken into the stomach unites with the pepsin 
and albumen, while a part is converted into Gallic and Pyro-gallic Acids, 
and in this form is both absorbed and excreted. It is a crystalloidal body, 
but combines with colloids, and is a valuable antidote in poisoning by the 
alkaloids and tartar emetic, with which it forms tannates which are nearly 
insoluble. Its continued use disorders digestion, irritates the mucous 
membranes, and produces emaciation. Injected into the veins it forms 
emboli and thus may cause death, but by the stomach it is non-toxic. 
Some authorities hold that Tannic Acid is merely Gallic Acid Anhydride ; 
others believe that the difference between them is one of oxidation. Gallic 
Acid does not coagulate albumen or gelatin, while Tannic Acid does. 



I 



j6 acidum tartaricum aconitum. 

Therapeutics. 

Tannic Acid is a more powerful astringent than Gallic Acid, and hence 
is preferred for local use and for astringent effect on the intestinal canal. 
It is well employed in hemorrhoids and hemorrhages from the lower bowel, 
in hematemesis, epistaxis, rectal ulcers or fissures, catarrhs and chronic 
affections of the mucous membranes, endocervicitis, conjunctivitis, dysen- 
tery and diarrhoeas, eczema, impetigo and other forms of skin-disease, 
otorrhoea, bed-sores, prolapsus ani, and many other affections. 

Styptic Collodion is used to stanch the bleeding from an open wound, 
to unite and protect incised or lacerated wounds, and to cover and change 
the character of foul ulcers. 

ACIDUM TARTARICUM, Tartaric Acid, H 2 C 4 H 4 6 ,— -is a 

crystalline acid, prepared from Acid Tartrate of Potassium (Cream of 
Tartar), by neutralizing a solution thereof with Chalk and Calcium Chlor- 
ide, then decomposing the Tartrate of Lime thus formed by Sulphuric 
Acid, evaporating and purifying. It occurs in colorless, transparent 
prisms, which are odorless, of acid taste and reaction, and soluble in 0.7 
of water and in 2)^ of alcohol at 59 F. Twenty grains exactly neutral- 
ize 27 of Potassium Bicarbonate, 22 of Sodium Bicarbonate, or 15^2 of 
Ammonium Carbonate. Dose, gr. x-xxx. 

Preparations. 
Tartaric Acid is an ingredient of the Effervescing Powders (see under Potassium), and 
is used in making all the preparations of Aconite. Five Tartrates are official (see 
Index). 

The actions and uses of Tartaric Acid are similar to those of the other 
Vegetable Acids, as described under Acidum Aceticum (a?itc, page 59). 
It is chiefly employed in preparing refrigerant drinks. 

ACONITUM, Aconite, — is the tuberous root of Aconitum Napel- 
lus, a perennial plant of the nat. ord. Ranunculaceae (Monkshood), found 
in mountainous regions of Europe, Asia and N. America. This plant has 
deep-blue, helmet-shaped flowers, and leaves which have deeply-cut, 
wedge-shaped segments, exciting slowly when chewed a sensation of 
tingling in the tongue and lips. The root is conical and tapering, from 
2 to 3 inches long, dark -brown externally, whitish internally, having a 
thick bark enclosing a seven-rayed, star-shaped pith, odorless, taste 
sweetish at first, soon becoming acrid. A minute portion, cautiously 
chewed, causes prolonged tingling and numbness. Its active principle 
is the alkaloid Aconitine (see below), which it contains in the proportion 
of .03 per cent. It also contains gum, sugar, Aconitic Acid, and several 
other principles, viz. — Aconine, Napelline, Pseudaconitine, Lyctonine, etc., 
concerning which there is much diversity of opinion. Dose, gr. ^-ij. 



ACONITUM. 77 

Other aconite-roots are those of A. Cammartim, A. ferox, and the 
Chinese or Japanese Aconite, A. Chinense vel Japonicum. From the latter 
an alkaloid is obtained, named Japaconitine, which is even more poisonous 
than pseud-aconitine. The Indian variety {A. ferox) contains pseud- 
aconitine but does not yield aconitine. The former is considered to be 
more active than the latter, and Japaconitine more so than either the 
other two. 

Preparations. 

Abstractum Aconiti, — is twice the strength of the powdered drug or its fluid extract. 
Dose, gr. %-y 

Extractum Aconiti, — is at least four times as strong as the extract official in the U. S. 
P., 1870, which was prepared from, the leaves, and is yet to be found in the shops. Dose, 

gr- Ve-H- 

Extractum Aconiti Fluidum, — each drop represents nearly one grain of the powdered 
drug : an alcoholic preparation. Dose, TTb^-ij. 

Tinctura Aconiti, — Aconite 40, Tartaric Acid 0.4, Alcohol to 100 parts. Is about 
twenty-eight times as strong as the former tincture of the leaf. Dose, rtv^-iv . 

Tinctures of Aconite root vary greatly in strength. In Fleming's Tincture 79 parts of 
aconite are used in preparing 100 of the tincture, in that of the Br. P. 16, the French 20, 
the German 10, while the Linimentum Aconiti (B. P.) is really a very strong tincture, of 
the strength of I to y 2 . Probably the best and safest preparation for ordinary use is a 
10 per cent, tincture, of which the maximum single dose for an adult is stated in the P. 
Ger. at TIL. ix, and the maximum daily dose at TT^ xxxv. 

The best rule for the administration of aconite preparations is to give the minimum dose 
at intervals of 15 to 20 minutes, until the desired effect is produced. 

Unofficial Preparations. 

Aconitina, Aconitine, C 33 H 43 N0 12 , — a white, and usually amorphous solid, of alka- 
line reaction, soluble in 150 of cold and 50 of hot water; much more soluble in alco- 
hol and ether. Is difficult to obtain of constant strength, some samples being all but inert, 
others extremely active. As obtained in the shops it is usually a mixture of several alka- 
loids. The Aconitine Crystalisee of Duquesnel, which, according to Squibb, is a nitrate 
of aconite, is considered to be the most active of those in the market. Dose, gr. 

Oleatum Aconitince, Oleate of Aconitine, — is a 2 per cent, solution in Oleic Acid, for 
external use. Duquesnel's crystals will not dissolve in Oleic Acid (Squibb). 

Napellina, Napelline, — is weaker than Aconitine, and has been used in doses of gr. 
\—\. It has lately been studied by Laborde, who claims for it most valuble hypnotic 
properties, and proposes to use it as a substitute for opium and chloral. 

St. facoVs Oil (a patent medicine), — is a weak Aconite Liniment, which also contains 
Ether, Alcohol, Turpentine, red coloring matter and water (Squibb). See Appendix. 

Physiological Action. 
Aconite is a powerful depressant of the sensory nerve ends, the heart, 
the respiration and the spinal system. It is also antipyretic, diaphoretic 
and diuretic. It acts chiefly on the peripheral ends of the sensory nerves, 
but paralyzes both the motor and sensory nerves — the sensory being 
affected first and from the periphery inwards, while the motor nerves are 
affected from the centres outwards. It stimulates at first but soon relaxes 
the inhibitory apparatus of the heart, and paralyzes finally the vagus ends, 
the cardiac muscle and its contained ganglia, the respiratory centres, and 
the spinal cord in all its functions — sensory, reflex and motor ; but does 
not affect the cerebrum. 



! 



yS ACONITUM. 

The primary stimulation which the drug produces upon the vagus 
centre in the medulla slows the heart-rate at first ; but its depressant 
action upon the motor cardiac centres and the vagus end-organs in the 
heart, is soon manifested ; and finally the vagus centre shares in the 
increasing paralysis, which affects the vaso-motor centre as well as the 
cardiac nervous apparatus. The heart rate becomes very rapid near the 
end, from paralysis of the vagus ends in its structure. 

Its taste is bitter, acrid and pungent. Soon after the ingestion of even 
a small quantity, a sensation of numbness and a persistent tingling are 
felt in the tongue and lips. Full medicinal doses cause a sense of con- 
striction in the fauces, irritation of the gastrointestinal mucous membrane 
with increased secretion ; sometimes nausea and vomiting, and severe 
pains in the joints and muscles ; always more or less salivation, diaphoresis 
and diuresis; reduced respiratory power, cardiac rate and force; lowered 
arterial tension and temperature. 

A lethal dose produces great muscular weakness, dim sight, dilated 
(sometimes contracted) pupils; shallow, irregular, and labored respiration, 
slow and weak pulse, cold surface, clammy sweat, great anxiety, numbness 
and tingling in the extremities, lowered body-temperature (2 to 3 ), 
abolished sensation, impaired reflexes and motility, and finally death from 
paralysis of the heart and respiration, with or without convulsions, con- 
sciousness being preserved until near the end, when C0 2 narcosis sets in. 
In two recorded cases, oedema of the entire body resulted from Aconite- 
poisoning by eating the leaves of the growing plant. 

Aconite is rapidly diffused and slowly excreted, the effects of a full 

medicinal dose continuing for three or four hours. Applied externally, 

it paralyzes the sensory nerves of the part, producing its characteristic 

numbness and tingling. 

Antagonists. 

Caffeine, Atropine, Morphine, Ether, Ammonia and Amyl Nitrite antagonize its 
effects on the heart and respiration. Digitalis counteracts its heart action and the relax- 
ation of cardiac inhibition. In Aconite poisoning, the stomach should be evacuated, 
warmth applied to the extremities, stimulants administered, artificial respiration if neces- 
sary, and the recumbent posture strictly maintained. Caffeine maybe administered hypo- 
dermically and per orem. 

Therapeutics. 
Aconite antagonizes the fever process, and rightly used is therefore one 
of the most valuable drugs we possess. It has well been called the 
"therapeutic lancet," and is certainly responsible to a great extent for 
the disuse of venesection. Its power over the circulation, respiration and 
transpiration renders it of the greatest value in all affections characterized 
by high resisting pulse, dry hot skin, and elevated body-temperature. It 
is especially useful in acute throat affections, the early stage of acute 
inflammations of the respiratory organs, catarrhal croup, acute pleuritis 



ADEPS AETHER. JQ 

and peritonitis before the stage of effusion, simple and eruptive fevers, 
puerperal and surgical fevers, facial erysipelas, acute rheumatism, cardiac 
affections with overaction or hypertrophy and without valvular lesion, 
diarrhoea and dysentery from cold or exposure, menstrual suppression 
from chill, and neuralgia of the 5th (externally and internally), it having 
a very positive and selective influence on that nerve. It is also highly 
recommended in otitis, nervous palpitations, restlessness, and sick head- 
ache, as also in the acute stage of gonorrhoea. 

Aconite is best administered in small doses frequently repeated ; from 
half a drop to a drop of the tincture every fifteen minutes in a teaspoon- 
ful of water as a rule give better results than do proportionately larger 
doses at longer intervals. 

Aconitine has been remarkably efficient in trigeminal neuralgia ; — so 
also has Napelline been in the same affection, and as an hypnotic it is 
well mentioned by several observers of authority. 

ADEPS, Lard, — is the prepared internal fat of the abdomen of 
Sus scrofa (Pig), purified by washing, melting and straining. A soft, 
white, unctuous solid, of bland taste and neutral reaction, entirely soluble 
in ether, benzin, and bisulphide of carbon ; composed of 38 per cent, of 
stearin and margarin, and 62 per cent, of olein. Lard forms 70 per 
cent, of Ceratum, and 80 per cent, of Unguentum, and enters into the 
composition of several of the official cerates. 

Preparations. 

Adeps Benzoinatus, Benzoinated Lard, — has 2 per cent, of Benzoin in powder incor- 
porated by stirring. 

Oleum Adipis y Lard Oil, — is a fixed oil expressed from lard at a low temperature. 

The actions of the Oils and Fats will be described under Morrhu/e 
Oleum (which see). 

Lard is only used as an ingredient of ointments and cerates. Lard 
Oil is used in making the Unguentum Hydrargyri Nitratis, but has been 
proposed as an inferior substitute for Cod-liver oil in cases where the 
taste of the latter is particularly offensive. 



^THER, Ether, Ethyl Oxide (C 2 H 5 ) 2 0,— in its absolute form is 
not official, the strongest preparation containing 6 per cent, of alcohol 
and some water. Considered as a generic term, an ether is analogous to 
a salt, as an alcohol is to a metallic hydrate. The particular ether 
officially so named is Ethyl Oxide, prepared from Ethyl Hydrate (Ethylic 
Alcohol) by a dehydrating agent with the aid of heat, and then purified 
by various processes. The agent used is Sulphuric Acid, hence this ether 
is improperly called " Sulphuric Ether," but the acid simply dehydrates 



\ 



SO .ETHER. 

the alcohol and remains in the retort, becoming constantly more diluted 
by the abstraction of water from the alcohol. Consequently H 2 is* the 
difference between Alcohol and Ether. (C 2 H 6 0) 2 — H 2 = (C 2 H 5 ) 2 0. 
The official ethers are the three following, viz. — 

^Ether, Ether, — is a liquid composed of about 74 per cent, of Ethyl 
Oxide, and about 26 per cent, of Alcohol containing a little water ; an 
inflammable, thin, very diffuse, clear and colorless liquid, having a 
burning, sweetish taste, and a neutral reaction, of sp. gr. about 0.750 at 
59 F. Its vapor is heavier than air and forms therewith a highly explo- 
sive mixture. Ether is freely soluble in alcohol, chloroform, benzol, oils, 
and in 8 volumes of water at 59 F. It boils at the temperature of the 
body (98. 6°), and is a solvent of oils, fats, resins, caoutchouc, gutta- 
percha, and many other substances. It has chiefly a pharmaceutical value. 

^Ether Fortior, Stronger Ether, — is a liquid composed of about 94 
per cent, of Ethyl Oxide, and about 6 per cent, of Alcohol containing a 
little water. Sp. gr. not above 0.725 at 59 F. It is the preparation 
employed for anaesthetic use, and is generally though improperly called 
" Sulphuric Ether," a term which belongs to Ethyl Sulphate (C 4 H 10 SO 4 ). 
The dose of ^Ether Fortior for internal administration is tt^x-3J, in syrup. 

^Ether Aceticus, Acetic Ether, Acetate of Ethyl, C 2 H 5 C 2 H 3 0, — is an 
inflammable liquid, transparent and colorless, of ethereal and acetous 
odor, soluble in alcohol, ether, chloroform, and 17 of water. Sp. gr. 
0.889 to 0-897. Is a constituent of Sp. Odoratus and Tr. Ferri Acetatis. 
Dose, ttl X-3J. 

Hydrobromic Ether, Ethyl Bromide, C 2 H 5 Br (Unofficial), — is not 
inflammable. Dose, internally and hypodermically, T^x-^j. 

Hydriodic Ether, Ethyl Iodide, C 2 H 5 I (Unofficial), — is a colorless 
liquid, non-inflammable, and insoluble in water. Dose, inhaled, tt^xv. 

[For the Chlorinated Ethers see under Chloroform.] 

Preparations. 

Oleum JEthereum, Ethereal Oil, — is a volatile liquid, consisting of equal volumes of 
heavy Oil of Wine and Stronger Ether. Used to prepare the Spt. ^Etheris Comp., and 
as it occurs in commerce is usually a worthless preparation. 

Spiritus JEtheris, Spirit of Ether, — has of Stronger Ether 30 parts, Alcohol 70. 
Dose, nxx-^j. 

Spiritus sEtheris Co??ipositus, Hoffman's Anodyne, — contains Stronger Ether 30, Alco- 
hol, 67, Ethereal Oil 3 parts. Dose, r^v- 3 j. 

Spiritus ALtheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre, — is an alco- 
holic solution of Ethyl Nitrate, C 2 H 5 N0 2 , containing 5 per cent, of the crude ether. It 
turns acid with age, and should not be kept long. It is a constituent of Mist. Glycyrrhizse 
Co. (3 per cent.). Dose, ^ss-^ss. Its incompatibles are Potassic Iodide, Ferric Sul- 
phate, Tr. Guaiaci, Tannic and Gallic Acids, and Antipyrine. 

Ancesthetic Mixtures. 
Nussbaum's has — Ether 3 parts, Chloroform 1, Alcohol I. 
Vienna General Hospital uses — Ether 9, Chloroform 30, Alcohol 9. 
The " Vienna Mixture" — Ether 3, Chloroform I. 

Medic o-Chirurgical Society of London (1864) proposed — Ether 3, Chloroform 2 
Alcohol 1. 



AETHER. 8 1 

Physiological Action of Ether. 

Ether is anodyne, antispasmodic, diaphoretic and anthelmintic ; a 
cardiac and cerebral stimulant, an anaesthetic, and a narcotic poison. 
Given internally, it is one of the most powerful stimulants of the secre- 
tions, acting especially on the secretions of the stomach, salivary glands 
and pancreas. On the cerebrum and the motor and sensory nerves its 
action is similar to that of alcohol, but more prompt and less protracted. 
It is eliminated rapidly, chiefly by the lungs. Externally it is a powerful 
refrigerant and local anaesthetic ; also rubefacient when rubbed into the 
skin. 

Inhaled Ether produces at first faucial irritation, a sense of strangula- 
tion and cough ; then a stage of excitement (cerebral intoxication), in 
which the face is flushed and the respiration and pulse are accelerated. A 
tetanic convulsive stage generally follows, the face being cyanosed, the 
muscles rigid, and the respiration stertorous. This soon subsides, and 
complete insensibility is established, the muscles being then relaxed, the 
reflexes abolished, and the cerebral functions suspended, the lower centres 
in the medulla carrying on the processes of respiration and circulation. 
If the inhalation be continued, these also become paralyzed, death usually 
resulting from slow paralysis of respiration, the heart pulsating long after 
breathing has ceased. If the inhalation be discontinued before the lower 
centres are affected, the patient gradually emerges from the condition of 
insensibility, and, as the narcosis subsides, vomiting is usually experienced. 

Dr. Brunton found that in a hot climate Ether will decompose within a few hours, and 
hence, during his investigations for the Hyderabad Chloroform Committee, he found it 
impossible to obtain pure ether. This may account for the preference for Chloroform as 
an anaesthetic which is so universal in the Southern States. 

Ether Compared with Chloroform. 

Ether is less irritant than Chloroform to the mucous membranes when 
swallowed, but its vapor is more irritant to the air-passages. It is more 
of a general stimulant, and less depressant to the heart and circulation. 
It does not clot the blood. Its vapor is very inflammable, less pleasant to 
inhale, slower in action, has a longer stage of excitement, and a less pro- 
found narcosis, and causes a greater degree of vomiting. It is much 
less dangerous than Chloroform, death from the inhalation of Ether 
occurring slowly and usually by paralysis of respiration — from Chloro- 
form, it is always sudden. Ether has undoubtedly caused a number 
of deaths, besides several which occurred some hours after the anaesthesia. 
The reported cases of fatal Chloroform narcosis number about 500, those 
from Ether about 20. 

Modes of Dying from Anesthetics. 

(1.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by reflex 
action proceeding from some peripheral injury before complete anaesthesia is produced. 
Thus, in the extraction of teeth, a small quantity of Chloroform having been administered, 
6 



I 



82 AETHER. 

the heart is enfeebled, and the action of the cerebral hemispheres suspended, but not 
those of the basal or medullary ganglia. If at this stage the 5th nerve be irritated, by 
the intimate relation of its nucleus with that of the pneumogastric reflex inhibition may 
be transmitted over the latter, arresting the cardiac ganglia. The stage of incomplete 
anaesthesia is always a dangerous one in which to perform any operation around the 
distribution of the 5th nerve. 

(2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, the blood 
backing up on the venous side, and the arresting of the heart's action, respiration ceasing 
before the cardiac action is stopped. 

(3.) In the stage of complete relaxation, by paralysis of respiration ; or by paralysis of 
the tongue, causing obstructed respiration. 

(4.) In the same stage, by paralysis of the motor ganglia of the heart. 

(5.) From depression of the functions by chloroform narcosis, and from shock, — and 
may occur in the anaesthetic state, or afterwards. 

Contraindications for Anesthesia are — fatty degeneration or dilata- 
tion of the heart, renal and pulmonary disease, enlarged tonsils, cerebral 
tumor, and chronic alcoholism — particularly the first and last named. 

Dangerous Symptoms should be met by withdrawing the vapor and 
inverting the patient head downwards, drawing the tongue forwards, and 
applying a cold douche to the face and chest. Atropine hypodermically 
is an agent of great value in combating the cardiac failure, — artificial 
respiration and faradization of the respiratory muscles if breathing ceases. 
Amy I Nitrite by inhalation, or Ammonia hypodermically. Heat to the 
body and limbs. 

Notes on Other Anesthetics. 

A comparison of these agents in respect to their safety has been lately made by Dr. 
Richardson, who considers Methylic Ether to be the safest of all, and the others as follows : 

Safe are — Ethyl Bromide, Ethyl Chloride, Ether, Ethene (defiant gas),Ethene Chlo- 
ride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene Chloride, Methane 
(marsh gas), Nitrous Oxide. 

Of doubtful value are — Amylene, Amyl Chloride, Butyl Chloride, Benzene (benzol), 
Carbon Disulphide, Carbon Dioxide, Carbon Tetrachloride, Methyl Alcohol, Methylal, 
Spirits of Turpentine. 

Dangerous are — Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl Hydride. 
Chloroform and Ethene Dichloride are considered useful, but requiring care. 



Physiological Action of Other Ethers. 

Hydriodic Ether is an antispasmodic and a general stimulant ; also 
an anaesthetic if inhaled for a sufficiently long time. Its use as a medici- 
nal agent is chiefly to bring the system rapidly under the influence of 
iodine. It increases appetite, stimulates the action of the heart, gives 
vivacity to the general feelings and activity to the intellect. 

Hydrobromic Ether has a not unpleasant odor, produces but little 
irritation of the air-passages, has very brief stages of excitement and 
rigidity, and but a short stage of insensibility, with prompt awakening 
and but little of the mental confusion and excitement consequent on the 
use of the other anaesthetics. It is not inflammable, acts quickly, and is 
a good local anaesthetic. Its actions in other respects correspond with 
those of Ether. 



.ETHER. 83 

Nitrous Ether is a mild diaphoretic, a diffusible stimulant, a carmin- 
ative, and an efficient diuretic. On the blood it acts similarly to Amyl 
Nitrite, diminishing oxygenation, relaxing the peripheral vessels, accel- 
erating the heart's action, and thus lowering arterial tension. Relaxing 
the renal and cutaneous vessels, it is diuretic and diaphoretic. 

Acetic Ether has a pleasant odor and taste, forming agreeable combi- 
nations with other carminatives as a stimulant and antispasmodic. 



Therapeutics. 

When diluted with alcohol Ether mixes readily with water, and may be 
administered internally with advantage in indigestion of fats, and to aid 
the digestion of Cod-liver Oil. It is also given in hysteria to relieve the 
paroxysm and flatulence, and in hepatic colic from calculi, Ether with 
Turpentine (Durande's solvent remedy), which acts only as an anodyne 
and antispasmodic, is considered by some as of great value. 

Subcutaneously Ether is used in the algid stage of cholera, sudden car- 
diac depression, neuralgia, and in the adynamia of hemorrhage, pneu- 
monia and the eruptive fevers. 

Local anaesthesia by the Ether-spray affords great relief in neuralgia of 
superficial nerves, lumbago, chorea, and spinal irritation. In minor sur- 
gical operations it is a valuable method. 

As an Anaesthetic the vapor of Ether is less prompt than that of 
Chloroform, but is equally efficient and much safer. It should be inhaled 
in as concentrated a form as possible, and will then produce insensibility 
in from 5 to 10 minutes. If a light be in the room it should be high 
above the patient. A grate-fire or gas-stove in the vicinity is very dan- 
gerous. [Compare Chloroform.] Besides its surgical uses ether-anaesthesia 
is employed in neuralgia, cancer, tetanus, chorea, colic, delirium, puer- 
peral mania and convulsions, infantile convulsions, hystero-epilepsy, epi- 
leptic seizures, laryngismus stridulus, whooping-cough, and asthma. The 
unpleasant after-effects may be greatly modified if not entirely prevented 
by the previous administration of Morphine (gr. xV40 an< ^ Atropine 
(gr. yJ-jj-) subcutaneously. 

Hydrobromic Ether had a short period of popularity as an anaesthetic, 
but fell into disrepute after a few cases of death under its influence, which 
were probably not due to the agent used (Levis' and Sims' cases). Its 
action is less prolonged than that of Ether, but it has many advantages, 
requiring only 3J to gij rapidly given, and being uninflammable. Its 
inhalation has been of especial value in hysteria, epilepsy, chorea and 
other spasmodic disorders ; and it has been employed subcutaneously in 
place of Ether in the treatment of such spasmodic affections as whooping- 
cough, chorea, etc. 



84 AGARICUS ALBUS AGARICUS CHIRURGORUM. 

The Compound Spirit of Ether (Hoffman's Anodyne) is an admir- 
able agent in gastralgia, colic, flatulence, syncope, etc., also in the various 
manifestations of the hysterical paroxysm. In combination with the 
camphorated tincture of Opium it is often remarkably efficient in checking 
the diarrhoea of hot weather. 

Spirit of Nitrous Ether is used as a diaphoretic, a diuretic and a 
carminative; also in expectorant mixtures, as an antipyretic in febrile 
affections, and to relieve pain in angina pectoris, dysmenorrhcea and 
asthma. 

Hydriodic Ether may be obtained in glass capsules containing five 
minims each, and is used by inhalation in chronic pulmonary disorders, 
cardiac dyspnoea, spasmodic affections of the bronchi and larynx, asthma, 
and in catarrhal laryngitis with dyspnoea. It is not employed as an anaes- 
thetic. 



AGARICUS ALBUS, Purging Agaric (Unofficial),— is a fungus, 
occurring in large white spongy pieces, obtained from the European larch. 
It contains Agaricin, a crystalline substance, and Agaric Acid ; also from 
40 to 70 per cent, of resins. 

The taste of Purging Agaric is first sweetish, then becoming very acrid 
and bitter. The powder inhaled causes violent sneezing, and taken inter- 
nally in full doses it produces watery stools. Small doses check diarrhoea 
and dysentery, and diminish the secretions of the bronchi and mammae. 

Agaricus Albus was formerly employed as a drastic purgative, in doses 
of gr. xxx to 3J. It has lately been used, with much success, in 15 -grain 
doses of the powder, or 3 grains of the alcoholic extract, to check the 
night-sweats of phthisis. 



AGARICUS CHIRURGORUM, Surgeon's Agaric (Unoffi- 
cial), — is the interior portion of the fungus Polypo?'us fomentarius, which 
grows on the trunks of beeches, birches, and oaks in Europe. It is pre- 
pared for use by boiling in weak lye and beating with mallets, and then 
occurs in light, thin, yellowish-brown pieces, soft and pliable, without 
odor or taste. It is almost pure cellulose. It was formerly used as a 
mechanical hemostatic, and for the purpose of mo.xa. When soaked in a 
strong solution of Potassium Nitrate or Potassium Chlorate and dried, it 
is very inflammable, and is then called Spunk. 



AGARICUS MUSCARIUS. 85 

AGARICUS MUSCARIUS, Amanita Muscaria, Fly-Agaric 

(Unofficial), — is a poisonous mushroom, of a disagreeable odor and a 
burning, acrid taste, used in infusion with milk for poisoning flies, and 
used by the Tartars as an intoxicant. It contains an actively toxic alka- 
loid, Muscarine C 5 H 13 N0 2 , of. syrupy consistence, odorless and tasteless, 
soluble in water and alcohol, and readily dissolved out by water and 
dilute acetic acid, so that a doubtful mushroom may be easily rendered 
innocuous. It may also be produced synthetically, but it is doubtful 
whether the article so prepared is as active as the natural product. It 
has been made from Choline by Schmiedeberg. 

Preparations. 

Muscarina, Muscarine (Unofficial). — Dose, gr. |— gr. ij. It may be used hypodermic- 
ally in watery solution. 

Muscarines Nitras, Nitrate of Muscarine (Unofficial), — may be used hypodermically, 
in doses of from gr. ^ to gr. £. 

Physiological Action. 

Muscarine is a powerful respiratory and cardiac depressant, paralyzing 
the respiratory centre and arresting the heart in diastole by paralyzing 
its motor ganglia while stimulating its inhibitory apparatus. It lowers the 
arterial tension, produces profound salivation, lachrymation and sweating, 
contracts the pulmonary vessels, causing intense dyspnoea, and increases 
the intestinal, hepatic and pancreatic secretions, but markedly diminishes 
the renal. It disturbs the gastro-intestinal tract, causing tetanic intes- 
tinal contractions, severe colic, vomiting and purging. It produces spasm 
of the accommodation, marked myosis and contraction of the pupil when 
given internally, but dilates the pupil widely when locallyapplied. [Gel- 
semium does so also.] Under its action the body temperature is decid- 
edly reduced, and the excretion of waste-products is lessened. It is 
eliminated unchanged by the kidneys. 

Agaricus acts as an intoxicant to the cerebrum, producing more vertigo 
and delirium than Alcohol, followed by profound sopor with lowered re- 
flexes, perhaps coma and death. 

Antagonists. 

Atropine exactly opposes Muscarine, and vice versa ; no example of physiological 
antagonism being so complete in all particulars. When a frog's heart is arrested by the 
topical action of a minute quantity of Muscarine, the application of a little Atropine will 
immediately paralyze the inhibition and restore the pulsations. An equally prompt 
antagonism runs through their entire spheres of action. Digitaline is to some extent 
antagonistic ; so also is Eserine. 

Therapeutics. 

Muscarine has been as yet little used in medicine, but it will probably 

prove to be a valuable drug. It has been long used, with marked benefit, 

in the night-sweats of phthisis. A tincture of Agaricus has been found 

beneficial in ataxic typhus, chorea, and chilblains. Muscarine promises 



OO AILANTHUS ALCOHOL. 

to be of great value in inflammations characterized by copious exudation, 
especially eye-inflammations, catarrhal jaundice, recent hemorrhoids, 
acute bronchitis, pulmonary hemorrhage, incipient pulmonary congestion, 
diabetes of both forms, and in constipation due to intestinal torpor and 
deficient secretion, accompanied by a torpid liver and difficult digestion 
of fats. In the latter affection it should be given in small doses, gr. Jg-, 
thrice daily. 



AILANTHUS, Tree of Heaven (Unofficial),— is the bark of 

Ailanthus glandulosa, a well-known shade tree, of the nat. ord. Simaru- 

bacese, indigenous to China, but cultivated elsewhere. It contains an 

oleo-resin and a volatile oil, on which its properties probably depend. 

Dose, gr. x-^j. 

Preparations. 

Extr actum Ailanthus Fluidum (Unofficial), — Dose, TT\, x-gj. 
Tinclura Ailanthtts (Unofficial), — Dose, tt\, x-gij. 

Physiological Action and Therapeutics. 

Ailanthus is a decided nauseant, and a drastic purgative, causing also 
vertigo, weakness, cold sweats, dull headache, pains in the back, numb- 
ness and tingling in the limbs. It paralyzes the cerebrum and spinal cord 
of animals, impairment of motility beginning in their hind extremities. 
The cardiac action, at first increased, soon slows, the pulse becoming 
small arid weak, and the respiration depressed, death occurring from 
paralysis of respiration. It is a good tseniafuge. 

Ailanthus is used against tapeworm, a decoction of the fresh bark (jj 
ad §iv), or the oleo-resin in drachm doses, being very efficient. It has 
also been well employed in malignant scarlatina, with dark and partial 
eruption, insensibility, delirium and other cerebral symptoms. 



ALCOHOL, — is a liquid composed of 91 per cent, by weight (94 

per cent, by volume) of Ethyl Alcohol, C 2 H 5 HO, and 9 per cent, by 

weight (6 per cent, by volume) of water. Sp. gr. 0.820 at 6o° F., and 

0.812 at 77 F. An inflammable, transparent, colorless, mobile and 

volatile liquid, of agreeable odor and burning taste. Obtained by the 

distillation of fermented saccharine fluids. Used in making all the 

Tinctures and Spirits ; also in some of the Liniments, Liquors and 

Mixtures. 

Preparations. 

Alcohol Dilutum, Diluted Alcohol, — consists of Alcohol and Distilled Water, equal 
parts of each. Sp. gr. 0.928 at 6o° F. 

Spiritus Frumenti, Whiskey, — obtained from the distillation of fermented grain, rye 
or corn (U. S.), barley (Scotch), and at least two years old. Sp. gr. 0.917 to 0.930. 
Has an alcoholic strength of 44 to 50 per cent, by weight ; also Ethers developed by 



ALCOHOL. 8f 

the action of acetic and butyric acids on the alcohol, and traces of Amylic Alcohol 
(fusel-oil) even in the best. 

Spiritus Vini Gallici, Brandy, — obtained from the distillation of fermented grapes, 
and at least four years old. Sp. gr. 0.925 to 0.941. Has an alcoholic strength of 39 to 
47 per cent, by weight, and CEnanthic and other Ethers developed by age. Pale Brandy 
is colored by the cask, the dark has caramel to color it. Is often prepared artificially by 
adding to high wines Acetic or Nitric Ether, Caramel, and Logwood or Catechu for 
astringency. 

Spiritus Odoratus, Perfumed Spirit, Cologne-water, — prepared by adding to 800 parts 
of Alcohol, Water 158, Acetic Ether 2, Oil of Bergamot 16, Oil of Lemon 8, Oil of 
Rosemary 8, Oil of Lavender Flowers 4, and Oil of Orange Flowers 4 parts. A per- 
fume or ingredient of lotions. 

Vinum Album, White Wine, — should contain from 10 to 12 per cent, by weight of 
absolute alcohol, and is made by fermenting the unmodified juice of the grape, freed 
from seeds, stems and skins. 

Vinum Album Fortius, Stronger White Wine, — should contain 20 to 25 per cent, by 
weight of absolute alcohol, and is made by adding I part of Alcohol to 7 of Vinum 
Album. Is simply a formal recognition of the fact that the stronger sherries are artifi- 
cially made. Used to prepare the official Vina (Wines). 

Vinum Rubrum, Red Wine, — should contain from 10 to 12 per cent, by weight of 
absolute alcohol, and is made by fermenting the juice of colored grapes in presence of 
their skins. 

Vinum Aromaticum, Aromatic Wine, — consists of Stronger White Wine 94 per cent., 
with Lavender, Origanum, Peppermint, Rosemary, Sage and Wormwood, of each 1 per 
cent. 

Unofficial Alcoholic Preparations. 

Rectified Spirit, sp. gr. 0.835, — nas &5 per cent, by weight of absolute alcohol, and no 
fusel oil. Is often spoken of as " 56 over proof," meaning that to reduce 100 volumes of 
it to the strength of proof spirit, requires 56 volumes of water. 

Proof Spirit, sp. gr. 0.920, — contains 49 per cent, by weight of absolute alcohol, with 
a peculiar oil and other foreign matters. 

Rum, — is obtained from the distillation of fermented molasses, and has about 42 per 
ceni. by weight of alcohol. 

Gin, — has about the same alcoholic strength as rum, and approaches very nearly to the 
official Spiritus Juniperi Compositus. It is usually distilled from rye or barley, and 
flavored, in Holland, with juniper berries and hops, in England, often with oil of turpen- 
tine, various cheap aromatics, acetate of lead, sulphate of zinc, cayenne pepper, etc. Pure 
gin is slightly diuretic, from the oil of juniper contained in it. 

Vinum Portense, Port Wine, — is not a natural wine, spirit being added during the 
process of manufacture, and the alcoholic strength raised to 30 or 40 per cent. 

Vinum Xericum, Sherry Wine, — a dry, spirituous white wine, generally made to order 
by the dealers, and having from 20 to 35 per cent, of alcohol. 

Sparkling Wines, as Champagne, Hock, Catawba, — are more or less sweet, and 
charged with carbonic acid, being bottled before fermentation is completed and the grape 
sugar all converted into alcohol. They contain 8 to 10 per cent, of absolute alcohol. 

Sweet Wines, as Burgundy, Tokay, Muscatel, Malaga, Angelica, Madeira, etc., — are of 
low alcoholic strength, 6 to 7 per cent, unless fortified. 

Light Red Wines, as Claret, Red Rhine, Concord, — have 5 to 7 per cent, alcohol, tan- 
nic acid, grape coloring, matter, etc. 

Dry Acid Wines, as Rhine and Moselle wines, California Hock, Ohio, and Kelley- 
Island Catawba, — in these fermentation is complete, and the alcoholic strength from 5 to 
7 per cent. 

Beer, Ale and Porter, — are fermented liquors, made from malted grain, with hops and 
other bitters added. Beer is made by slow fermentation, the yeast sinking ; Ale by rapid 
fermentation, the yeast floating. Their alcoholic strength is from 2 to 3 per cent, in beer, 
to 4 to 6 per cent, in ale and porter, — and they also contain malt extract, carbonic acid, 
lactic acid, various aromatics, potassium and sodium salts, etc. 

Koumiss, — is obtained by the fermentation of milk, that of the mare being used in 
Tartary, where it is largely employed as a food. It contains from I to 3 per cent, of 
alcohol, sugar, lactic acid, casein, fat, salts, carbonic acid and ethers. (See, per Index.) 



88 ALCOHOL. 

Principal Alcohols. 

Ethylic Alcohol, Ethyl Hydrate, C 2 H 6 0, — Grain-spirit. 

Methylic Alcohol, Methyl Hydrate, CH 4 0, — Wood-spirit. 

Amylic Alcohol, Amyl Hydrate, C 5 H 12 0, — Potato-spirit, Fusel Oil. 
Occurs also in the excessive distillation of fermented grain, after the 
ethylic alcohol has distilled over. 

Phenylic Alcohol, Phenol, Carbolic Acid, C 6 H 6 0, — from coal-tar (see 

page 61). 

Co?nJ>osition, etc., of Alcohols. 

An Alcohol is a volatile organic compound, which contains no N, has a great affinity 
for water, and reacts with acids, forming H 2 and ethers. Alcohols are therefore analo- 
gous to the metallic hydrates, and Ethers to salts. They are obtained by distillation from 
the fermented product of grape-sugar, or some substance (as starch) easily converted into 
grape-sugar, which, in the presence of certain low vegetable organisms (as the yeast 
plant), splits up into Alcohol and C0 2 ; and may be made synthetically by shaking de- 
fiant gas (C 2 H 4 ) with strong Sulphuric Acid), then diluting and distilling. C 2 H 4 -f- 
H 2 = C 2 H e O, Ethylic Alcohol. Absolute Ethylic Alcohol, which is only used for 
chemical testing, is made by shaking Rectified Spirit with Potassium Carbonate, decant- 
ing, and distilling with slaked lime. 

Alcohol very slowly oxidized forms Aldehyde (C 2 H 4 0), if less slowly, Acetic acid 
(C 2 H 4 2 ), if quickly as in burning, C0 2 and H 2 0, which are in all cases the ultimate 
products of its continued oxidation. 

Physiological Action. 

Alcohol is a cerebral excitant and depressant and a narcotic poison. 
It is anaesthetic, antiseptic, and antiparasitic, a mild counter-irritant, and 
it coagulates albumen by abstracting its water. It is very diffusible, and 
is partly oxidized by the organism, part being excreted unchanged. 

In small doses, Alcohol relaxes the vessels, stimulates the gastric glands, 
promotes appetite and digestion, lessens the elimination of waste-products 
(urea and C0 2 ), causes a subjective sensation of heat, and slightly raises 
the body temperature. It briefly stimulates the heart, prolonging its 
systole and reducing the length of the diastole, and increases the func- 
tional activity of all the organs. A portion is oxidized by the organism 
(about gjss in twenty four hours), yielding force which is utilized as 
nervous, muscular and glandular power. 

The continued use of small or moderate doses congests the stomach 
and liver, over-stimulating the gastric glands and the hepatic cells to the 
production of pathological secretions, causing gastric catarrh and morn- 
ing-vomiting of mucus, and impairing digestion. By irritation it sets 
up hyperplasia of the submucous connective tissue (sclerosis), especially 
in the stomach, brain, kidneys and liver (cirrhosis) ; produces fatty de- 
generation (steatosis) of the blood, the arterial walls, and the various 
organs, and depresses the heart and the arterial tension. Epilepsy, 
paraplegia, amaurosis and insanity may result from the long-continued 
use of spirits, alcohol having an especial affinity for the nervous system. 
The malt liquors (beer, ale, etc.) are less prone than the spirituous to 



ALCOHOL. . 89 

affect the brain, but are even more apt to set up fatty degeneration of the 
liver and heart 

In large doses Alcohol precipitates pepsin and destroys its activity as a 
ferment, arrests digestion, produces exhilaration, intoxication, hallucina- 
tions, delirium, muscular incoordination, depression of the heart, lowered 
arterial tension and body temperature, abolished reflexes and coma. 

A toxic dose, after a very brief period of excitement, produces insen- 
sibility, stertorous breathing, dilated or contracted pupils, complete 
muscular resolution, and death by paralysis of the heart and respiration. 

Acute Alcoholism may be confounded with apoplexy, opium narcosis, 
concussion of the brain, and even acute pneumonia, — the differential 
diagnosis being impossible to make in the^ stage of deep coma. The 
pupils are not a trustworthy indication, as in alcoholism they may be 
either dilated or contracted. 

Alcohol is a food within narrow limits, gjss per diem being the probable 
quantity which the adult organism can oxidize, more than this being 
probably poisonous, as it sets up structural changes in the various organs, 
and lowers the power of resistance to morbific influences. It has fre- 
quently caused an intractable form of phthisis. The very young and 
the very old stand more alcohol relatively than the adult. It has been 
proven to exist normally in the human organism. 

Treatment of Acute Alcoholism. 
The stomach should be evacuated, Ammonia by inhalation cautiously, warmth applied 
to the extremities, cold affusion to the head, faradism of the muscles of respiration. Milk, 
mucilaginous drinks, black coffee, are useful afterwards. Lupuline as a substitute stimu- 
lant, Chloral (cautiously) to secure sleep, but is dangerous in old topers. Capsicum is 
excellent for the same purpose in 20 to 30 grain doses. Nutritious, digestible diet in 
fluid form and small quantity frequently repeated. The Chloride of Ammonium, about 
5 ss in half a pint of water at one draught, has a marvellous effect in generally straight- 
ening up the victim^ antagonizing stupor, and restoring faculties. 

Therapeutics. 

Though Alcohol is decidedly injurious in health, in disease it is a most 
useful agent. It is invaluable in diphtheria, poisoning by cardiac depres- 
sants and snake-venom, adynamic fevers and cardiac failure from any 
cause. It is an excellent dressing to wounds and bed-sores, may prevent 
colds from exposure by relaxing the peripheral vessels and restoring the 
balance of the circulation, and in phthisis it does good if it promotes 
digestion and assimilation. In atonic indigestion of nervous and depressed 
subjects, cholera infantum, diarrhoea, etc., brandy is universally found to 
be beneficial. In the vomiting of yellow fever or of sea-sickness iced 
champagne is very efficient. In anaemia and chlorosis good red wines 
are almost indispensable, as also in convalescence from acute diseases, 
sudden and profuse hemorrhage, and in many other morbid conditions. 

Koumiss is an excellent food and stimulant in feeble digestion, phthisis, 
chronic bronchitis, and in all adynamic states in which the effects of 



90 ALLIUM ALNUS ALOE. 

alcohol and nutrients are indicated. The stomach is very tolerant of 
koumiss even when it will bear nothing else, and as it increases the body 
nutrition remarkably it is of great value in the treatment of all the 
cachexias. Each quart is estimated to contain 4 ounces of solid food, 
besides 1 to 3 per cent, of alcohol. (See also under Kumyss, per Index.) 

ALLIUM, Garlic, — is the bulb of Allium sativum, a plant of the 

nat. ord. Liliaceae, indigenous to Asia, but cultivated in Europe and 

America. It is sub-globular and compound, consisting of eight bulblets, 

covered by dry, membranous scales. Its odor is pungent and disagreeable 

and its taste is warm and acrid. It contains a Volatile Oil, which consists 

mainly of the Sulphide of Allyl (C 3 H 5 ) 2 S, on which its qualities depend. 

Allied species are Allium Cepa, the Onion, and Allium Porrum, the 

Leek. 

Syrupus Allii, Syrup of Garlic, — contains 15 per cent, of Garlic, Sugar 60, Dilute 
Acetic Acid 40 parts. Dose, 3 j-iv, according to age. 

Physiological Action and Therapeutics. 
Garlic, Leeks and Onions are stimulant to the digestion and to the 
nervous system, and are supposed to have a special influence upon the 
bronchial secretion. Garlic is also thought to be emmenagogue and an- 
thelmintic. It promotes diaphoresis and diuresis, and acts as a tonic and 
carminative. Many persons use it as a condiment. Large doses will 
often produce gastric irritation, flatulence, hemorrhoids, headache and 
fever. In domestic practice it is frequently employed as an external 
application in the cutaneous eruptions of children, and as a poultice or 
liniment in infantile disorders of many kinds. Internally it is of real 
benefit in feeble digestion and flatulence, chronic catarrhal affections of 
children, in nervous and spasmodic coughs and in nervous vomiting. 

ALNUS, Alder-Bark (Unofficial), is the bark of Alnus serrulata, 
the common American Alder, a small tree of the nat. ord. Betulaceae. 
It has similar properties to those of A. glutinosa, the European Alder, 
and A. urcana, the Tag Alder, and contains a tannic acid, an oil and a 
resin. The bark and leaves are astringent and bitter, and are chiefly 
used as gargles for the throat, as local applications to wounds and ulcers, 
and to restrain the secretion of milk. Dose of the powdered bark gr. x, 
in decoction or infusion, several times a day. The Tag Alder is highly 
recommended as a hemostatic. 

ALOE, Aloes, — is. the inspissated juice of the leaves of Aloe soco- 
trina, a plant of the nat. ord. Liliaceae, inhabiting the island of Socotra 
and the eastern coast of Africa near the southern shore of the Red Sea. 
It has orange-colored flowers and resembles in appearance the American 



ALOE. 91 

aloe or century-plant (Agave americand). It occurs in soft masses, hard 
exteriorly, of a yellowish-brown color, fragrant odor and bitter taste, 
soluble in alcohol and in boiling water, and containing a peculiar volatile 
oil, a resin and Soaloin, C 15 H 16 7 , a variety of the principle Aloin, which 
is common to all varieties of aloes, — also Aloetic and Chrysammic Acids. 
Dose, gr. j-v. 

Other varieties are Aloe Barbadensis, Barbadoes Aloes, from Aloe 
vulgaris ; and Aloe Capensis, Cape Aloes, from Aloeferox, the first of 
which is official in the Br. Phar. 

Preparations. 

Aloe Purijicata, Purified Aloes, — prepared by heating with alcohol, strainirjg and 
evaporating. Is almost entirely soluble in alcohol. Dose, gr. j-v. 

Extraction Aloes Aquosum, Watery Extract of Aloes, — prepared by mixing I with 10 
parts of Boiling Distilled Water, standing 12 hours, decanting, straining and evaporating. 
Dose, gr. ss-v. 

Tinctura Aloes, Tincture of Aloes, — has of Aloes 10, extract of Glycyrrhiza 10, Di- 
luted Alcohol to 100 parts. Dose, ^ss-ij. 

Tinctura Aloes et Myrrhcz, Tincture of Aloes and Myrrh, — Aloes 10, Myrrh 10, 
Alcohol to 100 parts. Dose, gss-ij. 1 

Vinum Aloes, Wine of Aloes, — has of Aloes 6, Cardamom I, Ginger 1, Stronger White 
Wine to 100 parts. Dose, gj-iv. 

Pilule Aloes, Pills of Aloes, — each has of Aloes, gr. ij with the same quantity of Soap. 

Pilulce Aloes et Asafetidte, Pills of Aloes and Asafetida, — each contains gr. !)/( of each 
ingredient. 

Pilulce Aloes et Ferri, Pills of Aloes and Iron, — each pill contains gr. j each of Aloes, 
Sulphate of Iron and Aromatic Powder, with Confection of Rose. 

Pilulce Aloes et Mastiches, Pills of Aloes and Mastic, Lady Webster's Pill, — each has 
of Aloes gr. ij, Mastic gr. ss, Red Rose gr. ss. 

Pilulce Aloes et Myrrhcz, Pills of Aloes and Myrrh, — each contains of Aloes gr. ij, 
Myrrh gr. j, Aromatic Powder gr. ss, mixed with Syrup. 

Pulvis Aloes et Canelhe, Powder of Aloes and Canella (Unofficial), — contains the pow- 
dered bark of Canella alba. Dose, gr. v-xx. 

Aloes is also a constituent of Pilulae Rhei Composite and Tinctura Benzoini Com- 
posita — (which see, per Index). 

Physiological Action. 
Aloes is a tonic-astringent and resin-bearing purgative, an emmena- 
gogue and an anthelmintic against the thread-worm. As a cathartic it 
acts chiefly on the lower half of the large intestine, in doses of gr. j-iv 
producing in about 10 hours copious soft evacuations with some griping 
pain. This effect is produced whether the drug be taken internally or 
absorbed from an exposed surface, so that it probably diffuses into the 
blood and is eliminated by the mucous membrane of the colon. It is a 
stomachic tonic in small doses, a stimulant of the hepatic functions, and 
an excitant of the pelvic circulation. It may cause abortion in the 
female and priapism in the male, and is said to have frequently produced 
hemorrhoids, which if existing it will certainly aggravate. Given to 
nursing mothers it imparts a purgative quality to their milk. 

Therapeutics. 
Aloes is chiefly used in combination with Iron, Myrrh, Nux-vomica, 
etc., for amenorrhcea and chronic constipation with atonic dyspepsia and 



92 ALTH^A ALUMEN. 

hypochondriasis. It is curative in certain forms of hemorrhoids, especially 
those occurring after delivery and where the condition is not one of 
active pelvic congestion. It is also used internally and as an injection 
in gonorrhoea, and for simple atonic jaundice. It must be avoided in 
irritable rectum, hemorrhoids of active form, menorrhagia and pregnancy, 
unless given in small doses and with care. The Pil. Aloes et Ferri is 
perhaps the most generally useful agent in anaemia, amenorrhcea and con- 
stipation of girls at the period of puberty. 

ALTHAEA, Marsh- Mallow, —is the peeled root of Althad offici- 
nalis, a European plant of the nat. ord. Malvaceae, occurring in dry 
cylindrical pieces, of white color, without pith, of faintly aromatic odor 
and sweetish mucilaginous taste. It contains about 35 per cent, each of 
vegetable mucus and starch, with 2 per cent, of Asparagin, also pectous 
matter, sugar, fixed oil, but no tannin. It is a constituent of Massa 
Hydrargyri and Pilulae Phosphori, and is much used as an excipient in 
extemporaneous pharmacy. Dose, indefinite. 

Syrupus Althcece, Syrup of Althaea, — has of Althaea 4 per cent., and should be freshly 
made. Dose, indefinite. 

Physiological Action and Therapeutics. 

Alth/Ea. is one of the best mucilaginous drugs, but has no active medi- 
cinal properties. It is used in Europe to make pectoral teas and syrups, 
and is extensively employed as a mucilaginous demulcent. The powdered 
root makes a good emollient poultice. In the German Pharmacopoeia a 
Compound Althaea Tea is official, which under the common name, 
"German Breast Tea," is a popular demulcent drink in bronchial 
affections, coughs, colds, etc. 

Asparagin is an organic principle, occurring in large rhombic crystals, 
and found in many other plants, as in the shoots of asparagus, vetches, 
potatoes, liquorice, the sweet almond, the root of the locust, etc. It is 
considered a derivative of Succinic Acid, and has diuretic properties, 
besides being sedative to the circulation. It maybe used in ascites, espe- 
cially in children, in the anasarca of Bright's disease, and in gout. Dose, 
gr. ij-iij, in water. 

ALUMEN, ALUM, Potassa-alum, — is the Sulphate of Potassium 
and Aluminium, K 2 A1 2 (S0 4 ) 4 . 24.H 2 0, which, when the 24 molecules of water 
are driven off, becomes Ahimen Exsiccatum, Dried Alum, K 2 A1 2 (S0 4 ) 4 . 
Alum occurs in large, octahedral crystals, or cubebs, of sweetish astringent 
taste and acid reaction. It is soluble in 10^ parts of water at 59 F., 
and in 0.3 part of boiling water, but is insoluble in alcohol. The 
Ammonia-alum (Aluminii et Ammonii Sulphas) was formerly official, and 
is still sold and dispensed as "Alum." Dose, gr. x-xx, — as an emetic 
5J for a child. 



ALUMINIUM. 93 

Preparation. 

Alumen Exsiccatum, Dried Alum, — is a white, granular powder, slowly soluble in 20 
parts of water at 59 F., and quickly soluble in 0.7 of boiling water. Dose, gr. x-xx. 

Physiological Action. 

Alum is an astringent, coagulating albumen and stimulating muscular 
contraction. At first it excites the flow of saliva and then markedly 
diminishes it. It coagulates pepsin and arrests digestion, stops peristalsis, 
and usually causes constipation, though sometimes inducing diarrhoea. 
Although coagulating albumen, even in weak solution, it enters the blood, 
constricts the capillaries, arrests secretions, especially those of mucous 
surfaces, and stops capillary hemorrhage. 

In teaspoonful doses Alum is an efficient and non-depressant emetic. 
In large doses it is a gastro-intestinal irritant, }>)5/% of dried Alum having 
caused the death of an adult in 8 hours. 

Therapeutics. 

Alum is used locally as an astringent in chronic catarrhs, leucorrhcea, 
gonorrhoea, hemorrhoids, bed-sores, ulcers, relaxed throat, colliquative 
sweats, catarrhal ophthalmia and granular lids. The dried powder is 
escharotic, destroying granulations and warty growths, and is used by 
insufflation in chronic nasal catarrh. 

Internally it is beneficial in gastric catarrh, gastralgia, enteralgia, pas- 
sive hemorrhages, lead colic and constipation. As an emetic it is em- 
ployed in croup, and it is a good antidote in lead-poisoning. 

Alum is best administered alone, as it forms precipitates with a large 
number of drugs. 

ALUMINIUM. — This metal is not official, though of its salts two 
are, besides Alum. They are — 

Aluminii Hydras, Hydrate of Aluminium, Hydrated Alumina, A1 2 H0 6 , — is a white, 
light, amorphous, tasteless powder, insoluble in water or alcohol, but soluble in strong 
alkaline or acid solutions. Dose, gr. iij-xx in powder or mixture. 

Aluminii Sulphas, Sulphate of Aluminium, Al 2 (S0 4 ) 3 .i8H 2 0, — is a white crystalline 
powder, soluble in 1.2 of water at 59 F., almost insoluble in alcohol. Used locally. 

Physiological Action and Therapeutics. 

The Hydrate is a feebly astringent and desiccant powder, occasionally 
used in inflammatory skin affections as a local application, and internally 
in diarrhoea. 

The Sulphate is antiseptic and astringent. It has been used internally 
in diarrhoeas, but is chiefly employed in a 5 per cent, solution locally to 
ulcers, or in stronger solution (^iij ad gvj) in foul discharges from mucous 
surfaces. A saturated solution is a mild caustic, and may be used daily 
as a local application to the enlarged tonsils, nasal polypi, ulceration of 



94 AMMONIACUM AMMONIUM. 

os uteri, and various chronic enlargements. The Benzoinated Solution 
of Alumina is an unofficial preparation used for the same purposes. 

AMMONIACUM, Ammoniac, — is a gum-resin, obtained from 
Dorema Ammoniacum, a Persian plant of the nat. ord. Umbelliferae, 
occurring in yellowish-brown tears of peculiar odor, and bitter, acrid and 
nauseous taste. When triturated with water it readily yields a milk-white 
emulsion, and contains a Volatile Oil, which differs from that of Asafcetida, 
in that it is neither sulphuretted nor phosphoretted. It also contains 
resin, gum, gluten, etc. Dose, gr. x-xxx. 

Misttira Ammoniaci, Ammoniac Mixture, — is an emulsion with water of 4 per cent, 
strength, the resin being suspended by the contained gum. Dose, ,^ss-j. 

Emplastrum Am??wniaci, Ammoniac Plaster. — Ammoniac 100 parts, digested with 140 
of Dilute Acetic Acid until emulsionized,then strained and evaporated. 

Emplastrum A?nmoniaci cum Hydrargyro, Ammoniac Plaster with Mercury. — Am- 
moniac 72, Mercury 18 per cent., and contains also Lead-plaster, Sulphur, Olive Oil, and 
Dilute Acetic Acid. 

Ammoniac isastimulating'expectorant and a laxative, and has a mildly 
irritant action on the skin. Its actions are similar to those of Asafcetida, 
but much less powerful. It is not much used, but may be employed with 
benefit in chronic bronchial affections, especially of the aged, the mix- 
ture with the Chloride or Carbonate of Ammonium facilitating expectora- 
tion and lessening wheezing. It is also recommended in asthma, and in 
glandular enlargements and indolent swellings the plasters are employed 
as stimulating alteratives and resolvents. 

AMMONIUM, NH 4 , — is a hypothetical compound radical, which 
does not exist in the free state, but which in combination with acids forms 
salts which closely resemble those of the elements Potassium and Sodium. 
Many of its salts are official, as well as the aqueous solutions of the gas 
Ammonia, NH 3 , which is produced during the putrefaction of all organisms, 
and of many organic nitrogenous compounds existing in the air and in 
the soil in the free state. The chief commercial source of Ammonium 
salts is the ammoniacal liquor from gas-works and bones. 

Preparations of Ammonia. 

Aqua Ammonia, Water of Ammonia, — is an aqueous solution of Ammonia, containing 
Y^th by weight of the gas. It is a colorless liquid of pungent odor, acrid taste and strongly 
alkaline reaction. Sp. gr. 0.959 at 59° F. Dose, rr^v-^ss, well diluted. 

Aqua Am?nonia Fortior, Stronger Water of Ammonia, — contains 28 per cent, by 
weight of the gas. Sp. gr. 0.900 at 59 F. 

Spiritus Am?noni&, Spirit of Ammonia, — is a 10 per cent, solution of the gas in alcohol. 
Sp. gr. about 0.810. Dose, VC^x-g], diluted. 

Spiritus Afnmonice Aromaticus, Aromatic Spirit of Ammonia, — contains Ammonium 
Carbonate, Aqua Ammonke, Oils of Lemon, Lavender, and Pimenta, Alcohol and 
Water. Used in the Tinct. Guaiaci Ammoniata and the Tinct. Valerianae Ammoniata. 
Dose, ^ss-ij. 

Linimentum Ammonia, Ammonia Liniment, — has of Aqua Ammonke 30 parts, Cotton- 
seed Oil 70. 



AMMONIUM. 95 

Ammonium Salts and their Preparations. 

Liquor Ammonii Acetatis, Solution of the Acetate of Ammonium, Spirit of Mindere- 
rus, — is prepared by neutralizing Dilute Acetic Acid with Carbonate of Ammonium, and 
contains about 7^ per cent, of the Acetate. It should be freshly made. Used in Mis- 
tura Ferri et Ammonii Acetatis. Dose, ^j-^j. 

Ammonii Benzoas, Benzoate of Ammonium, NH 4 C 7 H 5 2 , — in minute four-sided 
laminar crystals, soluble in 5 of water and 28 of alcohol at 59 F. Dose, gr. v-xv. 

Ammonii Bromidum, Bromide of Ammonium, NH 4 Br, — in prismatic crystals or as a 
granular salt, soluble in i]/ z of water and 150 of alcohol at 59 F. Dose, gr. x-^ss, 
well diluted. 

Ammonii Carbonas, Carbonate of Ammonium, NH 4 HC0 3 .NH 4 NH 2 C0 2 , — occurs 
in white masses consisting of both the bicarbonate and carbonate, which on exposure to 
air becomes a white powder (acid carbonate). Soluble in 4 parts of water at 59 F. 
Dose, gr. v-x. 

Ammonii Chloridum, Chloride of Ammonium, Sal-ammoniac, HN 4 C1, — a white, 
crystalline powder, of saline taste, and slightly acid reaction ; soluble in 3 of water and 
very sparingly in alcohol. Dose, gr. j-xx. 

Trochisci Ammonii Chloridi, Troches of Cnloride of Ammonium. — each contains 2 
grains of the chloride. 

Ammonii lodidum, Ioiide of Ammonium, NHJ, — a deliquescent, granular, white 
salt, soluble in I of water aad 9 of alcohol at 59 F. Dose, gr. ij-x. 

Ammonii Nitras, Nitrate of Ammonium, NH 4 N0 3 , — in colorless crystals or fused 
masses, soluble in 0.5 of water and 20 of alcohol at 59 F. Only used to prepare Nitrous 
Oxide Gas by heating to 365 F., for anaesthesia. 

Ammonii Phosphas, Phosphate of Ammonium (NH 4 ) 2 HP0 4 , — in colorless prisms, 
soluble in 4 of water, insoluble in alcohol. Dose, gr. v-xx. 

Ammonii Sulphas, Sulphate of Ammonium (NH 4 ) 2 S0 4 , — is only used for the prepara- 
tion of other ammonium salts. 

A?nmonii Valerianas, Valerianate of Ammonium NH 4 C 5 H 9 2 , — in white, quadrangu- 
lar plates, deliquescent; very soluble in water and alcohol. Dose, gr. j-v. 

RaspaiVs u Eau Sedative " (Unofficial), — consists of Aqua Ammonias 3 ij, Sodii Chlori- 
dum ^ij, Spiritus Vini Camphorat. Jiij, Aqua ^ xxxij. For local use. 

Physiological Action. 

The gas Ammonia is intensely alkaline and irritant to mucous mem- 
branes ; inhaled producing spasmodic cough and a sense of suffocation. 
Its prolonged inhalation will induce violent inflammation of the air- 
passages and oedema of the glottis. It stimulates the nasal branch of the 
fifth nerve, exciting the vaso-motor centre by reflex action, and thus rais- 
ing the arterial tension. Applied to the skin and allowed to evaporate, 
it has a slight rubefacient effect, but if evaporation be prevented it pene- 
trates the epidermis and has a powerfully vesicant action. The Aqua, 
swallowed undiluted, may cause death quickly by suffocation from the 
action of its vapor upon the air-passages ; if not, it may excite gastro- 
enteritis accompanied by coma, differing in the latter respect from 
potassium or sodium poisoning. After absorption it stimulates both the 
respiration and the circulation by direct action on their respective nerve- 
centres. Ammonia exists normally in the circulation, where it keeps the 
fibrin in solution and thus maintains the fluidity of the blood. It in- 
creases the glycogenic function of the liver, and is converted finally into 
urea. It is a powerful irritant to muscular tissue, causing tetanic contrac- 
tion and subsequent rigor mortis when directly applied. 

Ammonium Salts all stimulate and finally paralyze the spinal cord, 



96 AMMONIUM. 

motor nerves and muscles, in animals, but the order and readiness of the 
action vary with the salts employed, some having a predominating influ- 
ence on the cord, others on the motor nerves. In general they may be 
said to form a series, of which the members at one end stimulate the cord, 
and those at the other paralyze both the cord and the motor nerves. At 
the stimulant end are Ammonia and the Chloride ; at the paralyzant end 
the Iodide ; the Bromide, Phosphate and Sulphate lying between (Brun- 
ton). In medicinal doses they act on man as stimulating expectorants, in 
large quantity they injure the structure of the red blood-corpuscles, and 
if long-continued they produce rapid emaciation by impairing digestion 
and increasing-tissue-waste. 

The Chloride has decided cholagogue powers, increases the excretion 
of urea, in 20-grain doses is purgative, and is considered to have a select- 
ive action upon the gastric mucous membrane. The Carbonate is a 
powerful and very diffusible stimulant ; when administered internally in 
moderate doses it is probably decomposed by the HC1 of the gastric 
juice, nascent ammonia being set free and absorbed. It stimulates the 
respiratory centre, acts as a stimulating expectorant, and in very small 
doses stimulates the secretion of the gastric juice. It is also emetic, and 
has been supposed to prevent iodism when administered conjointly with 
Iodide of Potassium. The Solution of the Acetate is an active dia- 
phoretic if the body be warm, or a diuretic if it be cool. In wineglassful 
doses it will counteract many of the immediate effects of alcohol. The 
Phosphate is diuretic, and is believed to decompose the insoluble Urate 
of Sodium in the blood, converting it into the soluble salts Urate of 
Ammonium and Phosphate of Sodium, and thus promoting its elimina- 
tion. The Benzoate is also diuretic, and like Benzoic Acid passes out of 
the system in the urine as Hippuric Acid. It acidifies the urine where 
there is phosphatic tendency of the same. The Nitrate and Sulphate are 
only used for the preparation of other salts, while the Iodide, Bromide 
and Valerianate correspond in action to that of their titular bases, and 
are described under their respective titles, Iodum, BROMUMand Valeriana. 

Antagonists to Ammonia. 
When inhaled, give HC1 vapors by inhalation to form the chloride ; if taken in solu- 
tion, give Vegetable Acids, and demulcents to protect the mucous surfaces. Its physio- 
logical antagonists are the cardiac sedatives, Aconite, Digitalis, Veratrum, etc. 

Therapeutics. 
The strong solution of Ammonia may be used as a rubefacient and 
vesicant, and its vapor, by cautious inhalation, in syncope and the results 
of shock. Locally, it is a good application to bites of the less venom- 
ous reptiles and to the stings of insects. The Carbonate is used inter- 
nally in the eruptive fevers, delirium tremens, continued fevers, pneu- 
monia, etc., where much depression exists; as a stimulating expectorant 



AMMONIUM. 97 

in chronic bronchitis, in the broncho-pneumonia of children, and in 
cardiac asthma. It is highly recommended in scarlet fever in doses of 3 
to 5 grains every one, two or three hours, all acid drinks or fruits being 
prohibited while it is being administered. With ten-minim doses of tinc- 
ture of capsicum in an ounce of some bitter infusion it is exceedingly 
efficient, in 5-10-grain doses, for the sinking sensations and craving for 
stimulants experienced by subjects of alcoholism. It may be used as an 
emetic in bronchitis, when the tubes are choked with mucus and the cir- 
culation of the patient is weak. It may also be employed by inhalation, 
and administered internally, for similar purposes as Liquor Ammoniae. 

In dose of 5 grains, administered hypodermically in the vicinity of wounds caused by 
poisoned arrows, the carbonate was repeatedly used by Stanley's surgeon in Africa, with 
entire success in saving life when so employed immediately after injury. Those so 
wounded at too great a distance to receive this treatment invariably died within a short 
period of time. ■» 

The Chloride has a high repute in catarrh of the stomach, with anorexia, 
bad taste in the mouth, flatulence, coated tongue, etc., in short, the 
symptoms of so-called " biliousness ; " also, in chronic congestion of the 
liver, jaundice from catarrh of the bile-ducts, nervous and sick headaches, 
myalgia, amenorrhcea, muscular rheumatism and neuralgia. In the latter 
affection it should be given in 30-grain doses several times a day. It 
is also efficient in bronchial catarrh without fever, and in chronic bronchitis 
when the secretion is scanty and tough. It is remarkably efficient in 
straightening up a victim of acute alcoholism ; to one almost on the verge 
of delirium tremens, a y 2 drachm in half a pint of water, swallowed at 
one draught, will restore the patient's faculties so quickly as to astonish 
one who has never seen it so employed. Locally, in solution, it has 
been well employed in inflammatory swellings, as sprains, inflamed joints, 
orchitis, etc., as a lotion; also, to allay itching in prurigo, to remove 
ecchymoses and glandular enlargements. Eau Sedative is often a good 
local application in headaches. 

The Solution of the Acetate is especially beneficial in the exanthe- 
mata, influenza, coryza, anomalous febrile conditions of children, acidity 
and vomiting; also, in erysipelas when there is feeble circulation, cyan- 
osis and delirium. It is frequently combined with Spirit of Nitrous Ether, 
as a diuretic and diaphoretic in febrile affections. The Phosphate is 
particularly applicable to gout and lithsemia, and is a very efficient chola- 
gogue. The Benzoate is useful in cystitis with alkaline urine and phos- 
phatic deposits, as it acidulates the urine, at the same time stimulating 
and disinfecting the mucous coat of the bladder. 

Aqua Ammonite has been administered by intra-venous injection, with 
efficacy and safety, in sudden or threatened thrombosis, cardiac paralysis 
from Chloroform, and in poisoning by Hydrocyanic Acid and other car- 
diac depressants. In the same manner, it has been employed, but unsuc- 
7 



98 AMYGDALA. 

cessfully, in poisoning by the bite of venomous reptiles. Ten drops of the 
strong Liquor are diluted with three parts of water, and carefully injected 
into a vein, all air being rigorously excluded from entrance thereinto. 

The therapeutics of the Iodide, Bromide and Valerianate are enume- 
rated under the titles Iodum, Bromum and Valeriana respectively. 

AMYGDALA, Almond, — the seeds of two varieties of Amygdalus 
communis (nat. ord. Rosaceae), namely Amygdala amara and Amygdala 
dulcis, are official, together with several preparations, some prepared from 
one variety, some from another, while one is from either and one from 
both. An important point is the reaction between Amygdalin and 
■Emulsin in the presence of water producing Hydrocyanic Acid (see ante, 
page 68). Amygdalin, C 20 H 27 NO n , is a crystalline glucoside, existing in 
Amygdala amara but not in Amygdala dulcis ; while the ferment Emulsin 
is common to both varieties. 

Amygdala Amara, Bitter Almond, — is the seed of Amygdalus commu- 
nis, var. amara, a tree of the nat. ord. Rosaceae, indigenous to Western 
Asia, but cultivated in many other parts of the world. The seed is lanceo- 
late in shape, brownish in color, about an inch long, having a white, oily 
embryo of bitter taste, which, when triturated with water, emits an odor of 
Hydrocyanic Acid. Cultivated chiefly in Spain and the Balearic Islands. 

Amygdala Dulcis, Sweet Almond, — is the seed of Amygdalus commu- 
nis, var. dulcis, a tree of the nat. ord. Rosaceae. The bitter and sweet 
almond trees are identical botanically, and the fruits and seeds of the two 
varieties resemble each other closely, only differing in taste and the pres- 
ence of Amygdalin (see above). The sweet almond is largely cultivated 
about Malaga and in California. 

Preparations. 

Aqua Amygdala Amara, Bitter Almond Water, — is a weak solution of the Oil of 
Bitter Almond in Distilled Water (I to 1000). Is only a flavored water. Dose, indefinite. 

Oleum Amygdala Amara, Oil of Bitter Almond, — is a volatile oil, of peculiar and 
aromatic odor, bitter, burning taste, and neutral reaction ; soluble in 300 of water, but 
freely in alcohol and ether. Dose n^^-j, in mixture. 

This essential oil, one of the products of the reaction between Amygdalin and Emul- 
sin (see ante, p. 68), contains a varying quantity of Hydrocyanic Acid (3 to 14 per cent.), 
which may be removed by distillation with caustic potash. Nitrobenzol, or " Oil of Mir- 
bane," closely resembles the oil of bitter almond, and like it is used for flavoring. It 
contains no Hydrocyanic Acid, but is a dangerous poison, producing toxic effects when 
inhaled, even in small doses. 

Syrupus Amygdala, Syrup of Almond, — has of Bitter Almond 3 per cent., of Sweet 
Almond 10. Dose indefinite. 

Mistura Amygdala, Mixture of Amygdala, — made of Sweet Almond 6 per cent., with 
Acacia, Sugar and Water. A demulcent drink, used as a vehicle for cough mixtures. 
Dose, 3 ij- § ss. 

Oleum Amygdala Expressum, Expressed Oil of Almond, — is the fixed oil which is 
expressed from either Bitter or Sweet Almond. Used in Unguentum Aquae Rosae, and 
as a bland local application in skin affections. 



amyl nitris. 99 

Physiological Action and Therapeutics. 

The bitter and sweet varieties of the species Amygdalus communis differ 
in action only through the agency of the principle Amygdalin contained 
in the former. The Sweet Almond is demulcent and nutritive, while the 
fixed oil expressed from either variety is a bland application, having the 
same action as Olive Oil. The action of the Bitter Almond and its oil is 
due to the Hydrocyanic Acid contained in them (see ante, p. 68). 

The Expressed Oil of Almond is demulcent, and in doses of 3J-ij a 
mild laxative. It is used externally for excoriations, chapped hands, and 
inflammatory skin affections, and is applied to the ear in earache. The 
cake remaining after the expression of the fixed oil from the sweet almond 
is ground into flour, and used in the form of biscuits for diabetics as a 
substitute for bread, as it contains no starch. 

The Oil of Bitter Almond is used as a flavoring agent, and may be 
employed locally or internally in lieu of Hydrocyanic Acid. The Syrup 
is somewhat sedative, but is generally used as a demulcent or for flavoring 
purposes. The Mixture is used in catarrhal affections and as a vehicle for 
cough-mixtures. The poisonous character of the Bitter Almond and its 
essential oil (Oleum Amygdalae Amarae) should be kept in mind. 

AMYL NITRIS, Nitrite of Amyl, C 5 H n N0 2 ,— is a clear, yellow- 
ish liquid, of ethereal and fruity odor, aromatic taste, and neutral or 
slightly acid reaction, extremely volatile, insoluble in water but freely 
soluble in alcohol, ether, chloroform and benzin. It is produced by 
the action of Nitric or Nitrous Acid upon Amylic Alcohol, and when 
impure may have Nitric or Hydrocyanic Acid in it. Dose internally 
%}{-) dissolved in alcohol, — by inhalation ftbij-v; but larger doses are 
probably safe. 

Unofficial Analogue. 

Nitroglycerinum, — Nitroglycerin, Glonoin, Trinitrin, Trinitrate of Glyceryl, C 3 H 5 - 
(N0 3 ) 3 , — is a clear, oily liquid, insoluble in water, but soluble in alcohol, ether, oils, etc., 
produced by the action of nitric and sulphuric acids upon glycerin. Is a dangerous ex- 
plosive, and should not be kept in stronger solution than I per cent. Dose, TTb^o to 3iy 
or more, according to susceptibility. 

Unofficial Preparations of Nitroglycerin. 

Tinctura Nitroglycerini, Tincture of Nitroglycerin, — a I per cent, solution in alcohol. 
Dose, tt\^-x. The strong tincture sold by the homoeopathic pharmaceutists and official 
in their American Pharmacopoeia is a 10 per cent, solution, or ten times the strength of 
the above. It is an extremely dangerous preparation, both as an explosive and as a 
medicine. (See American Homoeopathic Pharmacopeia, 2d ed., Boericke & Tafel, 1883, 
page 235.) 

Tabetics Nitroglycerin^ B. P., — Tabellse Trinitrini, — are tablets of chocolate, each 
containing gr. T -J- 7 of pure Nitroglycerin. Dose, j-ij. 

Other Nitrites. 

Sociii Nitris, Nitrite of Sodium, and Potassii Nitris, Nitrite of Potassium (both unoffi- 
cial), are used as substitutes for Amyl Nitrite and Nitroglycerin. The former is a white, 



100 AMYL NITRIS. 

granular powder, deliquescent, with a cool, saline taste, very soluble in water, is made by 
heating Sodium Nitrate, and has the formula NaN0 2 . Dose, gr. J^-v, according to 
individual susceptibility. 

Ethyl Nitrite, C 2 H 5 N0 2 , — constitutes 5 per cent, of Spiritus ^Etheris Nitrosi. (See 
ante, page 80.) 

Physiological Action. 

Nitrite of Amyl and the other Nitrites agree closely in their general 
action, producing great vascular dilatation by paralyzing either the sym- 
pathetic system, the vaso-motor centre or the muscular coat of the arteri- 
oles, — which, is yet undecided. They cause tumultuous action of the heart 
by relaxing its inhibition ; — lowered respiration, from paralysis of the re- 
spiratory muscles and impairment of the ozonizing function of the blood ; 
— diminution of sensation, motility, and reflexes ; — a sense of heat, but 
lowered body-temperature ; also throbbing pain in the head, beating 
carotids, quickened pulse, flushed face and vertigo. 

The effect of an ordinary inhalation of Amyl Nitrite on man is very 
transitory, excepting the headache, which may last several hours. Of the 
nitrites it is the most prompt but least enduring in action, and is best 
administered by inhalation. It causes sugar to appear in the urine and 
increases the quantity voided. Mixed with blood it forms methaemoglobin, 
which is not so readily deoxidized as haemoglobin, and under its influence 
the blood in the body becomes of a dark chocolate color both in the 
arteries and in the veins. 

Nitroglycerin acts similarly, but less promptly, and its action is more 
enduring. Its headache is of intensely frontal character, and persists for 
hours after the other effects have passed off. It is more suitable for inter- 
nal administration. 

Nitrite of Sodium is also slower in action than Amyl Nitrite, and does 
not cause so much throbbing headache as Nitroglycerin. It may be 
given in solution with water. 

The action of all these agents is probably due to the Nitrous Acid 

contained in them. 

Antagonists. 

Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin, and all other agents 
which increase the functional activity of the spinal cord and sympathetic are antagonistic, 
though by reason of their slower rate of diffusion the antagonism may not be always avail- 
able. Stimulants, artificial respiration, the alternate cold and hot douche, with cold to the 
head, and Ergotin or Atropine subcutaneously, are the best means to be used in cases of 
poisoning by the Nitrites. 

Therapeutics. 
The inhalation of Amyl Nitrite is a useful palliative in angina pectoris, 
epilepsy, tetanus, and many of the respiratory neuroses, as spasmodic 
asthma, whooping-cough, laryngismus stridulus, etc. It is also indicated 
in migraine of the pale-face form, and in the cold stage of intermittents 
and pernicious remittents, to prevent internal congestion, — also in convul- 



AMYLUM. IOI 

sions of various kinds, including the puerperal. It has been sometimes 
used in threatened death from chloroform anaesthesia, and in poisoning 
by strychnine. 

Nitroglycerin has been used with benefit in neuralgic dysmenorrhcea, 
sea-sickness, and in chronic interstitial nephritis, by redistributing to the 
kidneys their blood-supply cut off by degeneration of the renal ganglionic 
centres. It promptly relieves hiccough, migraine of spasmodic character, 
and has afforded immediate relief in neuralgia of the fifth. Its adminis- 
tration in angina pectoris, though not producing such prompt results as 
that of Amyl Nitrite, gives excellent and much more lasting effects. It 
is useful in the weak heart of the aged, or that from fatty degeneration, 
or when, as in Bright's disease, the arterial tension is above normal ; also 
in irritable and overacting heart, which it relieves by lowering arterial 
tension. 

Nitrite of Sodium has been successfully employed in angina pectoris, 
hemicrania, and in asthma of purely bronchial and neurotic origin. It 
has also proved decidedly beneficial in the abnormally high arterial ten- 
sion of chronic desquamative nephritis, especially when complicated with 
a weakened and dilated heart. 



AMYLUM, Starch, C 6 H 10 O 5 , — is the fecula of the seed of Triticum 
vulgare, common wheat, a plant of the nat. ord. Graminaceae. Though 
wheat starch is the official kind, any other might be properly used, as the 
starch occurring in barley, oats, arrow-root, sago and tapioca, all of which 
foods were official in the U. S. P. of 1870. The last three are entirely com- 
posed of starch ; wheat contains about 70 per cent., and rice 90 per cent. 

Starch is a carbo-hydrate, and occurs in distinct grains, forming irregular, angular masses, 
white, inodorous, and tasteless, easily pulverized, of neutral reaction, and insoluble in 
alcohol, ether or cold water. Under the microscope the granules are seen to be lenticular 
in form and concentrically striated. When boiled with water it yields a whitish jelly of 
bluish tinge, which when cool gives a deep blue color with test-solution of iodine, the 
color disappearing on warming and returning on cooling. 

By boiling with dilute mineral acids starch is converted into glucose, 
dextrin being formed as an intermediate product. Hot concentrated nitric 
acid converts it into oxalic acid, but cold fuming nitric acid dissolves it, 
forming an explosive compound. Diastase, ptyalin and pancreatin con- 
vert it into glucose. [For Glycogen, Dextrin, Cellulose and other allied 
substances see the article Saccharum in the following pages.] 

Amylum Iodatutn, Iodized Starch, — has of Starch 95 parts, Iodine 5, triturated with 
distilled water and dried. Used as a method of giving Iodine {see Iodum). Dose, 

3J~.1 SS - 

Glyceritum Amyli, Glycerite of Starch, — has of Starch 10 parts, Glycerin 90, tritu- 
rated and heated to a transparent jelly. Used as a vehicle for external applications. 

Starch, though a nutritive of the first order, may be regarded as inert 



102 ANISUM ANTHEMIS. 

medicinally. It serves as a protective and absorbent if dusted over the 
skin, as a vehicle for enemata, and as an antidote in iodine-poisoning. 
Mixed with glue it makes an excellent stiff bandage for surgical purposes. 

ANISUM, Anise, — is the fruit of Pimpinella Anisum, a European 
plant of the nat. ord. Umbelliferae. It occurs in ovate bodies, y& inch 
long, hairy, of grayish color, aromatic odor, and sweet, spicy taste, 
resembling conium fruit in appearance. Dose, gr. x-xx. 

Preparations. 

Oleum Anisi, Oil of Anise, — is a volatile oil distilled from Anise or from Illicium 
anisatum (the star-anise), and represents the medicinal qualities of the plant. That from 
Anise congeals at 50 to 59 F., and is soluble in an equal part of alcohol. That from 
Illicium congeals at about ZS}i° F- The oil is an ingredient of Tinctura Opii Cam- 
phorata, Trochisci Glycyrrhizse et Opii, and of the two following preparations. Dose, 

Aqua Amsi, — has in 500 parts 1 of Oil of Anise mixed with distilled water by the aid 
of cotton. Dose, indefinite. 

Spiritus Anisi, — is a 10 per cent, solution of the oil in alcohol. Dose, 3 j-ij. 

The Volatile Oil is the active constituent of Anise. It has a slightly 
stimulant action on the heart and the digestive organs, and liquefies the 
bronchial secretion, being probably in part excreted by the bronchial 
mucous membrane. It is a favorite flavoring ingredient of cough-mix- 
tures, and relieves slight intestinal colic and flatulence in children. In 
full doses it has a weak narcotic power. 



ANTHEMIS, Chamomile,— the flower-heads of Anthemis nobilis, 
a European perennial of the nat. ord. Compositae, collected from culti- 
vated plants. Chamomile-flowers are sub-globular, about ^ inch broad, 
having numerous white, three-toothed florets on a conical, solid receptacle, 
a strong but agreeable odor, and an aromatic, bitter taste ; and contain a 
volatile oil, a camphor and a bitter principle but no alkaloid. There are 
no official preparations. An infusion (giv to Oj) may be given in doses 
of gj-ij. 

Oleum Antkemidis, Chamomile Oil (Unofficial), — the volatile oil is of a dark blue or 
green color, and is composed of various ethers, the Angelates and Valerianates of Butyl 
predominating. Dose, rr^ ij-x, on sugar. 

Physiological Action and Therapeutics. 
Chamomile is a stomachic tonic. It improves the appetite and aids 
digestion by increasing the vascularity of the gastric mucous membrane. 
In large doses the warm infusion is emetic, and perhaps diaphoretic, 
though the latter action is chiefly due to the hot water. The oil is re- 
markably efficient in reducing reflex excitability in frogs, even after its 
excitation by Strychnine or Brucine. 



ANT1M0NIUM. IO3 

Chamomile is popular in domestic practice. An infusion is used by 
nurses for many infantile complaints, and externally as a fomentation to 
relieve pain, as in colic, etc. The oil is very efficient in reflex cough, 
pulmonary catarrh, acute dyspepsia, diarrhoea of children, spasmodic 
asthma, whooping-cough, colic, and the spasmodic and pseudo-neuralgic 
affections of hysterical women. It should prove extremely useful in poi- 
soning by Strychnine, from its power over reflex excitability. 

The Chamomile of the homoeopaths is the Matricaria Chamomilla, or 
German Chamomile, official in the U. S. Pharmacopoeia as " Matri- 
caria," which see. 



ANTIMONIUM, Antimony, Sb.— Metallic Antimony is not 
official, nor is it used in medicine. It is represented, however, by the 
following official salts and preparations, viz. : 

Compounds of Antimony and their Preparations. 

Antimonii et Potassii Tartras, Tartrate of Antimony and Potassium, Tartar Emetic, 
2KSbOC 4 H 4 6 .H 2 0, — small white crystals or a granular powder of sweet, disagreeable 
metallic taste, soluble in 17 of water at 59 F., and in 3 of boiling water, insoluble in 
alcohol. Dose, gr. T \-^, but after tolerance is established as high as gr. ij may be given. 
Is an ingredient of the two following, viz. : 

Vinum Antimonii, Wine of Antimony, — has of Tartar Emetic 4, Boiling Distilled 
Water 60, Stronger White Wine to 1000 parts. Contains about 2 grains of Tartar 
Emetic to the ^ , and is an ingredient of Mistura Glycyrrhizae Composita. Dose, as a 
febrifuge and expectorant, TTLv-xv. 

Syrupus Scilhz Compositus, Cox's Hive Mixture, Hive Syrup (see under Scilla), — con- 
tains about 3j^f grain of Tartar Emetic to the £ , or more accurately 3 parts in 2000, with 
Squill, Senega, etc. Dose, rr^ j-^j, cautiously in children. 

Antimonii Oxidum, Oxide of Antimony, Sb 2 3 , — a heavy, gray powder, insoluble in 
water of alcohol, but readily and wholly soluble in Hydrochloric or Tartaric Acids. 
Dose, gr. j-iij. It constitutes j^d of — 

Pulvis Antimonialis , Antimonial or James' Powder, — consists of the Oxide of Anti- 
mony 33 parts, with 67 of Calcium Phosphate. Dose, gr. iij-viij, every 3 hours as a dia- 
phoretic, larger doses for emetic and cathartic effects. 

Antimonii Sulphidum, Sulphide of Antimony, Sb 2 S 3 , — is the native sulphide, purified 
by fusion, and as nearly free from Arsenic as possible, — steel gray masses, or a black, 
lustreless powder, insoluble in water or alcohol. Dose, gr. l£— j. 

Antimonii Sulphidum Purificatum, Sb 2 S 3 , — is purified by maceration in Aq. Ammo- 
niae, washing and drying. Dose, gr. %-]. 

Antimonium Sulphuratum, Sulphurated Antimony, — is chiefly Sb 2 S 3 , with a very 
small amount of Sb.,0 3 . A reddish-brown, odorless and tasteless powder, insoluble in 
water or alcohol. Is a constituent of Pil. Antimonii Compositae. Dose, gr. j-v. 

PUuIcb Antimonii Composita;, Plummer's Pills, — each pill containing gr. ^ each of 
Calomel and Sulphurated Antimony. 

Physiological Action. 
Tartar Emetic in its action represents the other official antimonial 
preparations, being a cardiac, arterial and general depressant, a proto- 
plasmic poison, a systemic and local emetic, a specific gastro-intestinal 
irritant, an expectorant and a diaphoretic. Like Aconite, Arsenic, Hy- 
drocyanic Acid and Potassium, it is destructive to protoplasm, destroying 
function in all nitrogenous tissue, and paralyzing the spinal cord, the motor 



104 ANTIMONIUM. 

nerves, the muscles and the sensory nerve terminations. It is especially 
depressant to the heart-muscle and the cardiac motor ganglia ; it combines 
with the red blood-corpuscles, lessening their oxidizing power, lowering 
the blood-pressure and reducing the body-temperature. Its taste is styp- 
tic and one of its earliest effects is the production of constriction of the 
fauces. It promotes waste and rapid excretion of waste-products, carbonic 
acid and urea being especially increased. Being eliminated by all the 
excretory organs, including the skin, it excites follicular inflammation at 
the points of elimination ; resulting in an eruption which is papular at 
first, then becomes vesicular, and finally pustular, the pustules being um- 
bilicated, like those of variola. This same eruption is also produced by 
the application of the drug to the skin with friction. Aphthous ulcerations, 
extending from the mouth to the stomach, with salivation and painful 
deglutition, may also result from its continued use. 

In small doses Tartar Emetic stimulates secretion in the bronchial and 
salivary glands, the stomach, intestinal canal, liver and pancreas. In 
larger doses it excites nausea, vomiting and purging, with evacuations 
like the "rice-water discharges" of cholera, and great prostration of the 
vital powers. Toxic doses produce similar symptoms, besides epigastric 
pain, cyanosis, delirium, cramps, motor and sensory paralysis, suppression 
of urine and collapse, — much the same phenomena as observed in Asiatic 
cholera. 

The Sulphide occurs native, and is the source from which the other 
compounds are prepared. It seems to be inert medicinally. Sulphurated 
Antimony owes its efficacy to the small quantity of the Oxide contained 
in it, and as this is variable, the action of the preparation is uncertain. 
The Oxide has a similar action to that of Tartar Emetic, but being in- 
soluble in water, it is of much less certain activity. 

Antidotes and Antagonists. 

Tannic Acid, or any substance containing it, is the antidote, forming the insoluble tan- 
nate. Opium, Alcohol, Ether, and other antispasmodics are physiological antagonists. 
Demulcent drinks should be freely administered to protect the mucous membranes. Al- 
kalies and Salts of Lead decompose Tartar Emetic. 

Therapeutics. 
• Tartar Emetic was formerly much employed as an antiphlogistic on 
account of its power to cut short acute inflammations of sthenic type, and 
its use was very much abused, so that it has now gone out of fashion as a 
remedy. The contra-stimulant treatment of pneumonia and other inflam- 
matory diseases by large doses of this salt after tolerance was established, 
is only worthy of reference as an historical fact. The same may be said 
of its external use as a counter-irritant as well as of its employment as an 
emetic, in both of which capacities it is too severe, while its emesis is too 
tardy in action to be of any value in poisoning. It is, however, a very 



ANTIPVRINA. I05 

efficient agent in many grave affections, if used in small doses (gr. -^-^) ; 
being highly recommended in acute inflammatory affections of the respi- 
ratory tract, especially pneumonia, broncho-pneumonia, acute oedema of 
the lungs, feverish and catarrhal colds, bronchitis, laryngitis and tonsil- 
litis. In many respects it acts like Aconite in these and kindred affections, 
producing copious diaphoresis, slowing the pulse and allaying restlessness. 
It is considered a good remedy in puerperal peritonitis, mammitis and 
orchitis, in lumbago and other muscular rheumatisms, also in photophobia 
and in gastric indigestion after beer-drinking. In still smaller doses 
(gr. T i- 7 hourly) it is particularly efficient in catarrhal inflammations of 
the respiratory mucous membrane in children, accompanied by rattling 
breathing and much mucus, which is expelled with difficulty. Such cases 
often simulate asthma, the attacks being marked by cough, wheezing, and 
difficult respiration, also sibilant rales in the chest, and usually follow on 
severe colds or on measles. The Compound Syrup of Squill is commonly 
used as an expectorant and nauseant in the treatment of bronchitis and 
croup. The quantity of Tartar Emetic in it (gr. ^ to the j§) should be 
remembered in administering it to children. (See Scilla.) 

The Oxide is chiefly employed in the form of James' Powder (Pulvis 
Antimonialis) for its mild diaphoretic qualities. The Sulphide is not 
used in medicine. Sulphurated Antimony is very uncertain in action 
and is but little used. The Compound Pill of Antimony (Plummer's 
Pill) was devised to obtain mercurial results without writing Hydrargyrum 
on a prescription. 

ANTIPYRINA, Antipyrine, Dimethyl-phenyl-pyrazolon, 
Phenazone, C 20 H 18 N 4 O 2 (Unofficial), — is a synthetical base, which forms 
salts analogous to those of Ammonium. It is a product of the destructive 
distillation of Coal-tar (compare Chinolina), and prepared by a patented 
and complicated process. It may also be obtained synthetically by heat- 
ing Methyl-oxy-chinicine with Phenyl-hydracine, and collecting the 
powder. It occurs as a grayish or reddish-white crystalline powder, which 
combines with acids to form salts, is somewhat bitter, and soluble in one- 
half its weight of hot water, and in its own weight of cold water ; but is 
still more so if the water is acidulated with dilute nitro-hydrochloric acid. 
It is less soluble in alcohol, chloroform or ether, gives an intensely red 
color with Ferric Chloride, a beautiful green with Nitrous 4°id, an <3 a 
yellow color with Nitric Acid, which deepens to crimson on warming. 
It is not irritant to either the stomach or the tissues, and may be admin- 
istered hypodermically. 

Dose and Ad??rinistration. 
The full antipyretic dose for an adult was at first stated at 30 grains hourly for three 
hours, or 90 grains for the antipyretic effect. For children, gr. j for each year of age as 
a dose, to be repeated twice, or thrice, with the same intervals between each dose. That 



106 ANTIPYRINA. 

such dosage was far too great, soon became evident from the many reports of alarming 
symptoms of collapse resulting in numerous instances; and the tendency has lately been 
towards a decreased size of dose at shorter intervals, which should be lengthened as soon 
as the drug-effects begin to be manifested. An average adult dose is now placed at io 
grains, for children % grain per year of age between 2 and 5, y 2 grain per year from 5 to 
10; not exceeding 5 grains at a dose for any child under 15 years of age. 

Antipyrine has but little flavor, is not unpleasant, and is therefore readily taken by chil- 
dren, in which respect it is greatly superior to Quinine. It may be administered in com- 
pressed tablets, each having from I to 5 grains ; — or in Elixir Aurantii, — say gr. lxxx 
in ^ iv, of which solution each 3 contains gr. ijss. If vomiting result, the same dose may 
be dissolved in half its weight of hot water, and injected hypodermically while warm. 

Antagonists and Incompatible*. 

Antipyrine may be decomposed when brought into contact with Nitrous compounds, a 
new and poisonous substance being supposed to be formed, of uncertain composition, but 
resembling the Anilin greens. The mixture of this drug with Spiritus Etheris Nitrosi is, 
therefore, highly dangerous, if this supposed reaction is at all likely to occur. 

It is more or less decomposed or thrown out of solution by a large number of chemical 
compounds and other preparations, of which the following are the most important, viz. : — 

Acid, Hydrocyanic Dil. Arsenic and Mercury, Solution of 
Acid, Tannic. the Iodides of. 

Butyl-chloral Hydrate. Mercuric Chlor. 

Chloral Hydrate. Naphthol /? (solid). 

Cinchona, Decoction. Nitrites in solution (acid). 

Cinchona, Fluid Extract. Sodium Bicarbonate. 

Catechu, Infusion (cone). Sodium Salicylate (solid). 

Ferrum, Sulphate. Tinctures containing Tannin, Iron, 
Ferric Salts in Solution. or Quinine. 

Hamamelis, Tincture. Rose, Infusion. 

Iodine, Tincture. Uvse Ursi, Infusion. 

Antipyrine and Phenyl-urethane liquefy when rubbed together. 

Derivatives and Allied Compounds. 

Antipyrine Salicylate, Salipj/rin, — is the only salt of the base which has any thera- 
peutic importance. It is a white, crystalline, odorless powder, very soluble in alcohol, in- 
soluble in water. Its claims to preference are based upon its comparative harmlessness 
( 3 ijss having been taken within 3 or 4 hours without the slightest ill effect) ; also its 
freedom from unpleasant after-results. Dose, gr. x-xxx every hour or 2 hours until 3 ij 
have been taken. 

Salipyrin has been employed with excellent results in acute and chronic rheumatism, 
rheumatic sciatica, neuralgia, and influenza. In rheumatic fever 15-grain doses are given at 
short intervals ( y 2 hour to 1 hour), until about 3 ij have been taken, continuing with smaller 
doses for a long time after convalescence, to prevent relapses. A dose of 8 grains is often 
sufficient against neuralgia. It was extensively used during the epidemic of influenza in 
1891, and highly extolled for efficiency therein, as well as for its freedom from cardiac 
action. 

It is best administered in wafers as a powder, or in mixture, rubbed up with glycerin 
and flavored with raspberry syrup. 

Hypnal is a combination of Antipyrine and Chloral, occurring as tasteless and odor- 
less rhombic, crystals, soluble in 6 of water, and credited with simultaneous action as a 
hypnotic and analgesic. Dose, gr. xv-xxx in aqueous mixture with some alcohol, flavored 
with syrup of orange. It is said to cause no gastric disturbance. 

Although Chloral and Antipyrine are incompatible with each other, they form, when 
heated together, the above described compound, which resembles both and yet differs 
from each. Its chemical appellation is Tri-chloraldehyd-phenyl-dimethyl-pyrazolon, and 
its formula is C 13 Ch 3 N 2 H 15 3 . 

Antipyrine is a powerful antipyretic, a local anaesthetic, and a general 
analgesic, — and also possesses diaphoretic, mydriatic, antiseptic, disinfec- 



ANTIPYRJNA. IO7 

tant, hemostatic and slightly hypnotic powers. After the ingestion of a 
full medicinal dose (gr. xxx), there is a stimulant stage of short duration, 
in which the heart's action is increased, and a subjective sense of heat is 
experienced, with flushing of the face. This is soon followed by profuse 
sweating, coldness of the surface, slowed pulse, considerable depression, 
and if fever be present by lowered temperature ; the latter coming on 
within half an hour after taking the drug and its degree being in direct 
ratio to the quantity administered, as also its continuance, — the former 
being usually from 3 to 5 degrees, and the latter from 1 to 10 hours, a fair 
average being about 2 hours. In one case a fall of 12 F. was observed. 

When given with Kairine, the mixture of the two drugs has been found to produce a 
much greater fall of temperature, with longer continuance down, than that produced by 
an equal quantity of either drug given alone. 

After the antipyretic effect of the dose has passed off, the temperature 
(in fever) commences to rise again, — the onset being usually preceded by 
a chill, which is of slight degree when compared with the severe rigors 
and dangerous depression occurring under the action of Kairine, Chino- 
line, and other members of the group. 

In health its administration gives rise to slight nausea, singing in the 
ears, and a reduction of the body temperature of scarcely any extent, 
about -^q° F. It slightly raises the arterial tension and blood-pressure ; — 
sometimes (but seldom) induces vomiting, also a peculiar eruption on the 
skin ; — and (very rarely) such a degree of depression as to amount to 
collapse. It has no effect upon the respiration, but acts as a sedative 
upon the cerebrum, leaving behind a somewhat depressant influence on 
the brain. It dilates the pupils and is eliminated by the kidneys, appear- 
ing in the urine some three hours after its ingestion. The profuse sweat- 
ing which it causes may be prevented by giving in advance a small dose 
of Atropine or Agaricine. 

In toxic dose its principal influence is exerted upon the blood, altering 
the shape of the red corpuscles, separating the hematin, and causing 
decomposition of that fluid. 

As an Antipyretic, Antipyrine, like Alcohol, acts by a double mode of 
operation, — (1) by diminishing oxidation, and (2) by promoting heat- 
loss. The latter is attained by dilating the cutaneous vessels, allowing 
free radiation from the surface, and by the refrigerant action of the evapo- 
ration of the sweat. 

As an A?ialgesic> Antipyrine has a very considerable degree of power, 
in common with all the Chinoline derivatives ; but its property in this 
respect is found to act almost entirely upon pain due to manifestations 
of the rheumatic diathesis. In general anodyne action, it is not to be 
compared with the derivatives of Opium. Its hemostatic power is 
claimed to be superior to that of Ergotine. 



108 APIOL. 

Therapeutics. 

One of the most popular of the modern antipyretics, Antipyrine deserves 
its high rank in professional esteem, being the most certain and most 
powerful, though somewhat dangerous, and devoid of any other influence 
upon the course of any febrile disorder. Its principal applications are as 
follows, viz. : — 

In hyperpyrexia from any cause it is efficient. In acute rheumatism, 
it has held a high place as a remedy, for some time. In typhoid fever 
and other febrile conditions, wherein hyperpyrexia occurs, as phthisis, 
erysipelas, pleuritis, pneumonia, surgical fever, etc. In neuralgias, neu- 
ritis, and other paiiiful affections, especially when of rheumatic origin, — 
as lumbago, sciatica, hemicrania, supra-orbital neuralgia, etc., in which 
io-grain doses are generally sufficient, and may be given hypodermically. 
In painful affections of hysterical persons ; — pain from cerebral tumors 
and from cardiac diseases, — also painful menstruation ; — all of which are 
often relieved by it. In acute paroxysms of gout, a dose of 10 grains 
every two hours, preceded by a commencing dose of 25 grains, promptly 
relieved the pain and shortened the duration of the attack in one very 
thoroughly observed and carefully reported case. In chronic gout, very 
remarkable results are reported from the use of this agent, indicating a 
specific action thereon of curative character. ' 

It has seemed to render efficient service in dysmenorrhcea, carbuncle, 
and cerebro-spinal meningitis ; and affords valuable aid in the pyrexia of 
intermittents, in which stage the slow action of Quinine prevents its 
availability for immediate relief. 

It has rendered signal service in the diarrhoea of children, given in 
doses of gr. ss to gr. jss ; also in the urticaria-like eruptions of children 
its action when administered internally has been so promptly efficient as 
to indicate for it a direct influence upon the vascular nerves. As a 
symptomatic remedy against itching it is equally efficient in nervous 
pruritus, true prurigo, urticaria, erythema, pemphigus vulgaris, and lichen 
ruber. As an antigalactagogue 4-grain doses every two hours have proven 
highly efficacious. It is successfully employed against whooping-cough, 
chorea, bronchial asthma, and sea-sickness. 

For the purpose of relieving pain, the conjoint administration of Anti- 
pyrine and Morphine is said to be much more efficient than the use of 
either agent alone. 

APIOL (Unofficial), — is a non-volatile, oily liquid, of acid reaction 
and pungent taste, soluble in alcohol, ether, chloroform, and in glacial 
acetic acid. It is extracted from the fruit of Petroselinum sativum (Pars- 
ley), a biennial plant of the nat. ord. Umbelliferse, which also contains a 
gelatinous substance named Apiin, and a Volatile Oil which is by some 



APOCYNUM APOMORPHINA. 1CX) 

considered to be the true emmenagogue principle of the plant. Apiol \s> 
probably a mixture of several substances, and as found in commerce is 
often an impure oleoresin. Dose, n^ iij-x in capsule two or three times a 
day ; as an emmenagogue, %xv in one daily dose. 

Physiological Action and Therapeutics. 

In small doses (n^ iij-v) Apiol is carminative, diuretic, diaphoretic, ex- 
pectorant and stimulant to the circulation. In full doses (nr xv) it is 
decidedly emmenagogue and feebly antiperiodic, producing headache, 
tinnitus aurium, intoxication, giddiness, etc., its action generally resem- 
bling that of Quinine. Large doses (ttl xxx-^j) are decidedly narcotic. 

It has had some reputation in intermittents and in malarial neuralgise, 
but is most frequently employed in amenorrhcea and dysmenorrhcea, 
being of especial advantage in the amenorrhcea of anaemia, also when 
the menstrual discharge is fetid. It is becoming fashionable as a supposed 
abortifacient, but is useless for this purpose, and if freely used may produce 
decided narcotism, especially if the preparation employed should happen 
to be an active one. The capsules of Apiol put up in France and sold in 
this country over the counters of drug-stores to any applicant are gen- 
erally inert; hence cases of poisoning by this drug are seldom observed. 
They are, however, an important source of revenue to the retailers, as, 
being "imported" preparations, they command a high price, which is 
readily paid by gullible women who wish to " bring around their courses." 

APOCYNUM, Canadian Hemp, — is the root of Apocynum can- 
nabinum, an indigenous perennial plant of the nat. ord. Apocynaceae, 
and inodorous but of bitter, disagreeable taste. It contains a peculiar 
active principle, Apocynin, also tannic and gallic acids, resin, wax, 
caoutchouc, etc. Dose of the powdered root, gr. v-xxx. A decoction 
(^ss to the pint) may be given in doses of ^j-ij thrice daily. 

Physiological Action and Therapeutics. 

Apocynum is powerfully emetic and cathartic in full doses, also diapho- 
retic, expectorant and sometimes actively diuretic. It lowers the pulse- 
rate, produces much nausea, and induces drowsiness. It should not be 
confounded with Indian or American Hemp (Cannabis sativa), which 
have entirely different qualities. 

The only condition in which Apocynum has proven of much value is 
dropsy, especially the anasarca of Bright's disease and ascites, in which 
15-grain doses are indicated. The active principle, Apocynin is a good 
expectorant, in doses of gr. ^ to gr. y 2 . 

APOMORPHINA, Apomorphine, — is an artificial alkaloid, pre- 
pared from Morphine or Codeine by the action of strong acids or zinc 



IIO AQUA. 

chloride. The Hydrochlorate (C 17 H 17 N0 2 HC1) is official, and occurs in 
minute, colorless crystals, odorless, of bitter taste, and neutral or faintly 
acid reaction; soluble in 7 of water and 50 of alcohol at 59 F., almost 
insoluble in ether or chloroform ; decomposed by boiling water or boil- 
ing alcohol. 

Dose, gr. ^ to -^ hypodermically, gr. -^ to £ by the mouth. For young children, gr. 
■^ to g 1 ^ should not be exceeded. Solutions should be fresh when used, and as they 
alter rapidly by keeping, should have a few drops of hydrochloric acid added to them, to 
prevent decomposition. 

Physiological Action and Therapeutics. 

Apomorphine is a systemic emetic, acting directly on the vomiting 
centre, and is the quickest, most certain and least irritating of all emetics, 
acting in from five to twenty minutes with but moderate nausea. In large 
dose it is very depressant to the heart (gr. ^ having caused death in a 
weak adult by cardiac failure), and produces paralysis of the motor and 
sensory nerves, delirium, convulsions, and depression of respiratory 
power. Small doses (gr. -3^) are expectorant. 

The Hydrochlorate is the preparation usually employed, and the only 
official one. It is the best emetic to use in many cases of poisoning, 
particularly when swallowing is difficult, but is useless in narcotic 
poisoning after narcosis has blunted the vagus centre. It is a very desir- 
able agent in any case where time is of great importance. 

As an expectorant it is highly recommended but has not yet been much 
used. In catarrhs the -^ of a grain every 3 hours will prove of great 
advantage, but it must be used with caution, especially in young chil- 
dren, who bear this remedy very badly. 

In hacking coughs without expectoration it has proven a very efficient 
agent, given in minute doses, gr. -^ to 2V m tne 2 4 hours. 

AQUA, Water, H 2 0, — is natural water, in its purest attainable 
state, a colorless, limpid liquid, devoid of odor or taste, of neutral reac- 
tion, and containing not more than 1 part of fixed impurities in 10,000 
parts. Besides entering into the composition of most of the official 
extracts, fluid extracts, and many other pharmaceutical preparations, 
from it are prepared the 13 official Waters (Aquae), and also the official — 

Aqua Destillata, Distilled Water, H 2 0, — 1000 parts of water are distilled, the first 
50 parts obtained being thrown away, 800 parts are preserved. It is as near chemically 
pure water as can be obtained. 

Aqua Carbonata, Carbonated Water, Soda-water, is water highly charged with carbonic 
acid gas, C0 2 , the excess of gas being dissolved in the water by pressure, and escaping 
in bubbles when the pressure is taken off. It was official in the U. S. P., 1870, under 
the title Aqua Acidi Carbonici, the formula requiring that the water be charged with five 
times its volume of gas, for which a pressure of five atmospheres is required. The 
materials usually employed by soda-water manufacturers for producing the gas, are either 
Sodium Bicarbonate or Marble-dust, and Sulphuric Acid. 



AQUA. I I I 

Nomenclature of Water. 

Aqua Fluvialis, River-water. Aqua Destillata, Distilled Water. 

Aqua Fluvialis, Rain-water. Aqua Bulliens, Boiling Water. 

Aqua Fontana, Spring or Well-water. Aqua Fervens, Hot Water. 

Aqua Marina, Sea-water. Aqua Communis, Common Water. 

Aqua Carbonata, Carbonated Water, Balneum Maris, Warm-water Bath. 

Soda Water. Balneum Vaporis, Vapor Bath. 

Mineral Waters. 
Natural Water differs from Distilled in containing saline and other con- 
stituents in varying proportions, — from common water (Aq. Communis), 
in which they are so small in quantity as not to alter the taste, color, etc., 
up to the Sea- water, having 3 3/3 per cent., and that of the Dead Sea with 
26^ per cent. Spring waters, impregnated with foreign substances so as 
to have a decided taste and a marked action on the human system, are 
called Mineral Waters, which may be subdivided into various groups, 
according to their prevailing constituents, as Carbonated, Alkaline, Saline, 
Sulphuretted, Silicious, etc. Full analyses of all the principal mineral 
waters of Europe and America are given in the United States Dispensa- 
tory, 16th edition, but a few of the most prominent will be mentioned 

here. 

Carbonated Mineral Waters. 

Selters, Nassau, Germany, 30 cubic inches "J 

Apollinaris, Nuenahr, Prussia, 47 " of C0 2 

Old Sweet Spring, West Virginia, 1 1 " to the pint. 

Sweet Chalybeate Spring, Virginia, .... 13 " J 

These waters are cold, contain generally Carbonates of Calcium, Magnesium and 
Sodium (in some, Iron), which are held in solution by the excess of Carbonic Acid, also 
Chlorides of Sodium and Potassium, Sulphates, Phosphates, etc. 

Alkaline Mineral Waters. 

Ems, Germany. Perry Spring, Ills. 

Salzbrunn, Germany. St. Louis Spring, Mich. 

Gleickenberg, Austria. Buffalo Lithia Spring, Va. 

Vichy, France. Hot Spring, Va. 

Vals, France. Warm Spring, Va. 

Bladon Spring, Ala. Berkeley Spring, Va. 

Congress Spring, Cal. Bethesda Spring, Wis. 

Seltzer Spring, Cal. Gettysburg Spring, Pa. 

These waters are generally cold, those of Vichy and Ems being warm. They contain 
a considerable amount of Sodium Carbonate, also Sodium Chloride and Sulphate, and 
various other Chlorides, Carbonates and Sulphates, with Carbonic Acid gas in varying 
quantity. Vichy and Vals waters depend for their efficacy almost wholly on the quantity 
of Sodium Carbonate contained in them, which is for Vichy from 26 to 50 grains and for 
Vals about 60 grains to the pint. 

Saline Mineral Waters. 
Friedrichshall, Germany. Cheltenham, England. 

Hunyadi Tanos, Hungary. Kissengen, Bavaria. 

Baden-Baden, Germany. Reichenhall, Bavaria. 

Wiesbaden, Germany. Adelheidsquelle, Bavaria. 

Carlsbad, Bohemia. Kreutznach, Prussia. 

Pullna, Bohemia. Saratoga Springs, N. Y. 

Seidlitz, Bohemia. Ballston, N. Y. 

Marienbad, Bohemia. Hot Springs, Arkansas. 

St. Catherine's, Ontario, Canada. 



112 AQUA. 

These waters are of more complex composition, the various waters of Saratoga contain- 
ing more than thirty constituent salts. Those usually present are the Sulphates and 
Carbonates of Sodium, Calcium, Magnesium, etc. (Magnesian waters); Chlorides of 
Sodium, Potassium and Lithium [Chlorinated waters) ; Ferrous salts [Chalybeate waters), 
with Iodine, Bromine, Manganese salts, and Phosphates in some few. Carbonic Acid 
gas is present in all. Most of them are purgative, some are considered alterative, and 
many are warm (ioo°-i6o°). 

The most powerful member of the saline group is Hunyadi Janos, which contains about 
150 grains each of Magnesium and Sodium Sulphates to the pint, and is, therefore, effec- 
tively purgative. Nearly as strong is Pullna water, with 1 24 grains of Sodium Sulphate 
and 93 grains of Magnesium Sulphate to the pint. Friedrichshall is less powerful, but 
perhaps a better aperient water in doses of 6 to 10 fluid ounces. Marienbad contains no 
Magnesium Sulphate, but has 36 grains of Sodium Sulphate, 9 of Sodium Carbonate, 11 
of Sodium Chloride, and a small quantity of Ferrous Carbonate to the pint; in transpor- 
tation, however, it loses its Carbonic Acid and deposits the Iron. It is not aperient in 
ordinary doses. Carlsbad water contains 20 grains of Sodium Sulphate and 9 each of 
Sodium Carbonate and Chloride to the pint. The so-called " Carlsbad Salt" is simply 
Sodium Sulphate with a trace of the Carbonate. Hartnack gives the following formula 
for its artificial preparation : Sodium Sulphate 100 parts, Sodium Bicarb. 80, Sodium Chlo- 
ride 40 ; a dessertspoonful in water as a mild saline purgative. These waters are imported 
into the United States in large quantities, and may be ordered through any druggist. 

Sulphurous Mineral Waters. 

Aix-la-Chapelle, Prussia. Blue Lick Spring, Ky. 

Bareges, S. France. Sharon Spring, N. Y. 

Eux-Bonnes, S. France. Yellow Sulphur Spring, Va. 

Llandrindod, Wales. White Sulphur Spring, W. Va. 

Harrowgate, England. Salt Lake Warm Springs, Utah. 

These waters all contain Sulphuretted Hydrogen gas, also Carbonic Acid gas and Car- 
bonates, Chlorides and Sulphates of Sodium, Potassium, Magnesium and Calcium; some- 
times Carbonate and Oxide of Iron, Iodide and Bromide of Sodium. 

Silicious Mineral Waters. 
Hot Springs, Iceland. Geysers of Yellowstone. Park. 

The constituents of these waters are chiefly alkaline Silicates. 

Physiological Action of Water. 

Water is an essential constituent of all the tissues of the body, form- 
ing from 0.2 per cent, of the enamel of the teeth to 77 per cent, of the 
ligaments. In the liquids of the organism it is contained in the propor- 
tions of 78 per cent, of the blood to 93 per cent, of the urine, and 99 
per cent, of the tears. In moderate quantity it is necessary to digestion, 
but in large amount it weakens digestion by diluting the gastric juice. 
Ice-cold water, if freely used, suspends the action of the pepsin, de- 
presses the nerves of the stomach, and lowers the blood supply. The free 
use of water internally produces increased cutaneous and renal excretion, 
and promotes the elimination of some of the products of tissue-change, 
as urea, phosphoric acid, etc. In some subjects it favors the deposition 
of fat. 

Cold Water applied externally, as by a bath (4o°-6o° F.), abstracts 
a portion of the body-heat, lowering the surface temperature and depress- 
ing the cutaneous nerves, producing spasmodic breathing and a quick- 



AQUA. 113 

ened pulse. If the temperature of the water is not too low and the 
bodily vigor is good, reaction soon occurs, and the general effect is tonic 
to the muscular power, circulation and respiration. If this does not take 
place a secondary chill occurs, and serious depression may result. 

Warm Water (q5°-ioo F.) applied to the surface of the body, as 
by baths of water or steam, packing, etc., acts in the opposite manner at 
first, increasing the circulation in the skin, the rapidity of the pulse and 
respiration and the body temperature. Rapid tissue-change occurs, the 
waste products being eliminated chiefly by the skin and the pulmonary 
mucous membrane. If long-continued, precordial oppression, giddiness 
and muscular debility are experienced. 

Hot Water (iio°-ii2° F.) at first dilates the vessels of the part to 
which it is applied, and soon afterwards contracts them. It is a valuable 
means of relieving congestion and inflammation, and is a most effective 
hemostatic when the bleeding is from small vessels or of capillary charac- 
ter. Whether generally or locally applied it is one of the most reliable 
means of relieving spasm. 

Hot Vapor applied to the surface accelerates the circulation and pro- 
duces profuse sweating. Its general action is similar to that of warm water. 

Mineral Waters taken internally act chiefly by virtue of the water, 
partly in accordance with the effects of their various constituents. As 
baths, their action is doubtless entirely due to their temperature. 

Therapeutics of Water. 

Cold Water or Ice has many external applications of value in the 
treatment of disease. As a wet pack it is used in tonsillitis, diphtheria 
and croup. Cold baths are the most effective antipyretic in the high tem- 
perature of fevers, and the cold wet pack is used for the same purpose. 
Ice or cold water is applied to the head in acute cerebral congestion, and 
to the spine in chorea, etc. ; also locally in hemorrhoids, bubo, orchitis, 
and to the uterus in post-partum hemorrhage. Cold affusion to the body 
is employed as a preventive of spasmodic croup, as well as to lessen the 
tendency to taking cold. 

Hot Water externally as fomentations, hot wet pack, baths, etc., is 
most effective in reducing local congestion and setting up resolution of 
local inflammation. Hot fomentations to the renal region are useful in 
functional inactivity of the kidneys. The hot spinal douche is used in 
affections of the spinal cord and meninges, and in the backache of women. 
The hot wet pack is highly esteemed in inflammations of the chest organs, 
and hot injections for chronic inflammation of the uterus. Hot water 
dressings for wounds are strongly recommended by many high surgical 
authorities. Vapor and Turkish baths are used as diaphoretics in advanced 
kidney disease, in acute and chronic rheumatism, mineral poisoning, and 
8 



114 AQUA. 

syphilis. Warm baths, with cold applications to the head, are esteemed 
as of value in infantile convulsions and chorea. 

Internally, water is chiefly of value as a diuretic, and if hot as a dia- 
phoretic. A glass of cold water before breakfast daily is often an effective 
means of overcoming constipation, while the drinking of hot water an 
hour before each meal has been of great value to many dyspeptics. The 
value of the popular teas in chronic diseases is almost entirely due to the 
diluent, diuretic and diaphoretic actions of the hot water used. 

Carbonated Water, or "Soda-water," as it is popularly called, is 
employed as a grateful beverage in hot weather, being flavored with various 
syrups. It is also an agent of great value for febrile cases, as it allays thirst, 
lessens nausea, and promotes the secretion of urine. It forms an excellent 
vehicle for the administration of the saline cathartics, especially Magne- 
sium Sulphate, and of the various carbonates. It is one of the numerous 
agents which have been found efficacious in the vomiting of pregnancy. 

Therapeutics of the Mineral Waters. 

An undue value is placed by the laity and interested proprietors on the 
medicinal value of mineral waters, causing the various localities of the 
best advertised springs to become resorts for invalids and idlers from every 
civilized country. The benefit derived is in most instances due to the 
change of climate and scene, freedom from home cares and business 
worry, regularity of life and diet, drinking of water in quantity, and in 
many cases the substitution of water for alcoholic beverages. In order to 
get the worth of their money, people will gladly submit to rigid hygienic 
and dietetic restrictions at a watering-place which they would totally 
ignore at home. The same may be said of the treatment at the so-called 
"hydropathic" or "water-cure" establishments. As a rule, those 
springs will prove of most value which are furthest removed from the 
patient's residence, for " distance lends enchantment" in these matters as 
well as in many others. Invalids whose homes are in the vicinity of some 
wonder-working spring will not usually derive much benefit from its 
water, but will by that of another spring, similar in constituents, but 
located several hundred miles away. 

The principal affections in which mineral waters are esteemed most 
highly are the following : dyspepsia, cirrhosis of the liver, gout, rheu- 
matism, lithiasis, diabetes of hepatic origin, constipation, strumous dis- 
orders, obesity, plethora of the pelvic organs, hypochondriasis, skin dis- 
eases, especially those dependent on gastric derangement, phthisis, con- 
stitutional syphilis, metallic poisoning, etc., in all of which the influences 
above mentioned are especially efficacious, and are no doubt the chief 
factors in producing any benefit which may be attainable. Aperient and 
purgative waters are useful in many cases where a prejudice exists against 



ARGENTUM. I I 5 

purgative medicine, but none against the same agents in a natural water. 
The strong saline-aperient waters, as Carlsbad, Hunyadi, Friedrichshall, . 
etc., have considerable repute in the treatment of the uric-acid diathesis 
and calculous affections, and the waters of St. Catherine's Wells are 
credited with decided influence upon local and chronic rheumatism. 

The special therapeutics of mineral waters are to be found in this volume under the 
heads of their principal constituents, as Sodium Chloride, Sodium Sulphate, Magnesium 
Sulphate, etc., also in the therapeutical part of the work. 



ARGENTUM, Silver, Ag, — is represented by the following four 
official salts, viz.: — 

Compounds of Silver and their Preparations. 

Argenti Nitras, Nitrate of Silver, AgN0 3 , — occurs in colorless rhombic crystals, of 
bitter caustic taste and neutral reaction, soluble in 0.8 of water and 25 of alcohol at 59 
F. Is best given in pill or distilled water; never with tannin or a vegetable extract, lest 
an explosive compound result. Dose, gr. ^-^, — if watched, up to gr. j may be given. 
When melted with 4 per cent, of Hydrochloric Acid, it makes — 

Argenti Nitras Fusus, Moulded Nitrate of Silver, Lunar Caustic, — for local use as a 
mild caustic and an astringent. Argenti Nitras Dilutus, Diluted Nitrate of Silver, 
Mitigated Stick, — is the same melted with an equal weight of Potassium Nitrate. Is 
used locally by ophthalmologists. 

Argenti Cyanidum, Cyanide of Silver, AgCN, — has no medicinal use except for the 
extemporaneous preparation of Hydrocyanic Acid. (See ante, page 67.) 

Argenti fodidum, Iodide of Silver, Agl, — a greenish yellow powder insoluble in water 
or alcohol. Is used instead of the nitrate internally, as it is supposed not to discolor the 
skin. Dose, gr. }(-) in pill. 

Argenti Oxidum, Oxide of Silver, Ag 2 0, — a brownish black powder, nearly insoluble 
in water and insoluble in alcohol. It should not be triturated with readily oxidizable or 
combustible substances, and should not be brought into contact with ammonia. Dose, gr. 
^-ij in pill. Is not dangerous. 

All the silver salts should be protected from light in dark amber-colored vials. 

Physiological Action. 
Nitrate of Silver is a powerful astringent and a limited escharotic. 
Applied to the skin or mucous membrane it combines with the albumen 
of the tissue, excites superficial inflammation, which is soon followed by 
an altered condition of the part, and stains the same black under the 
influence of light. The stains may be removed by washing with a strong 
solution of Potassium Cyanide. Given internally in small doses it 
increases secretion, stimulates the heart, promotes nutrition, and acts as a 
nerve tonic. Its continued use produces symptoms which are collectively 
termed Argyria, and are as follows : gastro-intestinal catarrh, tissue 
waste, uraemia, albuminuria, fatty degeneration of the heart, liver and 
kidneys, hemorrhages, fluidity of the blood, a slate-colored line along the 
margin of the gums, and a similar discoloration of the skin and mucous 
membranes, with centric impairment of the nervous system producing 
paralysis on a large scale, loss of coordination power, convulsions, and 



Il6 ARGENTUM. 

finally death by paralysis of respiration. Large doses produce violent 
gastro-enteritis, also ulcer of the stomach from thrombosis of its veins, 
and destruction of the gastro-intestinal mucous membrane. 

The Iodide and Oxide are sometimes used to produce the same con- 
stitutional effects, they being supposed not to discolor the skin, but this 
has been found to be fallacious. The oxide is much the least irritant of 
the silver salts. 

Antagonists and Incompatible*. 

Common Salt freely used is the antidote, precipitating the insoluble chloride of silver 
and acting as an emetic. The nitrate is exceedingly sensitive to organic material and 
light, which decompose it readily. Incompatibles are all the soluble chlorides (hence it 
should be used in distilled water), most of the mineral acids and their salts, alkalies and 
their carbonates, lime water and astringent infusions. 

A course of silver medication should be regulated by suspending the remedy after 5 
or 6 weeks' use, and then promoting elimination by purgatives, diuretics and baths. To 
prevent the general discoloration Potassium Iodide should be given conjointly with the 
silver, and baths of Sodium Hyposulphite used frequently. 

Therapeutics. 

Locally the Nitrate is much used as a stimulant application, an astrin- 
gent, a caustic, an alterative and an antiphlogistic. To ulcers and in 
throat affections the solid stick may be used, but solutions of various 
strengths from gr. j to gr. xl to the § ar e much better. The mildest 
solutions are employed in conjunctivitis (never over the cornea), the 
stronger in throat and mouth affections, and the strongest in lupus, 
erysipelas and other skin diseases. A solution in Nitrous Ether (gr. xl to 
the g) is said to abort superficial inflammations if applied early to the 
neighboring integument, and in erysipelas a solution of gr. xx to the 3 
is often used over the inflamed surface and beyond, after careful washing 
and drying, in the hope of preventing the extension of the disease, which 
it will not do. The mucous membranes of the conjunctiva, fauces, 
larynx, urethra, bladder, uterus, vagina and rectum, have all been sub- 
jected to the local action of this salt. 

Internally the silver salts are used in dyspepsia with vomiting of yeasty 
fluid, chronic gastritis and gastric ulcer, dysentery of chronic type, espe- 
cially if rectal ulcer (the Nitrate internally and by enema), the diarrhoea 
of phthisis and typhoid fever (Nitrate with Opium), chronic spinal in- 
flammations causing locomotor ataxia or paraplegia, and epilepsy, in the 
latter affection the Nitrate having occasionally given good results. 

The Oxide has been used internally for gastric neuralgia, irritative 
dyspepsia, pyrosis, gastric and pulmonary hemorrhages, and menorrhagia. 
The Iodide is used to obtain the constitutional effects of silver, but has 
no advantages over the other preparations. 



ARNICA. 117 

ARNICA, — is the plant Arnica monlana or Leopard's Bane, a peren- 
nial of the nat. ord. Compositae, indigenous to the mountains of Northern 
Europe and Siberia, and said to have been also found in the mountains 
about the headwaters of the Missouri and Columbia rivers. It has large 
orange-yellow flowers, and a small, curved rhizome with several rootlets. 
Both the flowers and the roots are official. Its most important constituent 
is Trimethylamine, C 3 H 9 N, an ammoniacal alkaloidal principle which is 
probably the active ingredient. It also contains Arnicin, Inulin, Capro- 
nic and Caprylic Acids, tannin, mucilage, resins, and two essential oils, 
one of which exists in the flowers, the other in the root. 

Arnica Flores, Arnica Flowers, — the flower-heads of Arnica montana, 
large, yellow, having r4 to 16 strap-shaped florets in the ray, twice as 
long as the disk, which consists of numerous tubular florets. The odor is 
feebly aromatic, the taste bitter and acrid. Used in Tincture and Infusion. 

Arnica Radix, Arnica Root, — the rhizome and rootlets of Arnica 
montana, is about 2 inches long and y& to j£ inch thick, externally brown 
and rough from leaf-scars, internally whitish, with a thick bark contain- 
ing a circle of resin-cells and a large, spongy pith. Odor somewhat aro- 
matic, taste pungent, aromatic and bitter. Resembles Valerian, which is 
distinguished by its smell ; Serpentai'ia, which has many contorted root- 
lets ; and Veratrum Viride, which has thicker rootlets. Dose, gr.v-xx. 

Preparations of the Flowers. 

Tinctura Arnica Florum, — 20 per cent. Dose, TTlv-xxx. 

Infusum Arnica (Unofficial), — Arnica flowers 20 to 100 parts of water, is thought by 
many observers to be the best form for local use, as it does not excite dermatilis, probably 
from containing none of the Volatile Oil, or the insoluble principle Arnicin. 

Preparations of the Root. 
Extractum Arnica Radicis, — Dose, gr. j-iij. 
Extractum Arnica Radicis Fluidum, — Dose, TTLv-xx. 
Tinctura Arnica Radicis, — 10 per cent. Dose, TTUr-xxx. 

Emplasiru7?i Arnica, — contains Extract of Arnica Rcot 50 parts to 1 00 of Lead 
Plaster. 

Derivative. 

Trim ethy lamina, Trimethylamine, C 3 H 9 N (Unofficial), — is a thin, colorless, strongly 
alkaline liquid, boiling at 50 F., and at ordinary temperatures is a colorless, inflammable 
gas. The Hydrochlorate is the most stable salt, crystallizing in white or colorless prisms, 
nearly odorless, of pungent taste, very deliquescent, and freely soluble in water and in 
alcohol. Dose, gr. ij-iij in syrup every 2 hours. 

Trimethylamine has been obtained from Arnica flowers and those of several other 
plants, from Ergot, Hops, Codeine, Cod-liver Oil, and decomposing albuminous sub- 
stances, such as human urine, herring-pickle, and the residue left in making sugar from 
beets. It is sometimes incorrectly named Propylamine, a term also applied to an impure 
trimethylamine, but in reality an allied and isomeric compound. 

Physiological Action. 
Arnica is irritant, stimulant, depressant, antipyretic, diuretic and vul- 
nerary. It irritates the gastro-intestinal tract, and in some persons the 
local use of an alcoholic preparation of the flowers will excite erysipela- 



Il8 ARNICA. 

tous inflammation of the skin, though those of the root have not been 
observed to do so. In small doses internally it increases the action of the 
heart, raises the arterial tension and stimulates the action of the skin and 
the kidneys. Large doses produce a transient excitement, followed by 
depression of the circulation, respiration, and nerve-centres ; headache, 
unconsciousness, and even convulsions being induced, the body-tempera- 
ture lowered, the pupils dilated, and muscular paresis produced. A toxic 
dose paralyzes the nervous systems of animal and organic life, causing 
collapse and death. 

Trimethylamtne is an active escharotic and a gastro-intestinal irritant. 
It lowers the rate and force of the heart, decreases the body-temperature, 
and diminishes (though sometimes increases) the excretion of urea. The 
Hydrochlorate is a powerful antipyretic in doses of gr. ij every 3 hours. 

Therapeutics. 

Arnica is a popular remedy with those who patronize the so-called 
homoeopathic school of practice, but like many other agents which the 
homceopathists claim to have given to medicine, it is a remedy much 
older than homoeopathy, and was investigated originally by regular physi- 
cians, notably by Van der Kolk in the sphere of mental affections. 

Externally, the tincture in water has a popular reputation in sprains, 
bruises, etc., though an infusion is better for local use. Ecchymoses are 
rapidly dispersed by its administration internally as well as externally ; 
and, in internal bruises from shocks or concussions, its internal use has 
proven very efficacious. The aqueous preparation locally promotes the 
rapid union of cut surfaces. 

Internally, besides its value as noted above, Arnica is undoubtedly 
effectively employed in typhus and typhoid fevers as a stimulant and 
antipyretic, also in delirium tremens, rheumatism and rheumatic gout, 
hemorrhages, epistaxis, haemoptysis, amaurosis, concussion of the brain, 
chronic dysentery, and paralysis of the bladder. 

In idiopathic mania, after the first excitement has diminished, Arnica, 
in aqueous preparation internally, has given great satisfaction. It has 
often checked an exhausting diarrhoea after many other remedies have 
failed. 

Trimethylamtne has been found useful in acute rheumatism and gout, 
relieving pain, reducing temperature, and diminishing the frequency of 
the pulse. In chronic rheumatism, as a liniment (1 to 3 of Glycerin), it 
is said to give relief equal to that produced by any anodyne. It has also 
been used with benefit in chorea, moderating the spasmodic movements 
when not suspending them entirely. 



ARSENIUM. 119 

ARSENIUM, Arsenic, As. — The metal Arsenic is not used in 
medicine, but is represented by one of its Oxides, a salt of another Oxide, 
and the Iodide, which are official ; together with four preparations of 
these compounds, or of their salts, viz. : — 

Arsenic Compounds and their Preparations. 

Acidum, Arseniosum, Arsenious Acid, Arsenious Oxide, White Arsenic, As 2 Q 3 , — is a 
heavy, white solid, occurring as an opaque powder, or in semi-transparent masses having 
usually a striated appearance, soluble in 30 to 80 of water at 59 F., the solubility varying 
with its physical condition, also soluble in 15 of boiling water, in alkalies and their carbo- 
nates, hydrochloric acid and in glycerin. It is volatilized at 424. 5 F., without melting, 
and when thrown on ignited charcoal it emits an alliaceous odor. Arsenious Acid is 
obtained by roasting native arsenides, and condensing the fumes in a long horizontal 
chimney. Dose, gr. ^ to T L. 

Liquor Acidi Arseniosi, Solution of Arsenious Acid (Liquor Arsenici Hydrochloricus, 
B. P.), is a 1 per cent, solution of Arsenious Acid in Hydrochloric Acid and Distilled 
Water. Dose, TT\ij-x. 

Liquor Potassii Arsenitis, Solution of Arsenite of Potassium, Fowler's Solution, — is 
prepared by boiling together Arsenious Acid I, Bicarbonate of Potassium 1, and Distilled 
Water 10 ; then adding Compound Tincture of Lavender 3, and Distilled Water up to 
100 parts. Dose, TT^ij-x. 

Sodii Arsenias, Arseniate of Sodium, Na 2 HAs0 4 .7H 2 0, — is a salt of the second 
oxide, Arsenic Acid, As 2 5 . It is in colorless, prismatic crystals, of feebly alkaline taste 
and a faintly alkaline reaction, soluble in 4 of water at 59 F., very soluble in boiling 
water, hardly soluble in alcohol. Dose, gr. j 1 — | ; of the dried salt, gr. ^V" fV 

Liquor Sodii Arseniatis, Solution of Arseniate of Sodium, Pearson's Solution, — has of 
the Arseniate dried 1 part in 100 of Distilled Water. Dose, mjj-xv. 

Arsenii Lodidum, Iodide of Arsenic, Asl 3 — in glossy, orange-red, crystalline masses or 
scales, gradually losing iodine by exposure to the air, soluble in 3% of water and in 10 
of alcohol at 50 F., is gradually decomposed by boiling water and by boiling alcohol, 
and is completely volatilized by heat. Dose, gr. jg— ¥• 

Liquor Arsenii et Hydrargyri Lodidi, Solution of Iodide of Arsenic and Mercury, 
Donovan's Solution, — has of Iodide of Arsenic I, Red Iodide of Mercury I, in 100 parts 
of Distilled Water. Dose, mjj-x. 

Unofficial Salts of Arsenious Acid. 

Cupri Arsenis, Arsenite of Copper, — occurs in the various cupro-arsenical pigments, 
Scheele's green, Mineral green, Paris green, etc., used for wall-paper coloring, and as 
insect poison. It is highly poisonous. 

Arsenii Bromidum, Bromide of Arsenic. Liquor Bromi Arsenitis, Solution of the 
Arsenite of Bromine, Clemen's Solution. Dose, TT\j-v, in water, twice daily after meals. 

Physiological Action. 

Arsenious Acid, when applied to the skin denuded of its epidermis, 
acts as a painful escharotic, producing violent inflammation and resulting 
in a slough which forms a barrier to its absorption. If applied in dilute 
solution over a large surface, it will be absorbed, and may produce the 
systemic effects to be described. 

In small doses it is a stomachic and general tonic, promoting the appe- 
tite and digestion, increasing the cardiac action, the respiratory power, 
and the intestinal secretions, — stimulating peristalsis, exalting mental 
activity and the sexual appetite, and producing a fair skin and a rotund 
form. When tolerance of the drug is established, large doses are used 
with impunity, as by the arsenic-eaters of Styria, who can swallow at 



120 ARSENIUM. 

once as much as 5 grains with safety. They are careful, however, not 
to take any water into the stomach at the same time, so that the dose is 
slowly absorbed, and probably eliminated rapidly. Not all those who 
begin its use can acquire tolerance of it, but those who do so seem to 
continue it without injury, and live to an old age, undergoing great 
exertion without exhaustion, and being enabled to ascend steep moun- 
tains without difficulty of respiration. 

In full medicinal doses, continued for some time, it causes itching and 
oedema of the eyelids, ptyalism, nausea and vomiting, diarrhoea or dysen- 
tery, epigastric pain and soreness, feeble and irritable heart, dyspnoea, 
disordered sensibility, herpes zoster, urticaria, eczema and other skin 
eruptions, jaundice and albuminuria. 

In large doses, it is a powerful irritant to the gastro-intestinal and 
bronchial mucous membranes. Toxic doses may produce either symptoms 
of gastro-enteritis, or those of profoundly narcotic character. In the 
first and most usual form of acute arsenical poisoning, there is burning 
pain in the throat and stomach extending over the abdomen, vomiting, 
thirst, bloody stools, strangury, suppressed, albuminous or bloody urine, 
rapid and feeble heart, great anxiety, cold breath, finally exhaustion and 
collapse, — a group of symptoms much resembling cholera. Autopsy 
shows erosions, ecchymoses, and softening of the gastro-intestinal mucous 
membrane, congestion of the lungs and bronchi, and fatty degeneration 
of the liver, kidneys and cardiac muscle. The poison is found in the 
urine, saliva, tears, sweat, etc., and may be detected even in the paren- 
chymatous tissues. In the nervous form of poisoning by Arsenic, pro- 
found coma and insensibility come on suddenly without any gastro- 
intestinal symptoms. 

Arsenical preparations are generally classed as alteratives, but they are 
valuable tonics and antiseptics, and possess antiperiodic powers second 
only to those of Quinine. 

Chronic Arsenical Poisoning may occur from the inhalation of arsenical 
vapors or dust arising from wall-papers or other substances containing the 
poison. The quantity necessary to produce symptoms of poisoning 
when inhaled seems to be very small. The most prominent symptoms 
are, at first increased appetite, next colicky pains, mucous or dysenteric 
stools, irritation of the eyes, coryza, a short, dry cough, and a white and 
silvery tongue, all accompanied by great bodily prostration. 

To avoid arsenical poisoning during a course of the drug, full doses 
(tr^x of Fowler's Solution) should be used at the commencement, and 
always taken on a full stomach. The dose should then be steadily re- 
duced. Susceptible persons often tolerate it better if a few drops of 
Tinctura Opii are administered with each dose. 



ARSENIUM. 121 

Antidoles and Incompatibles. 

Poisoning by Arsenic is treated by prompt evacuation of the stomach, and washing it 
by means of the stomach pump, then Magnesia, Chalk and Lime-water freely, or better 
still, the chemical antidote to Arsenic in solution, viz., the Hydrated Oxide of Iron, 
freshly precipitated and in a soft magma, in the proportion of gr. viij for each grain of the 
poison ingested. (See Ferri Oxidum Hydratum for the preparation of this antidote.) 
Oil or mucilaginous drinks should be given to protect the mucous membranes, and dilu- 
ents, alkaline mineral waters or Iodide of Potassium to promote elimination. Dialyzed 
Iron has been shown to be quite efficient as an antidote, and is more easily obtained 
than the hydrated oxide. It has rendered good service in many cases of poisoning from 
inhalation of arsenical fumes. 

Incompatibles are salts of iron, magnesia and lime, and astringents. 



Therapeutics. 

Externally, Arsenic has been employed in the form of paste as a depila- 
tory, and as an escharotic in cancers, but is excessively painful. Most of 
the secret " cancer cures " have arsenious acid for their basis. Internally, 
it is used as a tonic and astringent to the intestinal canal, as a tonic and 
antispasmodic in nervous diseases, and for its action on tissue change. It 
is of especial value in irritative dyspepsia, gastralgia, pyrosis, gastric 
ulcer or cancer, regurgitation of food without nausea, diarrhoea coming 
on immediately after taking food, vomiting of drunkards and chronic 
alcoholism. It has proven of signal service in the commencement of 
phthisis, and in catarrhal pneumonia, probably by causing fatty degen- 
eration of the exudation in the alveolar cavities, thus breaking it up and 
quickening its absorption. It is often very serviceable in chronic bron- 
chitis with copious expectoration, in acute catarrh, hay-fever, whooping- 
cough, asthma, chorea, epilepsy, angina pectoris and other spasmodic 
nervous disorders. In many forms of neuralgia, it often gives prompt 
and permanent relief, especially in cases due to malarial poisoning. As 
an antiperiodic, it has high rank, being, however, of particular value in 
chronic malarial poisoning, and as an adjunct to Quinine in the intervals 
between the paroxysms of intermittents. Anaemia and chlorosis are re- 
markably benefited by it, and in rheumatic arthritis and chronic rheuma- 
tism it is sometimes of great service. In chronic scaly and papular skin 
diseases its value is very great, but it is not serviceable in acute forms, 
and the more chronic the cutaneous affection the more likely is it to be 
amenable to Arsenic. Epithelioma may be retarded by small doses long 
continued, ,and it has certainly been useful in delaying the progress of 
other cancers, particularly scirrhus of the stomach and uterine carcinoma. 
Hypodermically its solutions have been extremely efficient in histrionic 
spasm, local chorea of the head and neck, obstinate cases of general 
chorea, and in lymphadenoma. 

The Bromide of Arsenic is much in favor, in the form of Clemen's 
Solution, as a remedy for diabetes of hepatic origin. 



122 ASAFCETIDA. 

ASAFCETIDA, Asafetida,— a gum-resin obtained by incision 
from the living root of Ferula Narthex and Ferula Scorodos??ia, peren- 
nial herbs of the nat. ord. Umbelliferse, and natives of Persia and 
Afghanistan. It occurs in whitish tears embedded in a grayish sticky 
mass, of alliaceous odor and taste, soluble in alcohol to at least 60 per 
cent., and triturated with water it yields a milk-white emulsion. Its 
principal constituent is a Sulphuretted Volatile Oil, consisting chiefly of 
Sulphide of Allyl, C 6 H 10 S ; it also contains a gum and a resin, with 
ferulaic, malic, acetic, formic and valerianic acids. Dose, gr. v-xx. 

Preparations. . 

Tinctura Asafoetidce, — strength 20 per cent. Dose, ^ss-ij. 

Mistura Asaf&tidce, — a watery emulsion of strength 4 per cent. Dose, ^ss-^ij. 

Emplaslrum Asafcetidce, — Asafetida 35, Lead Plaster 35, Galbanum 15, Yellow Wax 
15, and Alcohol 120 parts. 

Pilules Asafoetidce, — each has gr. iij with gr. j of Soap. Dose, j-iv. 

Pihdcz Aloes et Asafcetidce, — each has gr. 1^ of each ingredient. 

Pilulce Galbani Composite?, — each has gr. ^ of Asafetida, and gr. jss each of Galbanum 
and Myrrh, with syrup. Dose, j-iv pills. 

Mistura Magnesice et Asafoetidce, Dewees' Carminative, — Magnesium Carbonate 5, 
Tinct. Asaf. 7, Tinct. Opii 1, Sugar 10, Aqua Dest. q. s. ad 100 parts. Dose, ^ss-^ss. 

Spiritus Ammonice Fcetidus (Unofficial), — Asafetida \y z , Liquor Ammonia? Fortior 2, 
Spirit 20 parts. Dose, gss-j. 

Physiological Action. 

Asafetida is a powerful antispasmodic, a stimulant to the brain and 
nervous system, a stimulating expectorant, also tonic, laxative, diuretic, 
diaphoretic, emmenagogue, aphrodisiac and anthelmintic in action. Its 
odor and taste are extremely nauseous and persistent. 

In small doses continued it is said to cause impaired digestion, alliace- 
ous eructations, acrid sensation in the fauces, gastralgia, flatulent disten- 
tion, fetid flatulence, burning urination, diarrhoea and tenesmus. Full 
doses produce various nervous or hysterical phenomena, with nausea, 
vomiting and purging. 

The Volatile Oil diffuses into the blood and tissues, and is excreted in 
the urine, sweat, breath, etc. By its action the circulation is stimulated, 
the arterial tension raised, the power of the cardiac motor ganglia is 
increased and the inhibition relaxed. Asafetida also stimulates the brain 
even to a very pleasant intoxication, and produces a subjective sensation 
of warmth without any rise of body temperature. It stimulates the 
nervous system, the secretions and excretions, the menstrual flow and the 
sexual appetite. In Asia it is used as a condiment with food, and though 
at first it is extremely nauseous to most people, a taste for it may be 
readily acquired. 

Therapeutics. 
• The disgust which is generally felt for this remedy makes its use very 
restricted, though a valuable medicine. The Mixture is extremely service- 



ASCLEPIAS ASPIDIUM. I 23 

able in the flatulent colic of infants, and as an enema in infantile con- 
vulsions. There is no better remedy in hysteria and hypochondriasis 
with indigestion and flatulence, — in constipation with amenorrhcea of 
anaemic subjects, due to ovarian and intestinal torpor, — in bronchial 
affections, cough of habit, chronic catarrhs, and flatulent indigestion. 



ASCLEPIAS, Pleurisy Root, — is the root of Asclepias tuberosa, 
a plant of the nat. ord. Asclepiadaceae and a native of the Eastern and 
Southern States. Two other species of Asclepias are used in medicine 
and were formerly official. There are no official preparations, but a fluid 
extract is in the market, the dose of which is about 3J every four hours. 
An infusion or decoction may be made in the proportion of ,^j of the 
powdered root to a quart of water, and given in teacupful doses every 2 
or 3 hours. 

Physiological Action and Therapeutics. 
Asclepias contains two resins, a peculiar principle, tannic and gallic 
acids, albumen, pectin, gum, various salts and a volatile, odorous, fatty 
matter. It is emetic and cathartic in full doses, also diaphoretic and 
expectorant, as well as depressant to the action of the heart, and prob- 
ably slightly sedative and astringent. It is a popular remedy in the 
Southern States for pleurisy (hence its common name), and has been used 
in medicine for catarrh, pneumonia, phthisis, diarrhoea, dysentery, rheu- 
matism, gastralgia, and to promote the eruption in exanthematous fevers. 
It is undoubtedly a powerful diaphoretic. 



ASPIDIUM, — is the rhizome of Aspidium Filix-rnas (Male Fern) 
and of Aspidium marginale (Marginal Shield Fern), plants of the nat. 
ord. Filices, the former found in most parts of the world, the latter indi- 
genous to N. America. It is 3 to 6 inches long, thick, scaly, having 
fibro-vascular bundles within, arranged in an interrupted circle ; odor 
slight but disagreeable, taste sweetish and bitter, astringent and nauseous. 
The above principle is Filicic Acid, C u H 18 5 , which is extracted in the 
oleo-resin. It also contains a green, fatty oil, a volatile oil, resin, tannin, 
etc. Dose, gss-^jss in a single dose fasting, or in divided doses at short 
intervals, followed by a purgative. 

Preparation. 

Oleoresina Aspidii, — is an ethereal extract and deposits Filicic Acid on standing. It 
should be well shaken before being used. Dose, ^ss-^j,in capsules, repeated every 
3 hours for 2 or 3 doses. 



124 aurantium. 

Physiological Action and Therapeutics. 
Aspidium is an efficient vermicide against tape-worm, particularly the 
unarmed variety (Bothriocephalus latus). The oleoresin is the best form 
in which to use it, the patient having fasted for the previous day, or only 
used a milk diet, gj may then be given in 4 doses ^ hour apart. This 
may be repeated the next morning and followed by three drops of croton 
oil in emulsion. This is one of many methods. Brayera (Kousso) may 
be combined with it advantageously. A formula for a mixed treatment 
by Aspidium, Pomegranate and Pumpkin-seed is given under the title 
Granatum. 



AURANTIUM, Orange, — occurs in two official varieties of fruit 
and flowers, viz., those of Citrus vulgaris, the Bitter Orange, and Citrus 
Aurantium, the Sweet or Portugal Orange, both trees of the nat. ord. 
Aurantiacese, cultivated in almost all warm climates. Other varieties are 
described under Limon. The official titles are — 

Aurantii Amari Cortex, Bitter Orange Peel, — the rind of the fruit 
of Citrus vulgaris, characteristics well known. Contains a Volatile Oil 
isomeric with Oil of Turpentine. C 10 H 16 , and a bitter, crystalline princi- 
ple, Hesperidin or Aurantiin. 

Aurantii Dulcis Cortex, Sweet Orange Peel, — is the rind of the 
fruit of Cit7'us Aurantium. It contains a Volatile Oil differing from that 
of the bitter orange, and less of the bitter principle. 

Aurantii Flores, Orange Flowers, — the partly expanded fresh flowers 

of Citrus vulgaris and Citrus Aurantium. They contain an aromatic 

Volatile Oil (the official Oleum Aurantii Florum), and a trace of bitter 

principle. 

Preparations. 

Extraction Aurantii Amari Fluidum, — Bitter Orange Peel 100, Alcohol and Water. 
Used as flavoring. Dose, gss-j. 

Tinctura Aurantii Amari, — Bitter Orange Peel 20, Diluted Alcohol q. s. ad 100. A 
flavoring preparation. Dose, £j— ij. 

Tinctura Aurantii Dulcis, — Sweet Orange Peel 20, Diluted Alcohol q. s. ad 100. For 
flavoring. Dose, gj-ij. 

Syrupus Atirantii, — Sweet Orange Peel 5, Alcohol 5, Calcii Phosphas Prsecip. 1, Sugar 
60, Water q. s. ad 100. FJavoring. 

Oleum Aurantii Corlicis, — a volatile oil, extracted by mechanical means from fresh 
orange peel. Is soluble in 2 of alcohol, and is an ingredient of Bay Rum (Sp. Myrciae). 
Dose, gtt. j-v. 

Elixir Aurantii, Simple Elixir, Oil of Orange Peel I, Sugar 100, Alcohol and Water 
q. s. ad 300. An excipient for extracts and tinctures, designated to replace the unofficial 
elixirs. 

Spiritus Aurantii, — Oil of Orange Peel 6, Alcohol 94 parts. Dose, to be regulated by 
the quantity of alcohol desired. 

Aqua Aurantii Florum, Recent Orange Flowers 40, Water 200 parts distilled to 100 
parts. Dose, indefinite. 

Oleum Aurantii Florum, Oil of Neroli, — a volatile oil, distilled from fresh orange 
flowers. Is the most important constituent of Cologne Water (Spt. Odoratus). Dose, 
gtt. j-v. 



AURUM. 125 

Syrupus Aurantii Florum, Orange-flower Water 35, Sugar 65. A delicate flavoring 
agent, but having to some persons an extremely sickish taste. 

Physiological Action and Therapeutics. 
Orange is aromatic and tonic, also more or less bitter, but has little 
action except a mild influence on the nervous system due to its volatile 
oil. Persons much exposed to its fumes are liable to cutaneous eruptions 
and various nervous disorders. The oil may produce violent colic and 
convulsions in children, one case being reported in which death resulted 
from eating the rind. Its use in medicine is confined to flavoring pur- 
poses, though the preparations of the Bitter Orange may be used as mild 
tonics and stimulants to the digestion, but they are usually combined with 
more energetic agents for these purposes. 



AURUM, Gold, Au, — is represented by but one official preparation. 

The Chloride is found in the shops, being much used by photographers ; 

and triturations of the metal itself may be prepared according to the 

general formula therefor. 

Preparations. 

Auri et Sodii Chloridum, — is a mixture composed of equal parts of dry Chloride of 
Gold and Chloride of Sodium, AuCl 3 -{- NaCl. An orange-colored powder, soluble in 
water. Dose, gr. yVlV 

Auri Chloridum (Unofficial), — occurs in needle-shaped prisms, of an orange-yellow 
color, deliquescent, freely soluble in water. Dose, gr. 3*5—^5-. Is best given in solution. 

Physiological Action. 
Locally used the Chloride of Gold is escharotic ; administered inter- 
nally its action closely resembles that of the Bichloride of Mercury. In 
small doses, it promotes appetite and digestion, and stimulates the func- 
tions of the brain, producing marked mental exhilaration and a general 
sense of well-being. Continued, it induces aphrodisiac effects in both 
sexes, and in women increases the menstrual discharge. Full doses cause 
nausea and vomiting, glandular irritation, salivation without loosening of 
the teeth or sore gums, increased urinary discharge, sweat and fever (the 
auric fever) ; nutrition is impaired and rapid waste set up. A toxic dose 
produces effects similar to those from corrosive sublimate, namely, violent 
gastro-enteritis, mental disturbance, priapism, tremor, convulsions and 

paralysis. 

Antagonists. 
Poisoning is treated by albumen (eggs) or flour, and evacuation of the stomach — just 
as in the case of Corrosive Sublimate. 

Therapeutics. 
Chloride of gold is a useful remedy in irritative dyspepsia, gastro- 
duodenal catarrh, hypochondriasis, amenorrhcea, functional impotence, 



126 AVENA SATIVA AZEDARACH. 

chronic metritis, habitual abortion, ovarian dropsy, vertigo and vertigin- 
ous sensations from disordered stomach. It is especially recommended 
in chronic albuminuria, hepatic sclerosis, granular and fibroid kidney, as 
it prevents hyperplasia of connective tissue. In syphilis its utility is 
proven beyond doubt, particularly in the tertiary manifestations and syphi- 
loma of the bones, in which it is fully as efficacious as the Bichloride of 
Mercury, with incomparably less inconvenience to the patient. 



AVENA SATIVA,— the common Oat, a plant of the nat. ord. 
Graminacese, — was official in the U. S. P. 1870, as Avena Farina, or 
Oat-meal. A concentrated tincture or fluid extract has recently been 
extensively advertised by drug manufacturers as a nerve stimulant and 
tonic, especially efficacious in the treatment of chorea, epilepsy, insomnia, 
nervous exhaustion, alcoholism and the Opium-habit. The seeds contain 
starch, gluten, gum, etc., and form a nutritious food, the meal being made 
into a porridge, or gruel. In the latter form it is a good demulcent for 
coughs. The pericarp contains an amorphous alkaloid, which has doubt- 
less some stimulant and narcotic power; but the claims advanced for it, 
as a specific remedy for the cure of the opium-habit, have been strenu- 
ously denied by many competent observers. Dose of the concentrated 
tincture or fluid extract may be stated at n^x-^ij. 



AZEDARACH, — is the bark of the root of Melia Azedarach, or 
Pride of China, a handsome tree of the nat. ord. Meliaceae, indigenous 
to China and India, but naturalized in the Gulf States. It occurs in 
curved pieces or quills, which are almost inodorous and have a sweetish 
taste, afterwards becoming bitter and nauseous. There are no official 
preparations, but a decoction of the fresh bark (^ij to Oj boiled to 0}4) 
may be used in tablespoonful doses. 

Physiological Action and Therapeutics. 
This drug is known to produce symptoms of narcotic poisoning, as gid- 
diness, dimness of sight, mental confusion, stertorous breathing, dilated 
pupils and stupor. Large doses are necessary to cause these effects, and 
some authorities question their occurrence. It is, however, a gastro- 
intestinal irritant, producing vomiting and purging, and an anthelmintic 
against the round-worm. Its active principle has not been isolated. It 
is only employed as an anthelmintic against lumbricoid worms, and as the 
fresh bark is difficult to obtain in any region where it does not grow, 
other agents will be more generally used. It is given to horses affected 
with "bots." 



BALSAMUM PERUVIANUM BALSAMUM TOLUTANUM. 12J 

BALSAMUM PERUVIANUM, Balsam of Peru,— is a bal- 
sam obtained from Myroxylon Pereirce, a Central American tree, of the 
nat. ord. Leguminosae. Occurs as a thick, brown-black liquid, its odor 
reminding of benzoin and vanilla, soluble in 5 of alcohol, almost 
insoluble in water, which only extracts from it some Cinnamic Acid and 
Cinnamein. It is not a true balsam, as it contains no volatile oil. Com- 
position is, — Cinnamein (Benzyl Cinnamate, C 16 H u 2 ) 60 per cent., 
Cinnamic Acid 6 per cent., Resins 30 per cent. ; also Benzoic Acid and 
other bodies. Dose, n^x-xxv, in emulsion. There are no official pre- 
parations. 

Physiological Action and Therapeutics. 

The actions of Balsam of Peru are those of its several constituents, 
namely, antiseptic, disinfectant, stimulant to the circulation, and sedative 
to the nervous system ; acting chiefly on the mucous membrane, it is tonic 
and expectorant, diuretic and diaphoretic. In large doses, it causes gas- 
tralgia, nausea and vomiting, colic and diarrhoea. It closely resembles in 
physiological action its congeners, Styrax and Benzoin. 

Balsam of Peru is used locally in chronic skin diseases of inflammatory 
type and sore-nipples, to relieve itching, cleanse bed-sores, promote the 
healing of wounds and sores, and to kill the acarus scabiei, being consid- 
ered by some authorities the best of all applications in itch. Internally, 
it is used as a stimulant and disinfectant expectorant in chronic bron- 
chitis, asthma, etc., as well as in gonorrhoea, gleet, leucorrhoea, and 
other discharges from mucous membranes. Incorporated with Iodoform 
it partially covers the odor of that drug. 



BALSAMUM TOLUTANUM, Balsam of Tolu,— is a balsam 
obtained from Myroxylon toluifera, a tree of the nat. ord. Leguminosae, 
native in Venezuela and New Granada. Its composition and properties 
are similar to those of Balsamum Peruvianum, except that it is of lighter 
color, more agreeable odor, and contains a volatile oil, Tolene, in the 
proportion of about 1 per cent. 

Preparations. 

Tinctura Tolutana, Tincture of Tolu, — contains 10 per cent, of the balsam dissolved 
in 90 of alcohol. Dose, rr^x-xxx. 

Syrupus Tolulanus, Syrup of Tolu, — has of the balsam 4 parts in 100 of sugar and 
water. Dose, 3 j — ij. Much used in cough mixtures. Covers the taste of Chloral well. 

Physiological Action and Therapeutics. 
Balsam of Tolu has similar actions to those of Balsam of Peru, but 
being more agreeable in flavor it is used internally more than the latter. 
It is chiefly employed as a pleasant excipient in cough mixtures, and is a 
constituent of the compound Tincture of Benzoin. 



128 BAPTISIA — BELLADONNA. 

BAPTISIA, Wild Indigo (Unofficial),— is the root bark of Bap- 
tisia tinctoria, a plant of the nat. ord. Leguminosae, native in North 
America, and contains an alkaloid and a resin, neither of which have 
been examined critically. The so-called Baptism is an impure resinoid, 
obtained by precipitation from the alcoholic extract with water. 

Preparations. 

Extractum Baptisicz, Extract of Baptisia (Unofficial). Dose, gr. j-x. 
Extractum Baptisice Fluidum (Unofficial). Dose, Tr^ij-xx. 
Tinctura Baptisice (Unofficial). Dose, tt\v-xxx. 
Baptisin (Unofficial), — the resinoid. Dose, gr. j-v. 

Physiological Action and Therapeutics. 

Baptisia has a bitter and acrid taste ; in small doses it is laxative, in 
large violently emeto-cathartic, and may excite severe gastro-intestinal 
inflammation. It is a decided stimulant of the liver, and increases the 
secretions of all the glandular appendages of the gastro-intestinal mucous 
membrane. It has considerable power as an antiseptic. 

Baptisia has been used locally in decoction or cataplasm to obstinate 
and painful ulcers, in threatened or exciting gangrene, and gangrenous 
sores. Internally, it is a useful remedy in amenorrhcea, typhoid and 
typhus fevers, variola, scarlatina, and epidemic dysentery. In the common 
continued-fever, or in the first stage of typhoid, it will be found of great 
service in drop-doses of a fresh tincture, repeated every hour. 



BELLADONNA, Deadly Nightshade, — is an herbaceous, peren- 
nial plant, of the nat. ord. Solanaceae, having dark-purple, bell-shaped 
flowers, and glossy, purplish-black berries about the size of cherries. It 
is indigenous in the mountainous districts of Central and Southern Europe 
and Asia, and is cultivated in Europe and in the United States. It con- 
tains two alkaloids, — the official Atropine (see below), and Belladonnine, 
the latter being considered by many authorities as identical with Hyoscy- 
amine, Daturine, and Duboisine. These exist in the plant in combination 
with Malic Acid. The plant also contains the usual vegetable constituents, 
as albumen, gums, etc., and a coloring principle named Atrosin. The 
official titles are as follows: — 

Belladonna Folia, Belladonna Leaves, — ovate and tapering, brown- 
ish green above, grayish-green below, of slight odor and bitter, disagree- 
able taste. Stramonium leaves are more wrinkled, Hyoscyamus leaves 
are more hairy. Dose, gr. j, gradually increased. 

Belladonna Radix, Belladonna Root, — cylindrical, tapering, wrinkled 
pieces, ^ to i inch think, nearly odorless, taste bitter and acrid. Dose, 
gr. j, cautiously increased. 



BELLADONNA. I 20, 

Preparations of the Leaves. 
Extractum Belladonnce Alcoholicum, — Dose, gr. j-q-}4- 
Tinctura Belladonnce, — 15 per cent. Dose, mj-xxx. 

Unguentum Belladonnce, — has of the Alcoholic Extract 10, Diluted Alcohol 6, Ben- 
zoinated Lard 84. 

Preparations of the Root. 
Abstr actum Belladonnce, — Dose, gr. jq— j. 
Extractum Belladonnce Fluidum, — Dose, Try -v. 
E7iiplastrum Belladonnce, — made with Resin Plaster. 
Linimentum Belladonnce, — Fluid Extract 95, Camphor 5. 

Atropine and its Derivatives. 

Atropina, Atropine, C 17 H 23 N0 3 , — in white, acicular crystals, odorless, of bitter taste 
and alkaline reaction; very soluble in alcohol and in chloroform, also in 600 of water at 
50 F. Is decomposed by prolonged contact with caustic alkalies and is resolvable into 
Tropin and Tropic Acid. 

Atropince Sulphas, Sulphate of Atropine (C n H 23 N0 3 ) 2 H 2 SC\, — a white powder of 
bitter taste and neutral reaction, soluble in 0.4 of water and in 6.5 of alcohol at 50 F. 
Dose, gr. T | -^- 

Homatropina, Homatropine, C 16 H 21 N0 3 (Unofficial), — is a derivative alkaloid obtained 
by the action of dilute HC1 on Amygdalate of Tropin. The Hydrobromate of Homa- 
tropine is used by ophthalmologists as a mydriatic, its effects passing off much sooner 
than those of Atropine. Homatropine slows the heart, Atropine quickening it. 

Tropeius (Unofficial), — is a result of the action of a mineral acid on Tropin. 



Physiological Action. 

Belladonna is an irritant narcotic, a mydriatic, an antispasmodic and 
an anodyne; in small doses a cardiac, respiratory and spinal stimulant — 
in large doses a paralyzer of the cardiac and respiratory centres, the 
spinal cord, the motor nerves and involuntary muscles. It produces con- 
gestion and dryness of the mucous membrane of the throat, mouth, nose 
and larynx, and at first lessens the gastric and intestinal secretions, but 
soon reproduces these in large quantity. The heart rate is at first slowed, 
but soon becomes very rapid and vigorous, the pulse being doubled in 
rapidity ; the arterial tension being at the same time raised, the circula- 
tion is greatly increased. This is accomplished by stimulation of the 
cardiac sympathetic, and paralysis of the pneumogastric, thus stimulating 
the accelerator apparatus while lessening the inhibitory. [Digitalis in- 
creases both.] The vasomotor ganglia are stimulated all over the body, 
but are afterwards paralyzed by over-stimulation, the heart weakens, the 
vessels relax, and the blood-pressure becomes greatly reduced. Complete 
motor paralysis follows, delirium, stupor, and finally death, which usually 
occurs by asphyxia. 

The pupils are dilated by the local or systemic use of the drug, it stimu- 
lating the end-organs of the sympathetic and paralyzing those of the 
motor oculi, thus increasing the power of the radiating iris fibres and 
lessening the action of its circular ones. Atropine locally also paralyzes 
accommodation and increases the intraocular pressure. The least quantity 
of Atropine which will affect the pupil is stated at gr. T owo (Wood), gr. 
9 



I3O BELLADONNA. 

lowo (Roosa), gr. ^L (Ely), gr. 12^00 Trousseau), gr. ^^ 
(Loring), gr. 70( f 000 (Donders). 

The brain is congested by Belladonna, headache, vertigo, busy delirium, 
hallucinations, etc., being produced, the latter from a selective action on 
the cells of the gray matter. The spinal cord is stimulated from the 3d 
cervical to the 10th dorsal vertebra, resulting in complete motor paralysis, 
central and peripheral, power being lost first in the lower extremities. 
Sensation is also impaired somewhat, but the muscular irritability is not. 
Respiration is increased and the body temperature elevated. Metamor- 
phosis is greatly promoted by the increased activity of the circulation. 

A diffused eruption of scarlet color, greatly resembling the eruption of 
scarlet fever, is often produced on the skin and fauces by Belladonna, 
with dysphagia and sore throat, and is sometimes followed by desquama- 
tion of the epidermis. It is due to capillary congestion caused by the 
greatly increased circulation. 

Belladonna is rapidly diffused and quickly eliminated, particularly by 
the kidneys. The urine of an animal under the action of the drug will 
dilate the pupil of another animal. Herbivorous animals and birds are 
scarcely susceptible to it, and pigeons are not affected by it at all. 

Atropine has the same actions as above described, being the active 
principle of the plant. Belladonnine was long supposed to be inert, 
but has recently been shown to be identical with Hyoscyamine. It is a 
mydriatic when given internally, but not when used locally. 

Antagonists and Incompatibles, 
Opium is the physiological antagonist to the effects of Belladonna on the cerebrum, 
pupil, heart, respiration, arterial tension and kidneys. Physostigmine, Aconite, Pilocar- 
pine and Quinine are each antagonistic to some of its effects, Muscarine to most of them. 
In poisoning by this drug, Tannic Acid and emetics should be used, then Morphine, 
Physostigmine or Pilocarpine for the nervous disturbances. Caustic alkalies decompose 
Atropine and are therefore incompatible with the preparations of Belladonna. 

Therapeutics. 
Belladonna is one of the most valuable drugs in the Materia Medica, 
ranking with Aconite, Arsenic and Opium in efficacy and wide range of 
use. It is especially useful in the pain of inflammation, particularly that 
of rheumatism, gout, neuralgia due to peripheral disturbance, sciatica, 
cancer and pelvic affections. In cerebral and spinal hyperemia, conges- 
tive headaches, encephalitis, meningitis and myelitis it proves one of the 
very best remedies. In erysipelas of superficial and non-vesicular charac- 
ter and when cerebral, it is really curative locally and internally adminis- 
tered. Inflammations of the lungs, iris, bladder, kidneys and breasts are 
all amenable to it. In constipation from atony of the bowels it is re- 
markably efficient, and in the enuresis of children it is equally so if used 
freely, 10 to 20 drops of the tincture thrice daily. In recent cystitis 



BENZINUM. 131 

from chill, spasm of the urethra, bladder, and sphincter ani, typhus and 
typhoid fevers, acute nasal catarrh, sore throat with fever, inflammation, 
and swollen tonsils, many skin diseases, asthma and whooping-cough, 
epileptic and puerperal convulsions, spermatorrhoea and seminal losses, 
Belladonna is often a highly useful agent. Its local application is effi- 
ciently used in ulcers of the rectum, anal fissure, abscesses, boils, carbun- 
cles, and other superficial inflammations. In scarlet fever it relieves 
many of the symptoms, and is especially indicated in this disease when 
the rash is imperfect, the pulse feeble and the condition one of adynamia. 
Its prophylactic power against scarlet fever is believed in by many of our 
best practitioners, though questioned by many others. 

Atropine is used in poisoning by Opium, Physostigma, and Prussic 
Acid; in ptyalism from mercury, pregnancy, etc. ; in the sweats of phthisis, 
sudden cardiac failure, and by eye-surgeons to paralyze accommodation, 
dilate the pupil, contract the vessels, lessen pain, and diminish (?) intra- 
ocular tension. In opium-poisoning it should be given in very small doses, 
and repeated for effect, as most of the unsuccessful cases of its use in this 
connection were due to overdosing with the antagonist, superinducing 
belladonna-narcosis upon the opium-narcosis. In cases of heart-failure 
from Chloroform or Ether inhalation, the hypodermic injection of Atro- 
pine has, in the writer's hands, saved several lives when all other methods 
of resuscitation had failed. 



BENZINUM, Benzin, Petroleum Ether,— is a purified distil- 
late from American petroleum, consisting of hydro-carbons, chiefly of the 
marsh-gas series, having a specific gravity from 0.670 to 0.675, an d boil- 
ing at 12 2° to 140 F. It is a transparent, colorless liquid, highly inflam- 
mable, very diffusive, insoluble in water, but soluble in alcohol, ether, etc. 
It should be distinguished from Benzol, which is called Benzene by Eng- 
lish chemists. In pharmacy it has many uses on account of its powers 
as a solvent for oils, fats, resins, caoutchouc and some alkaloids. Dose, 
gtt. v-x, on sugar or in mucilage. 

Physiological Action and Therapeutics. 
Benzin is reported to have caused death in one case from gastro-enteritis, 
but ordinarily it does not produce vomiting or diarrhoea. It has been 
used with some success externally as a remedy for rheumatic pain, neural- 
gia, itch and prurigo ; and internally as a vermicide against tapeworm. 
Its chief value is that of a solvent in cleaning old clothing and in phar- 
maceutical operations. 



132 BENZOINUM. 

BENZOINUM, Benzoin, — is a balsamic resin obtained from Styrax 
Benzoin, a tree of the nat. ord. Styracese, native in Sumatra and Siam, by 
incision of its bark. It occurs in agglutinated tears or a brown, mottled 
mass, is soluble in alcohol and solution of potassa, and is composed of 
Resins 80 per cent., Benzoic Acid 10 to 20 per cent., and a trace of 
Volatile Oil. Some varieties of benzoin yield also Cinnamic Acid. 

Preparations of Benzoin. 

Adeps Benzoinatus, Benzoinated Lard,; — has of Benzoin 2 parts in 100 parts of Lard. 

Tinctura Benzoini, Tincture of Benzoin, — has of Benzoin 20 parts, Alcohol q. s. ad 
100. Dose, .^ss-j. 

Tinctura Benzoini Composita, Friar's Balsam, — has of Benzoin 12, Aloes 2, Styrax 8, 
Balsam of Tolu 4, Alcohol q. s. ad 100 parts. Dose, gss-ij. 

Preparations of Benzoic Acid. 

Acidum Benzoicum, Benzoic Acid, HC 7 H 5 2 , — occurs in light, feathery plates and 
needles, and is obtained from Benzoin by sublimation. It is soluble in 500 of water, and 
in 3 of alcohol at 95 F., but its solubility in water is aided by Borax, one part of each 
being soluble in 100 parts. It is a constituent of Tinctura Opii Camphorata. Dose, gr. 
x-xxv, in wafers. 

Ammonii Benzoas, Benzoate of Ammonium, — is soluble in 5 parts of water and in 28 
of alcohol. Dose, gr. v-xxx. 

Lithii Benzoas, Benzoate of Lithium, — soluble in 4 parts of water and in 12 of alcohol. 
Dose, gr. v-xxx. 

Sodii Benzoas, Benzoate of Sodium, — is efflorescent on exposure to air, soluble in 2 
parts of water and in 45 of alcohol. Dose, gr. v— ^j. 

Physiological Action. 
Benzoin is decidedly antiseptic and disinfectant, and when used exter- 
nally is somewhat stimulant to the vessels. Its actions are due to its 
Benzoic Acid, which taken internally produces slight epigastric heat, 
increases the pulse-rate, and stimulates the action of the skin, the salivary 
glands, and of the bronchial mucous membrane. It is chiefly excreted 
by the kidneys, in part as hippuric acid by combination with glycocoll, 
and in part unchanged. It renders the urine acid and increases its quan- 
tity. Benzoin is irritant to the fauces, and the powder inhaled excites 
sneezing and coughing. 

Therapeutics. 
Benzoin is principally used as a stimulant expectorant, especially in the 
chronic bronchitis of the aged, and by atomization in laryngeal affections. 
The compound tincture, 3J to gj in a pint of boiling water, is a useful 
sedative inhalation for the irritation and cough of subacute laryngitis and 
tracheitis. It has also been used beneficially in chlorosis and some 
uterine disorders. The compound tincture is a good local application 
(1 to 4 of glycerin and water) for sore nipples and chaps of the hands 
and lips. For use as a cosmetic, either tincture is mixed with 20 parts 
of water, and employed to remove freckles and other skin affections, 
especially urticaria. They are excellent applications to foul-smelling 



BERBERIS. 133 

wounds, and form the basis of all the proprietary preparations sold for 
that purpose. 

Benzoic Acid and its salts are the only certain means we possess, by 
which to neutralize morbid alkalinity of the urine. In cystitis, with 
phosphatic deposits and alkaline urine, they are extremely valuable, acid- 
ulating the secretion, and stimulating and disinfecting the mucous surfaces 
involved. Phosphatic calculi are said to be dissolved by the long-con- 
tinued use of Ammonium Benzoate. 

Benzoate of Sodium has been largely used as a substitute for the 
salicylates in the septic diseases, being equally antiseptic and antipyretic. 
Though slower in action, its effects are more permanent, and it is capable 
of being used in larger doses (^ij-iij daily). In diphtheria and scarlet 
fever it has been highly efficient, and in acute rheumatism, typhoid and 
the malarial fevers, it has rendered good service. In phthisis, its use by 
inhalation to the extent of y^Vo of the body-weight daily has seemed to 
be of value in some cases. It has also proven very efficient in whooping- 
cough. 

Benzoate of Lithium is intended for use in gout and the uric acid 
diatheses, with the object of forming the very soluble urate of lithium in 
the system, as also on the theory that, as benzoic acid is converted into 
hippuric acid at the expense of nitrogenous material which would other- 
wise become uric acid, the latter product will be lessened. 



BERBERIS, Barberry (Unofficial), is the root of several species 
of the nat. ord. Berberidaceae, the one generally used being the Berberis 
aquifolium, or Oregon grape, which grows on the Pacific slope of the 
United States. Its value is probably due to its alkaloid, Berberine, 
C 20 H 1T NO 4 , a yellow, crystalline body, soluble in hot water and alcohol, 
but not in ether, which is found also in several other plants, as Hydrastis, 
Coptis, Podophyllum, Menispermum, Calumba, Xanthoxylum, etc. 

Preparations. 

Extr actum Berberidis Fluidum (Unofficial), — Dose, ttTv-xxx. 
Tinctura Berberidis (Unofficial), — 1 to 5. Dose, fT^x-^j. 

Berberina, Berberine (Unofficial), — Dose, gr. j-x. Usually occurs in commerce as 
" Hydrastin," which is a Muriate of Berberine, prepared from Hydrastis. 

Physiological Action and Therapeutics. 

Berberis is an astringent bitter, a tonic and stomachic in small doses, 
but in large doses it is cathartic, producing watery diarrhoea with abdom- 
inal pain. It is also believed to possess considerable alterative powers. 

Berberine has some antiseptic and antiperiodic value, and in large 
doses is a gastro-intestinal irritant. 

Berberis has been successfully used as a local application in conjunc- 



134 BERGAMII OLEUM BISMUTHUM. 

tivitis, and internally as a remedy for intermittent, remittent and typhoid 
fevers, diarrhoea and dyspepsia. As an alterative and tonic it has been 
found useful in syphilitic and strumous affections, and in pain, soreness 
and burning sensations along the biliary or urinary tracts with a tendency 
to gravel or gall-stones it will be found a useful remedy. 

The Muriate of Berberine is a useful injection in gonorrhoea, in which 
it acts by virtue of its antiseptic and astringent powers. 



BERGAMII OLEUM, Oil of Bergamot,— is a volatile oil, 
extracted from the rind of the fresh fruit of Citrus Bergamia, an orange- 
tree of the nat. ord. Aurantiacese, native in Southern Europe. It is of 
greenish color, faintly acid, sp. gr. 0.87, and is soluble in alcohol, glacial 
acetic acid and liquor potassae. It contains several hydrocarbons of the 
formula C 10 H 16 , together with Bergaptene or Bergamot Camphor. It is 
an ingredient of Spiritus Odoratus, and is exclusively used as a perfume 
in the manufacture of toilet articles. 



BISMUTHUM, Bismuth, Bi, — is represented by three of its salts, 
and one combination of the Citrate with Aqua Ammoniae. 

Preparations. 

Bismuthi Cifras, Citrate of Bismuth, BiC 6 H 5 7 , — is a white, amorphous powder, 
odorless and tasteless, insoluble in water or alcohol, but soluble in water of ammonia. 
Used only for pharmaceutical purposes. 

Bismuthi et Ammonii Citras, Citrate of Bismuth and Ammonium, — is not proven to 
have any definite composition. Small, pearly scales, very soluble in water. Dose. gr. j-v. 

Bismuthi Subcarbonas, Subcarbonate of Bismuth (BiO) 2 C0 3 .H 2 0, is a white or 
yellowish-white powder, tasteless, insoluble in water or alcohol. Dose, gr. x-gj, in 
powder or emulsion. 

Bismuthi Subnitras, Subnitrate of Bismuth, BiON0 3 .H,0, — a heavy, white powder, 
odorless and almost tasteless, slightly acid, insoluble in water or alcohol. Dose, gr. x-3 j. 

Physiological Action. 

The action of the last two Bismuth salts is chiefly a local one, being 
sedative to the end-organs of the nerves, though a minute quantity passes 
into the blood and acts as a tonic, promoting constructive metamorphosis 
by increasing the appetite and digestion. They are also feebly astringent, 
and produce constipation after a time, coloring the stools and tongue a 
dark clay color, from their conversion in part into the sulphide. Toxic 
effects when occurring are due to Arsenic, with which the commercial 
preparations are usually contaminated. 

The Citrate of Bismuth and Ammonium, being soluble, is more rapid 
in action, more astringent and probably more irritant, though it is prob- 
ably precipitated in the stomach by the hydrochloric acid of the gastric 
juice. 



boldus brayera. 135 

Therapeutics. 

The insoluble Bismuth salts are used internally in many forms of dis- 
ordered digestion, gastralgia, vomiting and diarrhoea, especially in chil- 
dren, but large doses are necessary for efficiency. The best vehicle for 
them is milk. Locally they are used with advantage in acne rosacea, 
stomatitis, nursing sore mouth, eczema, intertrigo, ulcers, conjunctivitis, 
coryza, gonorrhoea, gleet and leucorrhcea. The Citrate is not used 
except for pharmaceutical purposes, and the Citrate of Bismuth and 
Ammonium is only serviceable in diarrhoea without irritation of the 
intestinal mucous membrane, but rather with relaxation thereof. 

The Subiodide of Bismuth makes an excellent antiseptic dressing for 
ulcers and wounds. 



BOLDUS, Boldo (Unofficial), — the leaves and stems of Peumus 
Boldus, an evergreen shrub of the nat. ord. Monimiaceae, found in 
Chili. It contains a volatile oil and a bitter alkaloid, Boldine. A tinc- 
ture is made (i to 5), of which the dose is r^v-viij, gradually increased, 
but large doses have a somewhat narcotic effect, besides causing vomiting 
and purging. 

Boldo is used in anaemia, rheumatism, dyspepsia and general debility, 
also in catarrhal affections of the urinary passages, and as a substitute for 
Quinine. In France it is employed as a tonic, especially for cases with 
chronic torpor of the liver; and in South America it is much used in 
gonorrhoea and in chronic cystitis. 



BRAYERA, Kousso, — is the female inflorescence of Bray era 
anthelmintic a, an Abyssinian tree of the nat. ord. Rosaceae. It occurs 
in bundles or rolls, of fragrant, tea-like odor, and bitter, nauseous taste, 
and contains tannic acid, a volatile oil, and a crystalline principle named 
Koussin, which by itself is apparently inert. Dose of Brayera -jij-^j. 

Preparations. 
Extractum Brayerce Fluidum, — Dose, £ij-j§ ]■ 
Infusum Brayerce, — 6 per cent. Dose, f ^iv-viij, or more. 

Physiological Action and Therapeutics. 
Kousso has little or no effect except the nausea, vomiting, colic and 
slight diarrhoea produced by large doses. "Its chief action is anthelmintic 
against both varieties of tape-worm, but it rarely expels the head of the 
parasite, and is very nauseous to the taste and difficult of retention by 
the stomach in the large doses necessary to efficiency. 31J to gj of the 
flowers infused in §iv of boiling water is the usual dose, and should be 



I36 BROMUM. 

taken on an empty stomach and followed by a castor-oil or saline purge 
after 3 or 4 hours. An emulsion of the official infusion with castor-oil, 
yolk of egg, a few drops of ether and oil of anise with 10 to 20 drops of 
Oleoresin of Male-fern, is more agreeable and efficient than the infusion 
alone. 



BROMUM, Bromine, Br., — is a dark, brownish-red, volatile 
liquid, evolving an irritant vapor of peculiar and suffocating odor. It is 
soluble in 33 of water at 59 F., very soluble in alcohQl, ether, chloro- 
form and carbon disulphide ; is a non-metallic element found in sea- 
water, and in the mother-liquor of certain salt-works, usually in combi- 
nation. It is only used by inhalation and as an escharotic. 

Bromides and their Preparations. 

Potassii Bromidum, Bromide of Potassium, KBr, — colorless, cubical crystals, soluble 
in 1.6 of water, and 200 of alcohol. Dose, gr. v-^j. 

Sodii Bromidum, Bromide of Sodium, NaBr, — colorless, monoclinic crystals, soluble 
in 1.2 of water, and 13 of alcohol. Dose, gr. v-gj. 

Lithii Bromiaum, Bromide of Lithium, LiBr, — a white, granular, deliquescent salt, 
very soluble in water and alcohol. Dose, gr. v-xx. 

Ammonii Bromidiim, Bromide of Ammonium, NH^Br, — colorless, prismatic crystals, 
soluble in 1.5 of water, and 150 of alcohol. Dose, gr. v-xx. 

Calcii Bromidum, Bromide of Calcium, CaBr 2 , — a white, granular, deliquescent salt, 
very soluble in water and alcohol. Dose, gr. v-gj. 

Zinci Bromiduniy Bromide of Zinc, ZnBr 2 , — a white, granular, deliquescent powder, 
very soluble in water and alcohol. Dose, gr. j^-ij. 

Arsenii Bromidum, Bromide of Arsenic, — see under Arsenium, ante, page 1 19. 

Syrupus Ferri Bromidi, Syrup of Bromide of Iron, — is a syrupy liquid containing 10 
per cent, of Ferrous Bromide, FeBr 2 , prepared by acting on Iron Wire 35 parts with 
Bromide 75, adding Sugar 600 and Water up to iooo parts. A translucent, pale-green, 
odorless liquid of sweet, ferruginous taste and neutral reaction. Dose, .^ss-j. 

[ffydrobromic Acid is described on page 65, Ethyl Brotnide on pages 80, 82, and 
Camphora Monobromata under Camphora.^ 

Physiological Action. 

Bromide is an active and very painful escharotic, a deodorant and an 
antiseptic, setting free ozone. Its vapor is highly irritant to the respira- 
tory mucous membrane and the eyes, producing cough, hoarseness and 
dyspnoea. Internally, it is an active, corrosive poison, causing violent 
gastritis, depression and collapse. 

The Bromides are preeminently depressants of the cerebral and spinal 
functions, also alterative, antispasmodic and hypnotic. The Potassium 
salt is especially a cardiac and muscular paralyzant. 

They have a saline taste, and are very diffusible, but slowly eliminated. 
They are decomposed in the blood, and re-formed at the points of elimi- 
nation (fauces, bronchi, intestines, skin and kidneys), where they irritate 
the mucous membranes. Continued for some time, they produce severe 
gastric catarrh. They reduce the number of the respirations, and the 



BROMUM, BROMIDES. 137 

heart's action and force ; and though diminishing the calibre of the arte- 
rioles, they lower arterial tension. They lessen the activity of the brain 
cells, producing somnolence ; diminish the sensibility of the peripheral 
nerves, causing anaesthesia of the skin and mucous membranes. They 
impair motility and the sexual function, cause great pallor and emacia- 
tion, lowered body-temperature, acne on the face and upper extremities, 
fetid breath, dysphagia, sluggish reflexes and defective coordination ; and 
if long continued may even impair the mental faculties, producing hallu- 
cinations in some cases, in others melancholia with suicidal tendency ; 
also incompetence of the sphincters and paralysis, beginning at the 
periphery and extending to the centres. They sometimes cause maniacal 
excitement, as in the case of a physician who committed suicide in a 
frenzy caused by bromidizing himself for sea-sickness. 

The general result of their action is termed "Bromism," and is her- 
alded by the acne and lowered faucial sensibility. It is probably due to 
the sedative influence of these agents on the sympathetic system, causing 
general anaemia of the brain, spinal cord, sexual organs, and skin. 

Difference in Action between the Bromides. 

Potassium Bromide is the most toxic to the heart and the muscular 
system, and is the least hypnotic. It contains 66 per cent, of Bromine. 

Sodium Bromide is the least toxic, but the most hypnotic, and acts 
most energetically on the circulation. It contains 78 per cent, of Bromine. 

Ammonium Bromide resembles the Potassium salt in action, except that 
it exerts less influence on the heart and muscular system, and is somewhat 
more stimulating. 

Lithium Bromide contains the most Bromine, 92 per cent., and resem- 
bles the sodium salt in action. It has proved better than the others in 
some cases of epilepsy, and is by several authorities considered to be the 
best hypnotic of the series. 

Calcium Bromide is an efficient hypnotic, but otherwise much less 
active than the other salts. 

Znvc Bromide, in large doses, is violently irritant. It is supposed to 
combine the tonic effects of zinc with the sedative actions of the bromides. 

Ferrous Bromide is official only in the Syrup. It is supposed to 
combine the actions of iron and the bromides, and to produce the effects 
of a sedative chalybeate tonic. It is not an eligible chalybeate. 

Antagonists and IncompatibZes. 

Vaso-motor stimulants, as Digitalis, Ergot, Belladonna, antagonize many of the effects 
of the Bromides, but Morphine is the most efficient antagonist, especially for the mental 
symptoms. Nitrous Ether is incompatible with the Bromide of Ammonium, and Acids 
and metallic salts are so with all the Bromides. 



I38 BRYONIA. 

Therapeutics. 

The Bromides are used as sedatives to the nervous system, to lowe& 
reflex activity, to produce sleep, to subdue excitement of the genital appa- 
ratus, and to antagonize congestion of the brain. Their use is terribly 
abused, by patients, nurses, and even by physicians, — as Dr. Hammond 
well elucidates in the last chapter of his book on Nervous Diseases. 
They should not be used in anaemic conditions, and never for any length 
of time without the daily supervision of a physician. The combination 
of Potassium Bromide with Chloral is very unsafe in cases where fatty or 
weak heart exists, both drugs being active cardiac depressants. In con- 
vulsive and spasmodic affections, the bromides are very efficient, and in 
epilepsy, especially when the seizures are diurnal, the sodium salt is used 
with great advantage over a long period, in sufficient quantity to maintain 
anaesthesia of the fauces. It requires occasional purgation to prevent its 
accumulation, and arsenic to combat the acne. In diabetes of nervous 
origin, the ammonium salt, long used, has proved curative by its sedative 
influence on the medulla; and in acute rheumatism it is an excellent 
alkali. In muscular rheumatism, rheumatic arthritis and myalgia, also in 
the uric acid diathesis, and the various affections due to undeveloped gout, 
the lithium salt gives good results. In tetanus and strychnine-poisoning 
the potassium salt, in large doses, is antagonistic. The agents are gen- 
erally efficient in nervous erethism, insomnia with congestion, infantile 
colic, cholera infantum, vomiting of cerebral origin, cardiac irritability 
when not due to anaemia, delirium tremens, melancholia, whooping-cough 
and other reflex coughs, seminal losses when plethora exists, and nympho- 
mania. The potassium salt is, by some writers, considered almost specific 
in subinvolution of the womb, and uterine hemorrhage not due to a 
mechanical cause. 

Bromine is not much used. Its vapor may be inhaled from hot water 
in acute coryza, hay-asthma, etc., and in chancre and hospital gangrene 
it is the best escharotic. In diphtheria and membranous croup, a solution 
of n^viij to the %, used internally, and inhalation of the vapor have been 
used successfully in the most severe cases. 

The Syrup of the Bromide of Iron has been reported by some observers as 
very efficient in chorea, and its usefulness as strenuously denied by others. 

[The therapeutics of Hydrobromic Acid are detailed on page 65, ante.~\ 



BRYONIA, Bryony, — is the root of Bryonia alba and of Bryonia 
dioica, European perennial plants of the nat. ord. Cucurbitaceas. It occurs 
in transverse sections about 2 inches in diameter, having numerous small 
wood-bundles arranged in circles and projecting lines in the central 
portion, which is white or grayish. Its taste is acrid and bitter, but it is 



BRYONIA. 139 

inodorous. The active principle is the glucoside Bryotiin, C^H^Ou, which 
is intensely bitter, and soluble in water and in alcohol, but insoluble in 
ether. Dose, of powdered root, gr. x-xxx. 

Preparations. 

Tinctura Bryonia, Tincture of Bryonia, — a 10 per cent, solution of the root in alcohol. 
Dose, rr\v- ^ ss. 

Bryonin (Unofficial), — is a violent poison in doses of from 3 to 4 grains. Dose, as a 
drastic purgative, gr. l /6- l /i- 

Physiological Action. 
Bryonia is a pure irritant, setting up local inflammation wherever ap- 
plied, with febrile phenomena. It has a vesicant action on the skin, and 
is violently irritant to the serous and mucous membranes. Taken inter- 
nally, it has caused fatal gastritis; introduced into the pleura, fatal 
pleuritis has resulted with fibrinous effusion. It has a specific determina- 
tion to serous and synovial membranes, especially the pleurae, and is also 
irritant to muscular fibre, and to the bronchial mucous membrane, caus- 
ing dry, continuous, shaking cough, with soreness behind the sternum. 
It produces cerebral congestion, with frontal headache, vertigo, and epis- 
taxis; also, hepatic and renal congestion, burning pain and tenderness in 
the hepatic region with bilious disturbance amounting sometimes to 
severe jaundice, vesical tenesmus, and depression of the action of the 
heart. It is a drastic purgative and a powerful diuretic. 

Therapeutics. 
Bryonia is a very old medicine, its most ancient reputation having 
been in epilepsy, hysteria and mania, conditions in which it is now 
superseded by other agents. It is a most valuable drug in the second 
stage of serous inflammations, especially in pleurisy, pleuro-pneumonia, 
and pericarditis, after Aconite has reduced pyrexia, to limit the extent 
of the effusion and to promote its absorption. For this, small doses fre- 
quently repeated are required. Also, in rheumatic fever, after the swell- 
ing of the joints has been reduced by other means, Bryonia is extremely 
efficient for the pain and stiffness. It is one of the best remedies for a 
"cold-on-the-chest," with dry, shaking cough, soreness, or shooting 
pains. It has been used with success in common, continued, or Agas- 
tric" fever, relapsing fever, congestive headaches increased by stooping, 
bilious headache with vomiting, gastralgia with pyrosis and soreness of 
the epigastrium, constipation, cholera infantum during dry, hot weather, 
congestion of the liver, croup, and threatened mammitis. Pains of 
shooting or tearing character, which are increased by movement, are 
often quickly relieved by this drug. In dropsies of various forms it is 
used as a drastic purgative and diuretic to remove the accumulated fluid. 



14° BUCHU CADMIUM. 

BUCHU, — is the leaf of Barosma betulina, B. crenulata, and B. ser- 
ratifolia, S. African shrubs, of the nat. ord. Rutaceae, each species having 
differently-shaped leaves, but all the leaves having crenated or serrated 
margins, and conspicuous oil-glands at the edges and on their under sur- 
face. They contain a Volatile Oil, which is probably the active principle, 
and gives them a peculiar and penetrating odor, resembling that of pep- 
permint ; also, Barosmin, a bitter extractive, and resin, gum, lignin, etc. 
Dose, of the leaves, gr. xv-xxx. 

Preparations. 
Exlradum Buchu Fluidum, — Dose, TTLx-^j. 
Infusum Buchu (Unofficial), — ^j to the pint. Dose, Jss-ij. 

Physiological Action. 

Buchu in small doses causes a sense of heat in the stomach, which is 
gradually diffused over the body. It increases the pulse-rate, stimulates 
the appetite, and produces slight moisture of the skin. It increases the 
flow of urine, which becomes of darker color and strongly aromatic odor, 
and deposits a brownish sediment. 

In large doses, it produces vomiting, purging, and strangury, with a 
burning sensation at the stomach. 

Therapeutics. 

Buchu is of especial value in chronic affections of the genito-urinary 
mucous membrane, on which the volatile oil acts topically, being elimi- 
nated by the kidneys. It is a very useful remedy in pyelitis, cystitis, and 
urethritis ; also, in lithiasis, chronic bronchitis, and affections of the 
prostate gland. It is recommended in atonic dyspepsia, chronic rheuma- 
tism, affections of the skin, and for dropsy, but it is not so actively 
diuretic as to be very efficient in the latter condition. 

The infusion makes an excellent vehicle for saline diuretics. 

CADMIUM, Cd (Unofficial).— This metal was official in the Phar- 
macopoeia of 1870, but is no longer so. In its physiological action it 
resembles both Antimony and Zinc, being escharotic, astringent, and a 
very depressant emetic. In over-doses, its salts act as irritant poisons, 
with cerebro-spinal symptoms, such as coma and convulsions. It is never 
used internally. Its salts in general use are — 

Cadmii Sulphas (Unofficial), — transparent oblique prisms, efflorescent, and very soluble 
in water. Used externally in a solution of gr. ss-iv ad Jj aq. destil., or as an ointment 
(1 to 40 of fresh lard). 

Cadmii Iodidum (Unofficial), — large, white, pearly crystals, soluble in water and alco- 
hol. Used as an ointment, 1 to 8 of lard. 

Therapeutics. 
The Sulphate has been used almost exclusively as a stimulating astrin- 
gent in gonorrhoea and diseases of the eye. Corneal opacities are 



CAFFEA. I4I 

absorbed under the use of a solution of gr. ij to the 3, and in gonorrhoea 
a mild injection (gr. ^ ad ^j) is ver y beneficial. The ointment of the 
Iodide has been usefully employed for enlarged glands, chronic joint 
affections, cutaneous diseases, nodes and chilblains. 

CAFFEA, Coffee, the seed of Coffea Arabica, is officially repre- 
sented only by its active principle, Caffeine. The coffee-plant is a small 
tree of the nat. ord. Rubiacese, 15 to 30 feet high, native of South Arabia 
and Abyssinia, but cultivated in various parts of the world. Its seeds 
contain Caffeine (partly free, partly as a tannate), tannic and caffeic 
acids, sugar, legumin, etc. By roasting them, part of the caffeic acid is 
converted into methylamin, the sugar is changed into caramel, and several 
volatile substances are formed, which give to coffee its peculiar aroma and 
some of its stimulant qualities, and are collectively known as Caffeone, 
one of them being called Caffeol. 

Preparations. 

Caffeina, Caffeine, C 8 H 10 N 4 O 2 .H 2 O. The U. S. Phar. of 1880 defines Caffeine as 
"a proximate principle of feebly alkaloidal power, generally prepared from the dry leaves 
of Camellia T/iea, * * or from the dried seeds of Coffea arabica, * * or from Guarana, 
and occurring also in other plants." According to this, the principles severally named 
Caffeine, Theine and Guaranine, were officially declared identical, and such was the 
general opinion until very recently; their composition being expressed by the formula 
C g H ]0 N 4 O 2 , and the physiological action of one being accepted for the others. Recent 
investigations, however, leave no doubt as to the non-identity of the first two, and some 
observers maintain that Guaranine also is a separate body, distinct from either of the 
others. For the present, however, we mu^t look upon it as identical with Caffeine. The 
Caffeine of commerce is usually obtained from old tea-leaves, and is in reality Theine. 
It contains more nitrogen than almost any other proximate vegetable principle. It occurs 
in colorless, flexible crystals, which are soluble in 75 of water and 35 of alcohol at 59 F. 
Dose, gr. j-v. 

Extraction Caffece Viridis Flnidum (Squibb), Fluid Extract of Green Coffee (Un- 
official). — is intended as a substitute for the fluid Extract of Guarana. Dose, 3 ss— ij. 
[Compare the title Guarana.~\ 

Caffeines Cilras, Citrate of Caffeine (B. P.). A very uncertain mixture, not considered 
a definite compound. Dose, gr. ij-x. 

Theina, Theine, — that from Merck the most reliable. Its solubility in water is much 
increased by adding an equal part of Sodium Benzoate, say 5jj of each to the fluid ^ , 
with gr. x of Sodium Chloride. Of this, rr^vj equals gr. ]/ 2 of Theine. Dose, gr. y&-], 
hypodermicallv, several times a day, for relief of pain. 

Theine is contained in the leaves of Camellia T/iea, the tea-plant, a native of China 
and Japan, and a member of the nat. ord. Ternstromiaceas. The tea-plant also contains 
tannic acid, and a volatile oil, the latter being most abundant in green teas. 

Physiological Action. 
Coffee is a cerebro-spinal stimulant, a stomachic tonic, and a laxative. 
It is decidedly diuretic, and is somewhat antiperiodic and highly anti- 
septic. The green bean produces very different effects from those of the 
roasted one, exhibiting the action of Caffeine alone, unmodified by that 
of the empyreumatic products. A tincture of green coffee, besides being 
an efficient diuretic, has marked anti-lithic powers, and promotes the 
elimination of the poison of gout from the system. 



I 42 CAFFEA. 

As a beverage, if used with moderation Coffee assists digestion, promotes 
intestinal peristalsis, allays the senses of fatigue and hunger, lessens 
tissue-waste and consequently decreases the formation and excretion of 
urea (?). Used to excess it disorders digestion, and causes functional 
disturbances of the nervous system, shown by headache, vertigo, mental 
confusion, and palpitation of the heart. 

It increases secretion, blunts sensation, exalts reflex excitability, in- 
creases mental activity, and may produce insomnia and great nervous 
restlessness. It first briefly stimulates the heart and raises arterial tension, 
but soon depresses both. The wakefulness is usually preceded by a brief 
period of drowsiness. 

The brief stimulation of the intellect, consequent on drinking a cup of 
good coffee, cannot be obtained from an infusion of raw coffee, and is 
probably due to the volatile constituents developed in roasting. Caffeone 
opposes Caffeine in its action on the circulation, as it quickens the pulse 
and lowers arterial tension. Its action, however, is of brief duration, and 
soon gives way to the influence of the principal constituent. The Tannin 
is the ingredient which enables it to produce dyspepsia, and is most abun- 
dant in those infusions which are kept a long time on the stove before 
being served. 

The Common Stimulant Beverages Compared. 
The Qualities possessed in common by these substances, and for which 
they are so universally esteemed by mankind, are three-fold. They all 
(1) retard the retrograde metamorphosis of the body-tissues (tissue- 
waste) ; — thereby enabling the work of the individual to be done upon a 
smaller supply of reparative material (food), and with less fatigue. 
Furthermore, when used in moderation, they are all (2) more or less stimu- 
lating to the mental processes, and (3) sedative to the nervous system. 

This similarity of action they owe to the possession of principles, which, if not iden- 
tical, are so closely related to each other that until very recently they have been so con- 
sidered both by chemists and pharmacologists. Their divergence from each other, in the 
finer shades of their action, depends most probably on the existence in each of differing 
aromatic and volatile principles, which modify the action of the alkaloid in some degree. 
Similar principles are developed in them by the various processes of preparation (as 
roasting, drying, etc.), all of which have some part in determining the general action of 
the beverage containing them. 

Coffee is more stimulating than Coca, and less sustaining. It is apt 
to cause severe palpitations of the heart; and may disorder digestion, if 
long stewed. The Coffee-bean contains only 0.2 to 0.8 per cent, of 
Caffeine. 

Tea {Camellia Thea) is the most refreshing and stimulating member of 
the group. Used to excess, it powerfully affects the stability of the motor 
and the vaso-motor nerves, the action of the heart, and the digestive 
function, — producing flatulent dyspepsia, tremulousness of the limbs, 



CAFFEA 143 

pallor of the surface, irregular cardiac action, and feeble impulse, hallu- 
cinations, night-mare, anorexia, headache, nausea and vomiting, obstinate 
neuralgiae — especially of the supra-orbital and occipital nerves ; also con- 
stipation, and a pain in the left side are not infrequent. The condition 
of chronic tea-poisoning is termed "Theism," — and is very often seen 
among women of the lower class in cities, who do not indulge in alcoholic 
beverages, but freely accept the dominion of the " cup that cheers " and 
worse than inebriates. 

Mate {Ilex Paraguay ensi's, Paraguay tea), is supposed to be inter- 
mediate in its effects between tea and coffee. It also contains Caffeine, 
in the proportion of 1.2 per cent. 

Guarana (Paullim'a sorbilis of Brazil), contains an alkaloid — Guara- 
nine, in the proportion of 5 per cent., which is probably identical with 
Caffeine, though some think it more analogous to Theine. It is especially 
noted for relieving a nervous headache, for which purpose the official fluid 
extract may be used in doses of n^xx, three or four times daily, when the 
basis of that preparation happens to be of good quality. 

Coca, or Cuca {Erythroxylon Coca), is more sustaining and less of a 
direct stimulant, than either tea or coffee. The proportion of Cocaine in 
the leaves varies greatly in different samples, as they occur in commerce. 

Cocoa {Theobrbma Cacao, the Chocolate-tree), is more directly nutri- 
tious than any of the group, containing a large quantity of fat, Oleum 
Theobromce (cacao-butter), which makes it difficult of digestion to many 
persons. Its alkaloid, Theobromine, is closely allied to Caffeine, the latter 
being considered a Methyl-theobromine. The various preparations of 
this agent are made from the seeds, after the oil has been expressed from 
them. They are ground in a mill, mixed with rice, barley, sugar, flour, 
etc., and put up in powdered form, called Cocoa, — but if flavored with 
vanilla and pressed into a cake, the product is Chocolate. The thin husks 
which envelope the seeds are known as "Shells," and are used to make a 
beverage similar to but milder than cocoa or chocolate. 

Caffeine in general terms is a stimulant at first, and subsequently a 
paralyzant, to the nerve-centres in the cerebrum, medulla and cord. In 
small doses it quickens the action of the heart and raises arterial tension ; 
stimulates the cerebral functions, by increasing the supply of blood to the 
brain ; increases the respiration rate and the secretion of urine. Larger 
doses (gr. v-viij), often over-stimulate the cerebral circulation, causing 
thereby great heaviness of the head, flashes of light before the eyes, 
tinnitus aurium, insomnia, restlessness, and even delirium, — the pulse 
becoming rapid, feeble, irregular and intermittent, and the general body- 
temperature elevated, though that of the periphery may be lowered. 
Large doses depress the heart and respiration, and lower the blood-pres- 
sure ; — in the smaller animals exalting the reflex excitability of the cord 



144 CAFFEA. 

and producing tetanic convulsions ; — and in lethal doses paralyzing the 
cardiac muscle as well as its motor ganglia, but causing death by paralysis 
of respiration. It powerfully affects muscular fibre, both voluntary and 
involuntary kinds, throwing it into a state of tetanic contraction resem- 
bling rigor mortis. If administered in sufficient quantity it would doubt- 
less ^rove fatal to man, — but its lethal dose for him would be very large. 
Cafirine is excreted unchanged in the bile and urine, and is a reliable 
hydragogue diuretic ; acting by stimulation of the secreting apparatus in 
the kidney, as well as by generally raising the arterial tension. (Brunton. ) 

Theine, upon the smaller animals, agrees in most respects with Caffeine, 
except that it requires much larger doses to produce the same effects. It 
differs, however, in some important particulars. Theine chiefly affects 
the sensory, Caffeine the motor system. Theine causes spasms and con- 
vulsions, and impairs the nasal reflex, early in the course of the poisoning 
process; — while Caffeine does so late, if at all. Theine decreases the 
body-temperature, — Caffeine increases it. Theine causes convulsions in 
frogs, a power now denied to Caffeine, though hitherto ascribed to it. 
Both alkaloids tend to produce muscular contraction, but Theine causes 
a peculiar rhythmical contraction in voluntary muscles, which lasts for 
several hours, and seems to act transversely across the fibre, as the muscle 
is elongated at each contraction. In man, the principal action of the 
hypodermic injection of Theine is the production of a profound local 
anaesthesia at and below the point of injection, — acting therefore outwards 
along the nerve-trunk, and not towards the centre. It does not affect the 
motor apparatus, nor does it seem to produce narcosis. 

Guaranine is generally considered as identical with Caffeine, though 
some few observers find in its action a closer analogy to Theine. It affects 
both sensory and motor nerves, the sensory first, paralyzing them from the 
centres outwards. \_Cocai7ie and Brucine act from the periphery inwards.] 
It causes general hyperaesthesia, and subsequently convulsions of spinal 
origin, — at first increases and afterwards depresses respiration and the action 
of the heart. It seems to have a stronger affinity for the sensory than for 
the motor nerves, and hence resembles Theine more than Caffeine. 

Theobromine has the formula C 7 H 8 N 4 2 , and is closely allied to Caf- 
feine, physiologically and chemically. In fact, Caffeine may be considered 
a Methyl-theobromine, C 7 H 9 (CH 3 )N 4 2 . During roasting the cocoa-bean 
develops an aromatic principle which gives to chocolate its peculiar flavor. 
In large doses Theobromine is fatal to small animals. 

DIURETIN, Sodio-theobromine Salicylate (Unofficial), — is a new proprietary com- 
pound, consisting of Theobromine and Sodium Salicylate. It occurs as a colorless 
powder of sweetish, saline and alkaline taste, soluble in one-half its weight of water, and 
should contain 46^ per cent, of Theobromine. It should be cartfully kept from contact 
with the air, as it rapidly absorbs carbonic acid therefrom. Dose, gr. x-xv, several times 
daily, as a diuretic. 



CAFFEA. 145 

Diuretin was introduced as a soluble preparation of Theobromine, of value for its 
prompt diuretic action, influencing the kidneys without causing serious or dangerous 
results upon the heart, the action of which, however, it strengthens and regulates. Given 
to healthy persons it does not increase the quantity of the urine, but during its adminis- 
tration in morbid conditions of the renal or cardiac apparatus the volume of urine 
excreted daily increases three and four fold, and exudations of non- inflammatory charac- 
ter are rapidly absorbed. It may give rise to slight diarrhoea, and the author has found 
the body-temperature uniformly subnormal in non-febrile patients while under its influ- 
ence. 

Diuretin has been employed with marked benefit in both cardiac and renal dropsy, in 
hepatic cirrhosis, and in various diseases of the heart and kidneys accompanied by 
oedema. The author has seen a large pleuritic effusion disappear rapidly under its use, 
the fluid having re-accumulated after having been once removed by tapping the pleural 
cavity. It should be administered in aqueous solution, avoiding acids or acid vegetable 
juices, which are chemically incompatible, as they precipitate the alkaloid in the form of 
a thick white sediment. 

Therapeutics. 
Although without a very extensive range of usefulness, Caffeine is a 
valuable stimulant in many forms of nervous and cardiac depression, and 
has proved especially efficacious in headaches of neuralgic or nervous 
type, the pain being general over the head, gr. j of Caffeine every half 
hour, or the fluid extract of Guarana, in 20-minim doses every 2 or 3 
hours. In choleraic diarrhoea, and that of phthisis, it checks outward 
osmosis by stimulating the depressed nervous apparatus. In dropsy, car- 
diac and renal, Caffeine is a diuretic and cardiac stimulant. In cervico- 
brachial neuralgia, Caffeine hypoder. , gr. j, increased to gr. v. In 
lithgemia and gout, a tincture of the green bean has marked diuretic 
and antispasmodic powers, and is very useful in these conditions. In 
insomnia of chronic alcoholism, gr. y 2 of Caffeine hypodermically. For 
adynamic fevers, it may well be used in place of alcoholic stimulants. 
In intermittents, Coffee has a curative reputation among the inhabitants 
of the Philippines, which is corroborated by the Dutch physicians. In 
asthma, if not used habitually, Coffee is valuable in the paroxysm. In 
opium narcosis, Caffeine hypodermically, or better still strong black 
coffee, to antagonize the increasing torpor of the nervous centres. 

Therapeutics of Theine. 
This alkaloid is a valuable analgesic, especially so by reason of its pro- 
longed influence over sensation. Its great field of employment is in neu- 
ralgia of any kind, cervico-brachial, sciatic, etc., doses of gr. y& to gr. y 2 
hypodermically, are efficient, and may be kept up as long as required. 
To make a cure, however, the nutrition of the nerves must be attended to. 
In locomotor ataxia, lumbago, etc., it has been used with prompt benefit, 
in the same manner, promptly relieving pain, without producing any 
narcotic effect. (Mays.) 



I46 CAJUPUTI OLEUM CALAMUS CALCIUM. 

CAJUPUTI OLEUM, Oil of Cajuput,— is a volatile oil distilled 
from the leaves of Melaleuca Cajuputi, a tree of the nat. ord. Myrtacese, 
native of the Molucca Islands. It is a bluish-green or colorless liquid, 
of camphoraceous odor, and neutral reaction. Specific gravity about 
0.920, freely soluble in alcohol. It contains Cajuputol or Bihydrate of 
Cajuputene, which forms fz of it, the other ^3 being another oil. Dose, 

Physiological Action and Therapeutics. 

Cajuput Oil resembles Oil of Turpentine, and has similar actions to 
those of the other volatile oils, being a stimulant carminative, somewhat 
diuretic and diaphoretic, antiseptic, parasiticide and anthelmintic. Exter- 
nally used, it is irritant to the skin. Swallowed, it produces a sense of 
warmth in the stomach and accelerates the pulse. 

It is not much used internally, though it has been given with benefit 
in flatulent colic, dropsy, hysteria, chronic rheumatism, scrofula, syphilis, 
elephantiasis and other cutaneous disorders. Externally, as a strong, 
stimulating rubefacient, it is efficient in chilblains, muscular rheumatism 
and nervous headaches. 

CALAMUS, Sweet Flag, — is the rhizome of Acorus Calamus, a 
plant of the nat. ord. Araceae, native in Europe and North America, 
having an aromatic odor and pungent taste. The unpeeled root should 
only be used, peeled or bleached calamus being almost inert. It contains 
a volatile oil and Acorin, which is a nitrogenous, bitter principle, also 
benzoic acid, starch, etc. Dose, indefinite. 

Preparation. 

Extractum Calami Fluidum, — is made with Alcohol as a menstruum. Dose, 
TTtxv-gj. 

Calamus is an aromatic bitter, and stomachic tonic, increasing the 
appetite and stimulating digestion. It is one of the constituents of the 
preparations termed " bitters," and is chewed as an appetizer. 



CALCIUM, Ca, — is the metal characteristic of Lime, Chalk, and all 
calcareous substances, and though itself unofficial is represented by several 
official salts and preparations. 

Official Salts of Calcium. 

Calcii Carbonas Prcecipitatus, Precipitated Carbonate of Calcium, CaC0 3 , — a fine im- 
palpable, white powder, odorless and tasteless, insoluble in water or alcohol, but soluble in 
mineral acids or acetic acid with effervescence. Creta (chalk) is the native carbonate of 
calcium (see below). Dose, gr. v-xx. 

Calx, Lime, Oxide of Calcium, CaO, — hard, white masses, gradually resolving to a 
white powder in the air, odorless, of sharp, caustic taste and alkaline reaction, soluble in 



CALCIUM. 147 

750 of water and 1300 of boiling water, insoluble in alcohol. Not used internally except 
in solution. Is a constituent of Potassa cum Calce. (See under Potassium.') 

Calcii Chloridum, Chloride of Calcium, CaCl 2 , — hard, colorless masses, deliquescent, 
of sharp, saline taste, soluble in \ l / z of water and 8 of alcohol at 59 F. Dose, gr. x-xx 
in solution. 

Calcii Br omidum, — described under Bromides, ante, page 136. 

Calcii Hypophosphis, — described under Phosphorus. 

Calcii Phosphas Prcecipitatus, — described under Phosphorus. 

Calcii Sulphidum, — described under Sulphur. 

Preparations of the Carbonate. 

Creta Preparata, Prepared Chalk, — is native carbonate of Calcium freed from most 
of its impurities by elutriation ; a white, amorphous powder, odorless and tasteless, insol- 
uble in water or alcohol. Dose, gr. v-xx. Is a constituent of Hydrargyrum cum Creta, 
and also of the following : 

Pulvis Cretce Compositus, Compound Chalk Powder, — has of Prepared Chalk 30, 
Acacia 20, Sugar 50 parts. Dose, gr. v-gj. 

Mistura Creta, Chalk Mixture, — has of the preceding 20 parts, Cinnamon Water 40, 
Water 40, rubbed together and made fresh as required. Dose, 3 ss. 

Trochisci Cretce, Troches of Chalk, — each contains of Prepared Chalk 4 grains, Acacia 
I, Sugar 6, with a little Nutmeg. Dose, indefinite. 

Testa Preparata, Prepared Oyster-shell (Unofficial), — contains animal matter intimately 
mixed with the carbonate of calcium. Dose, gr. x-xx or more. 

Preparations of the Oxide. 

Liquor Calcis, Solution of Lime, Lime-water, — contains about 0.15 per cent, of Cal- 
cium Hydrate, Ca(HO) 2 . A clear, colorless liquid, of saline taste and alkaline reaction. 
Dose, Jss-ij. 

Syrupus Calcis, Syrup of Lime, Saccharated Solution of Lime, — contains 5 per cent, 
of Lime, 30 of Sugar, the latter aiding the solvent powder. Dose, 3 ss— ij. Is the antidote 
to poisoning by carbolic or oxalic acid. 

Linimentum Calcis, Lime Liniment, — contains equal parts of Liquor Calcis and Cotton- 
seed Oil. Is nearly the same as the application known as " Carron Oil." 

Calx Chlorata, — described under Chlorine. 

Calx Sulphurata, — described under Sulphur. 

Potassa cum Calce, — described under Potassa. 

Preparations of the Phosphate and Hypophosphite. 

Syrupus Calcii Lactophosphatis, ~\ 

Syrupus Hypophosphitum, v are described under Phosphorus. 

Syrupus Hypophosphitum cum Ferro, J 

Physiological Action. 

Lime before it assumes the condition of Hydrate is irritant and caustic, 
and if inhaled or swallowed may produce dangerous inflammation. The 
preparations of Lime and Chalk are feebly alkaline and astringent ; they 
neutralize the acid of the gastric juice and are sedative to the mucous mem- 
brane of the stomach. A small quantity of the oxide passes into the blood 
and promotes constructive metamorphosis, — but if used in large quantity 
or for a long time it will act in the opposite manner, producing waste. 

Calcium Chloride is a gastro-intestinal irritant, very diffusible and 
remarkably alterative, being apparently a powerful antagonist to the 
strumous diathesis. 

[The actions of the other salts of Calcium are described under the titles 
of their respective bases.] 



I48 CALENDULA. 

Antagonists and Incompatibles. 

The preparations of Lime and Chalk are incompatible with acids and metallic salts. 
In poisoning by Lime the antidote is a dilute vegetable acid, followed by demulcents or 
the fixed oils to protect the mucous membrane. 

Therapeutics. 

Lime may be used as a caustic and depilatory, but is better known as 
an agent for hastening decomposition, which it does by its affinity for water, 
the resulting Hydrate absorbing many of the products. Chlorinated 
Lime is an excellent antiseptic and disinfectant, but as it owes its 
energy entirely to its chlorine it will be noted under that title. Lime- 
water is a favorite remedy for vomiting, especially in children, and is 
added to milk to increase its digestibility. It is also efficient for acid 
dyspepsia and mucous enteritis, as an antacid and astringent. Locally it 
is usefully employed as an enema against thread-worms, as a lotion in many 
mucous and purulent discharges, and in aphthae. The vapor of slaking 
lime or lime-water as spray are often very serviceable inhalations in diph- 
theria. Syrup of Lime contains more lime in solution than lime-water, 
and may be used instead of the latter where a diluent is not advisable. 
It is the antidote for poisoning by Carbolic or Oxalic Acid, while lime in 
any form (as wall-plaster) is a valuable antidote for poisoning by any 
mineral acid. 

Chalk-mixture is used in the diarrhoeas of children with sour-smelling, 
watery stools ; and may be conveniently prescribed in combination with 
other astringents. Lime Liniment is used on cotton or lint as a dressing 
for burns. 

Calcium Chloride has been advantageously employed in the various 
manifestations of the strumous diathesis. It sometimes resolves glandular 
enlargements, calcifies tubercular deposits, aids the cicatrization of ulcer- 
ating cavities, and has been curative in eczema and lupus. It is strongly 
recommended in chorea, phthisis and in the colliquative diarrhoea of 
strumous children. In solution externally as a fomentation it will hasten 
the maturation of boils. 

[The therapeutics of the other salts of Calcium are included under those 
of their respective bases.] 

CALENDULA, Marigold, — is the fresh, flowering herb of Calen- 
dula officinalis, the common Garden Mangold, a plant of the nat. ord. 
Compositae, frequently cultivated for ornament. The tincture (20 per 
cent.) is also official, and is exclusively used as a local application to pro- 
mote the healing process in wounds, ulcers, burns and other breaches of 
tissue. Extravagant views of its powers as a vulnerary are promulgated 
by the so-called "homoeopathic surgeons," and serve as one of their 
excuses for professing an exclusive position in the art of surgery. 



CALUMBA CAMBOGIA. 1 49 

CALUMBA, Columbo, — is the root of Jateorrhiza Calumba, a plant 
of the nat. ord. Menispermacese, native in southeastern Africa, but culti- 
vated in the East Indian Islands. It occurs in nearly circular disks, 
having two or three interrupted circles of projecting wood-bundles, odor 
slight, taste mucilaginous, aromatic and bitter. It contains the alkaloid 
Berberine (see under Berberis, ante, page 133), a bitter principle named 
Calumbin, also Calumbic Acid and Starch, but no Tannin. Dose, gr. 
v-xxx. 

Preparations. 

Ext r actum Cahunhce Fluidum. — Dose, TT^ v-xxx. 
Tinctura Calumbce, — I in 10. Dose, ^ss-ij. 

Calumba is the first in alphabetical order of the simple bitters, having 
no astringency or aroma, and its action, as herein described, will apply 
to the other members of that class (Quassia, Gentian, Cornus). It stimu- 
lates the nerves of*taste, increases the flow of saliva, excites the flow of the 
gastric juice and the gastric circulation, thus increasing the appetite and 
promoting digestion, and so promoting the constructive metamorphosis. 
As it also increases the gastric mucus, its continued use will set up catarrh 
of the stomach, and interfere with digestion, though it is one of the 
least irritant of stomachic tonics. 



Therapeutics. 
As Calumba contains no Tannin, it maybe administered with the salts 
of Iron, and is often prescribed with the sub-carbonate. It is useful in 
atonic dyspepsia with pain after eating, in the convalescent stage of dis- 
ease to promote appetite and digestion, in diarrhoea and dysentery, 
vomiting, sea-sickness, cholera morbus and cholera infantum. An Infu- 
sion of Calumba with Ginger and Senna is effective in flatulence, and the 
same preparation is a good vehicle for the administration of acids and 
alkalies, tonics, aromatics, and mild cathartics. Having little or no irri- 
tant quality, it is an excellent tonic in the hectic of phthisis. 



CAMBOGIA, Gamboge, — is a gum-resin, obtained from Garcinia 
Hanburii, a Siamese tree of the nat. ord. Guttiferae. It occurs in cylin- 
drical pieces, of orange-red color, but yellow when powdered. Its taste 
is very acrid. It contains 73 per cent, of Gambogic Acid, a resinous sub- 
stance, also 25 per cent, of gum and 2 of water. It is partly soluble in 
alcohol and ether. The only official preparation is the Pil. Catharticae 
Co. (described under Colocynthis), each pill containing gr. ^ of Gam- 
boge. Its dose, as a cathartic, is gr. ij-v, — as a diuretic, gr. j at short 
intervals. 



I50 CAMPHORA. 

Physiological Action and Therapeutics. 

Gamboge is an irritant purgative, decidedly diuretic, and its powder 
is sternutatory. Its catharsis is accompanied by vomiting and colic, and 
the stools produced are watery, but not so much so as generally believed. 
It has no cholagogue action. Full doses are liable to produce violent 
gastro-enteritis, and incautiously used (as in Morrison's pills) it has fre- 
quently caused death. On the other hand,' large doses have been given 
continuously in some cases, without producing any dangerous symptoms. 

Gamboge was formerly much used as a hydragogue cathartic and diuretic 
in dropsies, but its irritant qualities have caused it to be superseded by 
other agents (elaterium, digitalis, etc.). However, for dysentery, espe- 
cially when in young subjects, very small doses (gr. -^f) at short intervals, 
up to gr. y^ in 24 hours, have proven to be remarkably efficacious. 



CAMPHORA, Camphor, C 10 H 16 O, — is a stearopten (solid volatile 
oil), derived from Cinnamomum Camphora, a tree of the nat. ord. Laura- 
ceae, and purified by sublimation. Occurs in white, translucent, waxy 
masses, of penetrating odor and pungent taste, lighter than water, in 
which it is sparingly soluble (1 to 1300), but dissolves readily in alcohol, 
ether, chloroform, benzin, oils, etc. The camphor-tree is indigenous in 
China, Japan, Formosa and other parts of eastern Asia. Borneo Cam- 
phor has the formula C 10 H 18 O, bears the same relation to Japanese Camphor 
as alcohol bears to aldehyde, and is heavier than water. Dose, gr. j-xx. 

Derivatives of Camphor are — Camphor-cymol which is obtained by its 
distillation with zinc chloride, — Camphoric and Caniphretic Acids, which 
result respectively from its lesser or greater oxidation. 

Preparations. 

Aqua Ca7nphor<z, Camphor-water, — Camphor 8, Alcohol 16, Distilled Water q. s. ad 
1000 parts. Used externally or as a vehicle. Dose, ^j-iv. 

Spiritus Camphora, Spirit of Camphor, — Camphor 10, Alcohol 70, Water 20 parts. 
Dose, rrvv-xx. 

Linimentum Camphora, Camphor Liniment, — Camphor 20, Cotton-seed Oil 80 parts. 
For external use. 

Ceratum Camphora, Camphor Cerate, — has of the Liniment 3, Olive Oil 12, Cerate 85 
parts. Used for itching skin-affections. 

Camphora Monobromata, Monobromated Camphor, C 10 H 1 5 BrO,— colorless, prismatic 
needles or scales, of mild camphoraceous odor and taste, and neutral reaction, almost 
insoluble in water, slightly in glycerin, freely in alcohol, ether, oils, etc. Dose, gr. j-x, in 
emulsion. 

Rubini's Tincture of Camphor (Unofficial), — is a saturated solution in alcohol, %} in 
o'i/4> °f which the dose is from 4 to 10 drops. tt\vij have caused toxic symptoms in an 
adult. 

Raspail 's " Eau Sedative " (Unofficial), — contains Aq. Ammoniae ^ ij, Sodii Chlori- 
dum ^ij, Camphorated Spirits of Wine giij, Water Oij. Used externally. 

Camphor is also an ingredient of Linimentum Saponis, Linimentum Sinapis Com- 
positum, and Tinctura Opii Camphorata. 



camphora. 151 

Physiological Action. 

Camphor is antispasmodic, anodyne, antiseptic, diaphoretic, a stimu- 
lant expectorant, a cerebral excitant, a gastro-intestinal irritant, and a 
rubefacient. It has an acrid, hot taste, and irritates the skin and mucous 
membranes, in quantity exciting severe gastric inflammation with all the 
effects'of an irritant poison. In medicinal doses it stimulates the vaso- 
motor system and the cardiac motor ganglia, and lessens the influence of 
the pneumogastric, — thus increasing the circulation and raising arterial 
tension. It also stimulates respiration and mental activity, even produc- 
ing intoxication ; promotes diaphoresis, allays pain, and increases the 
menstrual flow and the sexual appetite, but its continued use depresses 
the generative function. " Camphora per nares castrat odore mares." 

Large doses cause gastro-intestinal inflammation, depress the heart and 
lower arterial tension, diminish the reflex function of the spinal cord, 
produce coldness of the surface, insensibility, coma, convulsions and 
perhaps death. 

As many as 200 grains have been taken without fatal result, yet 6 or 7 
grains have produced extreme drowsiness and weakness of the pulse, and 
20 grains laid an Alpine guide up for a day. 

It is eliminated by the bronchial mucous membrane, skin and kidneys, 
and has often caused dysuria. 

Monobromated Camphor resembles the bromides in action, but is not 
identical therewith. In mammals it produces muscular weakness passing 
into paralysis, lowered temperature and respiration, stupor and death. In 
some cases its use by man has been followed by epileptiform convulsions. 
It is a nervous sedative and hypnotic, and a gastric irritant. 

Antagonists and Incompatibles. 

Arterial sedatives, coffee, cold, etc., antagonize its action. Water precipitates it from 
the alcoholic solution, alkalies and earthy salts precipitate even the small quantity which 
is soluble in water. Emetics to remove as much as possible. Opium and Bromides for 
the convulsions. 

Therapeutics. 

Camphor was much used by the older physicians as an antispasmodic, 
and is yet greatly valued in China and Japan. It has a reputation for 
uncertainty of therapeutic action, but is usefully administered in cholera 
and choleraic diarrhoea, summer diarrhoea and that of infants, vomit- 
ing, gastralgia, cardiac depression, nervousness and nervous headache, 
nymphomania, capillary bronchitis, typhoid and eruptive fevers, dysmen- 
orrhoea, afterpains, chordee, strangury, and catarrhal colds. Locally it is 
effective in myalgia, lumbago, toothache, gangrene, and other conditions 
where counter-irritation or a local anodyne are required. A solution in 
ether has been found to be a beneficial application in erysipelas. 

Monobromated Camphor is used as a nerve sedative and hypnotic, 



152 CANNABIS. 

but is not particularly efficient in this regard. It has been used with 
advantage in whooping-cough, neuralgia, chorea, hysteria, delirium tre- 
mens and epilepsy. 

Camphora Carbolata is a name given to a mixture of 2^ parts of 
camphor with one each of carbolic acid and alcohol. This preparation, 
mixed with olive-oil, is a good non-irritating and antiseptic dressing for 
wounds and breaches of surface. 

Camphor- Chloral is a fluid obtained by triturating together equal 
parts of camphor and chloral hydrate. It has decided solvent powers, 
dissolving sulphate of morphine readily (gr. xx in 31J), and many other 
salts of alkaloids. It is often a serviceable application in superficial 
neuralgia, and is said to allay spasmodic cough if painted over the larynx. 

Camphora Salicylata is obtained by heating together 11 parts of 
salicylic acid and 14 of camphor. An ointment prepared from this sub- 
stance has been used with very satisfactory results in the treatment of 
phagedena, spreading syphilitic sores, epithelioma, lupus, etc. 



CANNABIS, Hemp, — is Cannabis sativa, the hemp-plant, a 
coarse, pubescent, somewhat viscid annual of the nat. ord. Urticaceae, 
having an erect, branching stem 3 to 6 feet high, with alternate or oppo- 
site digitate leaves on long, weak petioles ; and dioecious flowers, the 
staminate clusters being lax, drooping, leafless at the base ; the pistillate 
clusters erect and leafy at the base. It is indigenous to Asia, but is culti- 
vated in most civilized countries for its textile bast-fibres and its oily 
fruit. The two official varieties are specifically identical with each other, 
differing only in the degree of their action, that grown in India being 
the most powerful. They contain a resin named Cannabin, and a Vola- 
tile Oil, from the latter of which are obtained Cannabe?ie, a light hydro- 
carbon, and Hydride of Cannabene, a crystalline body. Cannabis should 
not be confounded with the so-called "Indian or Canadian Hemp," 
Apocynum cannabinum (see ante, page 109). The official varieties of 
Cannabis are as follows : — 

Cannabis Americana, American Cannabis, — is Cannabis sativa, grown 
in the Southern United States and collected while flowering, having a 
stem about six feet long and rough, leaves petiolate and digitate, opposite 
below, alternate above, flowers dioecious, odor heavy, taste bitter and 
slightly acrid. No official preparations. 

Cannabis Indica, Indian Cannabis, Indian Hemp, — the flowering tops 
of the female plant of Cannabis sativa, grown in the East Indies. Is 
about two inches long, branching, compressed and brittle, having a few 
digitate leaves with linear-lanceolate leaflets, and numerous bracts, each 
containing two small pistillate flowers, sometimes with the nearly ripe 



CANNABIS. I53 

fruit, the whole agglutinated with a resinous exudation. Color brownish, 
odor peculiar and narcotic, taste slightly acrid. 

Preparations. 

Extractum Cannabis Indict, — Dose, gr. i-j, if active. 

Extractum Cannabis Indices Fluidum, — an alcoholic preparation which in mixtures 
must be emulsified with Gum Acacia, otherwise the resin will separate and float to the 
top or adhere to the sides of the bottle. Dose, n\j-v, but the author has frequently taken 
3J of a good fluid extract without experiencing untoward effects. Whatever may be the 
reason, it is a fact which he has often verified, that if the precipitate, formed when the 
alcoholic preparation is added to water, be of a brownish hue, a dirty, yellow- brown, the 
sample will prove to be almost inert ; — but if of a decided olive-green color, the prepara- 
tion will be active. The activity will be found to increase almost in direct proportion to 
the decided green of the precipitate. Samples from the same manufacturer show this 
difference, often seen between two bottles in the same shipment. The active principle 
seems to be intimately connected with the chlorophyll or other coloring matter present, 
and to be destroyed therewith by whatever injures the latter. 

Tinctura Cannabis Indices, — strength 20 per cent. Dose, n\xx— £j. The above 
remark on mixtures containing the fluid extract applies also to the tincture. 

Similar preparations of Cannabis Americana are prepared by the manufacturers and 
may be used in larger quantities. The dosage of all preparations of hemp is uncertain, 
as specimens of the plant vary very much in activity. The best rule is to begin with a 
small dose, gradually testing the activity of the drug and the susceptibility of the patient 
by carefully increased doses. 

Cannabin Tannate (Unofficial),— is a yellowish-brown permanent powder, insoluble in 
water and ether, slightly soluble in alcohol, having a not unpleasant odor and a bitterish, 
astringent taste. No formula has been published for it, but it is claimed to be the tannate 
of a glucoside by Merck, of Darmstadt, who placed it on the market. Dose, as a hyp- 
notic, gr. v-x. 

Preparations used in the East. 

Churrus is an impure resin, prepared by rubbing the leaves of the plant together and 
scraping off the adhering resin. 

Gunjah is the dried leaf and tops as sold in the bazaars for smoking purposes. 

Hashish, Bhang or Siddhi is a confection consisting of the leaves and small stalks 
coarsely broken and mixed with fruits and aromatics. It is employed in the preparation 
of various electuaries and beverages, and is also smoked with or without tobacco. 

Physiological Action. 
Cannabis is an antispasmodic, analgesic, anaesthetic and narcotic, a 
cerebro-spinal stimulant and a powerful aphrodisiac. It increases intel- 
lectual and motor activity, stimulates the vaso-motor nerves raising arterial 
tension, depresses sensation, and strengthens the energy of the uterine 
muscular fibre, but has no power to initiate uterine contractions. In 
large doses it causes a pleasurable intoxication, during which the peculiar 
traits of the individual are exalted, and the ideas follow each other so 
rapidly as to produce a sense of great prolongation of time, minutes seem- 
ing as if hours or even days. With this occurs increased sexual desire, 
great uterine activity, % and sensations of double consciousness and enor- 
mous dimensions. The sight and hearing are exalted, pupils dilated, 
anaesthesia sets in, the reflexes are lowered by stimulation of inhibition 
(Setchenow's centre?), and if the dose be a heavy one a cataleptic state 
is induced. Sleep or coma follows according to the size of the dose, but 
death has never been produced by this drug. 



154 CANTHARIS. 

After-effects are dullness, heaviness, vertigo, headache, and confused 
thought, anaesthesia of the skin, and marked diuresis, — but no nausea, 
no vital depression, no constipation. Repeated use of the drug causes 
mental weakness and impotence, the result of over-stimulation. A raven- 
ous appetite is usually one of its effects. 

Antagonists and Incompatibles. 

Strychnine and faradism are antagonistic. Caustic alkalies are incompatible. In 
poisoning by it the stomach should be evacuated, stimulants given cautiously, and respira- 
tion maintained. The effects of a large dose last over 24 hours. Lemon-juice is said to 
antagonize its effects. 

Therapeutics. 

Cannabis was formerly much employed as an anodyne and hypnotic, 
also as an anaesthetic during surgical operations. It is now somewhat out 
of fashion. In migraine it is useful to prevent recurrence of the attack, 
and in neuralgia it is often very efficient. Uterine affections, as — chronic 
metritis, subinvolution, menorrhagia, dysmenorrhcea, etc., are greatly 
benefited by its anodyne quality and its power over the uterine muscular 
fibre. It is the best hypnotic in delirium tremens, and in traumatic 
tetanus and paralysis agitans large doses will lower the reflex activity. 
Dysuria and retention of urine are often relieved by it, while in spasm of 
the bladder and other painful affections of that organ it will be found a 
most efficient remedy. It is useful in functional impotence, especially if 
combined with Ergot and Nux-vomica. In gonorrhoea it lessens the 
discharge, relieves the inflammation, burning pain and restlessness, and 
allays chordee. The tincture of C. Americana is the most useful in this 
affection, being fully as efficient as Copaiba or Sandal Oil, and much 
more agreeable. It should, however, be prepared from the fresh plant, 
and be given in 3 to 5 drop doses 3 or 4 times daily after the subsidence 
of the acute symptoms. Full doses of the tincture of the Indian plant are 
extremely efficient in many cases of headache at the menopause, but 
should be used cautiously until the activity of the sample and the suscep- 
tibility of the patient are tested. 

Tannate of Cannabin is recommended as a powerful hypnotic, not 
in any degree dangerous and neither disturbing the secretions nor leaving 
unpleasant after-effects. It has been used with benefit in acute mania. 



CANTHARIS, Cantharides, Spanish Flies,— is the dried beetle 
Cantharis vesicaloria, an insect of the nat. ord. Coleoptera, about an inch 
long, of a shining green color, the powder being grayish-brown, with 
green particles, odor very disagreeable. Contains Cantharidin, C 10 H 12 O 4 , 
the active principle, — also a greenish volatile oil and peculiar fatty bodies. 



CANTHARIS. 1 55 

Preparations. 

Tinctura Cantharidis, — strength 5 per cent. Dose, mj-xx. 

Ceratiim Cantharidis, Cantharides Cerate, Blistering Cerate, — Cantharides 35, Yellow 
Wax 20, Resin 20, Lard 25 parts. 

Ceratum Extracti Cantharidis, — Cantharides 30, Resin 15, Yellow Wax 35 parts, 
Lard 35 parts, Alcohol q. s. 

Charta Cantharidis, — Cantharides I, Canada Turpentine I, Olive Oil 4, Spermaceti 3, 
White Wax 8, Water 10 parts — spread on paper. 

Linimentuj?i Cantharidis, — Cantharides 15, Oil of Turpentine q. s. ad 100. 

Emplastrum Picis cum Cantharide,F\tch Plaster with Cantharides, Warming Plaster, 
— Burgundy Pitch 92 parts, Ceratum Cantharidis 8 parts. 

Collodium cum Cantharide, Cantharidal Collodion, — Cantharides 60, Flexible Collo- 
dion 85, Commercial Chloroform q. s. 



Physiological Action. 

Cantharis applied to the skin is a rubefacient and vesicant, acting more 
slowly than mustard but much more severely. Internally it is also irri- 
tant, causing heat of stomach, gastralgia, nausea, and vomiting, the circu- 
lation is stimulated, temperature elevated, urine becomes scanty and 
irritating, is voided with difficulty and pain, and often contains blood and 
albumen. Afterwards the pulse falls, temperature and arterial tension are 
lowered, and depression ensues. A toxic dose produces severe gastro- 
enteritis, abdominal tenderness, tenesmus, mucous or bloody stools, pain 
in the stomach and loins, dysphagia, ptyalism, strangury, priapism, hema- 
turia, swollen genitals, abortion, muscular tremor, convulsions, coma and 
insensibility. Post-mortem shows evidences of violent metritis, gastro- 
enteritis and general peritonitis. Cantharis is aphrodisiac by causing 
vascular turgescence of the genital apparatus, but only in doses which 
produce dangerous symptoms. It is only abortive in toxic doses. In 
small doses it is diuretic and emmenagogue. 

Counter-irritation by rubefacients or blisters acts on disease probably 
through the nervous system. Its influence is explained by the theory that 
the peripheral extremities of the nerves supplying the skin of the part to 
which the agent is applied undergo some molecular change, which extends 
to the nerve centre and is thence radiated to centrifugal or trophic nerves, 
effecting various changes in nutrition and secretion over the areas to which 
they are distributed. In addition to this method of action, neighboring 
parts are affected by direct extension of the inflammation produced, and 
distant parts are also affected by absorption through the vesicated surface 
of agents having special affinities for certain organs. 

Blisters act primarily as a stimulant to the body generally as well as to 
the organs in its vicinity, but if permitted to remain long enough to pro- 
duce large blebs, the result is a depression proportionate to the amount 
of serum abstracted, the serum containing nearly as much albumen as the 
blood itself. 



I56 CAPSICUM. 

Antagonists. 

There is no chemical or physiological antagonist to Cantharis. Evacuation of the 
stomach, mucilaginous drinks freely, Opium for the gastro-enteritis, are the best measures 
in poisoning by this agent. 

Therapeutics. 

As a counter-irritant and vesicant Cantharis is of great value in neu- 
ralgia if applied close to the emergence of the nerve from the spinal 
column, also in sciatica and neuritis, and in acute rheumatism around the 
affected joints. A blister at the nape of the neck controls many head- 
aches, and one behind the ear will modify inflammatory affections of the 
eye. In pleuritic effusions a succession of small blisters (flying-blisters) 
will promote absorption of the pleural contents, and a blister applied to 
the perineum will often cure a rebellious gleet. Though valuable as a 
therapeutic measure in very many conditions, blistering is going out of 
fashion except in hospitals and among people who believe in heroic 
treatment. 

As an internal remedy Cantharis must be employed in very small doses 
(wij-iij of the tincture) in order to be efficient. When so used it is an 
admirable agent in acute desquamative nephritis after the active inflamma- 
tion and fever have subsided, to reduce the albumen and blood in the 
urine. Drop-doses are particularly useful in irritable bladder with frequent 
desire to micturate, so often observed in women, also in the incontinence 
of the aged and of children, and in cystitis, gonorrhoea and gleet. The 
same dose thrice daily will generally abate chordee. In spermatorrhoea, 
prostatorrhoea, scanty menstruation and menorrhagia in subjects of lax 
fibre and general want of tone it is often very serviceable. Cutaneous 
squamae and vesiculae are greatly improved by small doses frequently ad- 
ministered and gradually increased, and it is one of the best remedies for 
psoriasis. For alopecia areata it is of the utmost value as an external 
application, and the tincture, greatly diluted, is an ingredient of all the 
hair-renewers in common use. In pleurisy, after effusion has taken place, 
it will be found admirable in 1 to 2 drop doses every 2 or 3 hours, and in 
the after-prostration of diphtheria it proves a serviceable stimulant. One 
of the best applications to burns or scalds is a cloth dipped in a lotion of 
the tincture one part to thirty or forty of water. The same lotion is an 
efficient application to vesicular erysipelas and herpes zoster. 



CAPSICUM, Cayenne Pepper, — is the fruit of Capsicum fasti- 
giatum, a plant of the nat. ord. Solanaceae, native in tropical Africa and 
America. Occurs in small red pods, enclosing two cells containing flat, 
yellowish seeds, and has a peculiar odor and an intensely hot taste. It 
contains Capsicin, which is a thick, red liquid, and is the active principle, 



CAPSICUM. I57 

— also a volatile alkaloid having the odor of Conine. Dose of the pow- 
dered drug, gr. v-x. 

Preparations. 

Extracttim Capsici Fluidum, — alcoholic. Dose, Vt\v-% j. 
Tinctura Capsici, — 5 per cent, strength. Dose, TTVx-5jj. 
Oleoresina Capsici, — prepared by ether. Dose, rr\J-v. 

Emplastrum Capsici, Capsicum Plaster, — prepared from the oleoresin of capsicum and 
resin plaster. 

Physiological Action. 
Capsicum is irritant to the skin and mucous membrane. Externally 
used for sufficient length of time it will produce vesication, internally in 
quantity it will excite gastritis. In medicinal doses it increases the saliva, 
excites a sensation of warmth in the stomach, promotes appetite and di- 
gestion, and produces more easy and copious alvine evacuations. It 
stimulates the action of the heart, is diaphoretic and diuretic, also 
decidedly aphrodisiac. It is a general stimulant to the nervous system, 
but in repeated doses produces a slight narcotic effect upon the brain. 
On the vascular system it acts like ergot, powerfully constringing the 
vessels by influencing the unstriped muscular fibre in their walls, either 
directly or through the vaso-motor nerves. 

Therapeutics. 

Capsicum is an excellent stomachic tonic in atonic dyspepsia and in 
that of chronic alcoholism with tremor and insomnia. In acute dipso- 
mania and delirium tremens large doses are efficient in producing sleep 
and promoting appetite. It is the best substitute for alcohol and opium 
in attempts to cure those habits. It is well used in intermittents, chiefly 
as an adjuvant to more active drugs, — in flatulent colic, especially when 
occurring in hysterical women and hypochondriacs, — also in low fevers 
and cholera as a stimulant. It gives good results in functional impotence, 
in spermatorrhoea from loss of tone, in chronic parenchymatous nephritis 
to check the waste of albumen, and is beneficial in chronic cystitis and in 
prostatorrhoea. The tincture internally and a plaster externally over the 
loins are efficient in cases of renal congestion with habitual pain in the 
back and a trace of albumen in the urine. 

Locally the tincture diluted (3J to ^viij) or the powder with honey, 
form excellent gargles for relaxed throat and its accompanying cough, 
relaxed uvula, inflammatory sore throat, and the cynanche of scarlet fever, 
but they must be used with caution as such applications are sometimes 
very irritating. 

The Capsicum-plaster is a mild counter-irritant, of great value in lum- 
bago and other muscular rheumatisms as a palliative application. 



I58 CARBO. 

CARBO, Carbon, — exists in nature in many forms, of which two 
are official, namely, the charcoals specified below. 

Carbo Animalis, Animal Charcoal, — prepared from bone, occurring 
in dull black fragments or powder, odorless and nearly tasteless, insoluble 
in water or alcohol. 

Carbo Ligni, Charcoal, — prepared from soft wood, is black, shining, 
brittle, inodorous, tasteless and insoluble. 

Preparations. 

Carbo Animalis Purificatus, Purified Animal Charcoal, — the bone-phosphate and cal- 
cium carbonate being removed by digesting with Hydrochloric acid and washing. Dose, 
gr. xx- 3 j. 

Carbonei-Bi-sulphidum, Bisulphide of Carbon, CS 2 , — is a clear, colorless, diffusive 
liquid, of strong, offensive odor, aromatic taste and neutral reaction; soluble in alcohol, 
ether, chloroform and oils, insoluble in water ; vaporizes at ordinary temperatures, and is 
highly inflammable. Dose, n\ss-j. 

Physiological Action. 

Charcoal is an efficient deodorant and disinfectant, as it absorbs and 
condenses many gaseous bodies and vapors. It is evacuated unchanged 
by the bowel and exerts no specific action on the body. 

Carbon Bisulphide is largely used in the arts, hence its effects are fre- 
quently observed. Persons exposed to its fumes are affected by headache, 
vertigo, over-excitement of the nervous system, emaciation, incoordination 
of movement, depression of all the special senses with impairment of sen- 
sation and motility and perhaps insanity. Inhaled directly, it excites vio- 
lent coughing and produces anaesthesia characterized by great muscular 
rigidity. Being a powerful cardiac paralyzant, it is extremely dangerous 
as an anaesthetic. In 3-drop doses it produces severe nausea and vomit- 
ing, with a sense of heat in the stomach and a weak and rapid action 
of the heart. It is a good solvent for Caoutchouc and many other 
substances. 

Therapeutics. 

Charcoal is used in pharmacy for decolorizing vegetable principles, 
removing alkaloids from infusions of plants, and making several prepara- 
tions, as acidum sulphurosum, potassii iodidum, etc. 

Externally, it makes an efficient disinfectant, absorbent and deodorant 
application to cancerous discharges, foul ulcers and gangrenous wounds. 
Having no odor it is not open to the charge of substitution of one smell 
for another. A small quantity added to water will keep it sweet for a long 
time. It is an excellent dentifrice if finely powdered. 

Internally, it is used for the same purposes, namely, to absorb gases and of- 
fending products of indigestion. In flatulent dyspepsia, gastralgia, pyrosis, 
diarrhoeas, nausea of pregnancy, epidemic cholera, and constipation, it 
has warm advocates. When used internally for any time, an occasional 



CARDAMOMUM CARDUUS. 159 

purgative should be given to prevent its accumulation in the intestines. 
It has been proposed as an antidote for several alkaloidal poisons on theo- 
retical grounds, but its efficacy in this respect is doubtful. 

Carbon Bisulphide has such a horribly offensive odor that it will never 
be used for any purpose for which another agent can be found. It relieves 
the pain of gastric cancer, and in ^-drop doses will alleviate nausea and 
vomiting, also gastralgia. Locally it has been used as a counter-irritant 
and a local anaesthetic, for deafness due to want of nervous energy, in 
facial neuralgia and various local pains. 



CARDAMOMUM, Cardamon,— is the fruit of Elettaria Carda- 
momum, a plant of the nat. ord. Zingiberaceae, cultivated in Malabar. 
Occurs as dried capsules, containing small, reddish-brown seeds, of warm, 
aromatic taste and agreeable odor. Contains about 4^ per cent, of a 
Volatile Oil, C 10 H 16 , isomeric with Oil of Turpentine, which oil is the 
active principle, also a fixed oil, coloring matter, etc. It is an ingredient 
of Pulvis Aromaticus and of Extractum Aromaticum Fluidum (see under 
Cinnamomum), as well as of several compound preparations. 

Preparations. 

Tinctura Cardamomi, — 15 per cent, strength. Dose, £j-ij. 

Tinctura Cardamomi Composita, — Cardamon 20, Cinnamon 20, Caraway 10, Cochi- 
neal 5, Glycerine 60, Diluted Alcohol q. s, ad 1000. Dose, ^j-ij. 

Infusum Cardamomi (Unofficial), — may be made in the strength of 3] to O l />, and 
used in wineglassful doses. 

Physiological Action and Therapeutics. 
Cardamon is aromatic, carminative and stomachic, and is used as an 
agreeable flavoring for bitter mixtures in dyspepsia and other stomach 
affections. It is especially useful when combined with purgatives to check 
flatulence and griping, and it makes the best flavoring for saline solutions 
or mineral waters. 



CARDUUS (Unofficial), — the seeds of Carduus marianus, or St. 
Mary's thistle, an annual European plant of the nat. ord. Compositae. 
A decoction (gij ad Oj) is the preparation usually employed. It is an old 
remedy recently revived as a hemostatic, and reported as very efficient in 
hemoptysis, uterine hemorrhage, melsenaand amenorrhcea connected with 
derangement of the portal circulation. It has proved curative in conges- 
tion of the liver and simple jaundice, and in Germany it has long been 
popularly deemed efficacious in' gall-stones, and liver affections generally. 
Dose of the decoction, £j-^ss, — of a tincture, nrx-xx. 

Carduus Benedictus, the "blessed thistle," also called Cnicus bene- 
dictus and Centaurea benedicta, is another plant of the same order, for- 



l60 CARUM — CARYOPHYLLUS. 

merly held in high esteem as a popular " cure-all." It contains Cnicin, an 
amorphous bitter principle, which has been used as an antiperiodic in 
doses of gr. v-x, but generally produces burning sensations and pharyn- 
geal constriction, with nausea, vomiting, colic and diarrhoea. It acts 
chiefly as a bitter tonic, resembling Calumba and Taraxacum most closely. 

CARUM, Caraway, — is the fruit of Carum Carvi, a European plant 

of the nat. ord. Umbelliferae, and is of oblong shape, ^th of an inch in 

length, separating into two parts, each having 5 ribs and 6 oil-tubes. Its 

odor and taste are aromatic and agreeable. The active principle is the 

Volatile Oil, which is also official. Caraway is an ingredient of Tinct. 

Cardamomi Composita. 

Preparations. 

Oleum Cart, — is the volatile oil distilled from Caraway, and is resolvable into Caruen, 
C 10 H ]6 , isomeric with Turpentine and Caruot, C^H^O, isomeric with Thymol. It is an 
ingredient of Spiritus Juniperi Compositus. Dose, Tmj-v. 

Infusum Cari (Unofficial), — 3 j — ij ad Oss. Dose, ^ss-ij. 

The Oil of Caraway is fatal to small animals, and in one case 33 pro- 
duced cerebral congestion, delirium and rigors in man. The chief use 
of Caraway is as a flavoring agent, but it is efficient in the flatulent colic 
of children, and to prevent griping from the use of purgatives. 

CARYOPHYLLUS, Cloves,— are the unexpanded flowers of 
Eugenia caryophyllata, a handsome evergreen tree of the nat. ord. Myr- 
taceae, cultivated in the East and West Indian Islands. They are about 
j^-inch long, of a dark-brown color, consist of a calyx-tube terminated 
by four teeth and surmounted by a globular head formed by four petals, 
which cover numerous curved stamens and one style. They emit oil when 
scratched, have an aromatic odor, and a pungent, spicy taste, and are 
contained in Tinctura Lavandulae Composita, Tinctura Rhei Aromatica 
and Vinum Opii. They contain a heavy Volatile Oil, which is official, — 
also Eugenin, C 10 H 12 O 2 , a crystalline body ; Caryophyllin, C 10 H 16 O, a cam- 
phor ; Carypohyllic Acid, and tannin, gum, etc. 

Preparations. 

Oleum Caryophylli, Oil of Cloves — a volatile oil distilled from Cloves, soluble in alco- 
hol, and of sp. gr. 1.050. It consists of a light and a heavy oil, the latter containing 
Eugenol, C ]0 H 12 O, a phenol-like compound, and Caryophyllin, C 10 H 16 O, which yields as 
a product of its oxidation Caryophyllinic Acid, C 20 H 32 O 6 . Dose of the oil TT\j-iv. 

Infusum Caryophylli (Unofficial), may be made of strength I to 40, and used in doses 
of one to two fluid ounces. 

Physiological Action and Therapeutics. 
Cloves may be considered as a type of several agents yielding aromatic 
oils, which as a rule consist of terpenes with camphors, resins, fatty and 



CASCA BARK CASCARA AMARGA. l6l 

other acids, etc., closely allied to phenol and benzoic acid, the balsams 
and gum-resins. Such are Orange, Lemon, Allspice, Cajuput, Caraway, 
Peppermint, etc. Their oils are antiseptic, locally anaesthetic, stimulant 
and irritant, antispasmodic, stomachic and carminative. Internally they 
increase circulation and temperature, promote digestion and nutrition (in 
quantity may cause inflammation), relieve pain and spasm, and are excre- 
ted by the kidneys, skin, liver and the bronchial mucous membrane, 
stimulating and disinfecting their routes through the organism. 

These agents are used to flavor pharmaceutical preparations, to correct 
the griping tendency of many purgatives, to correct flatulence, to relieve 
pain in the stomach and bowels, and to promote the flow of saliva and 
gastric juice. As external applications they are efficiently employed for 
anaesthetic and counter-irritant purposes, to relieve pain in chronic rheu- 
matism, myalgia, lumbago, superficial neuralgia, toothache, etc. The 
Oil of Cloves is an effective deodorizer for sponge-tents, a good applica- 
tion to a painful tooth, and is occasionally applied over the course of an 
aching nerve with relief to the pain. 



CASCA BARK, Sassy Bark, Ordeal Bark (Unofficial),— is the 
bark of Erythrophlceum Guinense, an African tree used by the negroes as 
an ordeal in trials for witchcraft. It contains a poisonous glucoside, 
Erythrophlein, and when used in quantity produces nausea and vomiting, 
stricture across the brow, severe cephalalgia, narcosis and death. It is 
used as a remedy in Africa for intermittent fever, dysentery, diarrhoea 
and colic, and in England is considered to resemble Digitalis in action 
and uses. A tincture is made (^ij ad Oj) of which the dose is ttlx, or a 
watery Extract may be used in doses of gr. j. 

Erythrophloein, the active principle, is a glucoside, and is said to be a local anaesthetic 
of extraordinary power, even surpassing Cocaine. It is found in Africa in a red mass, 
called " Hayah," which is proven to be identical with an extract of the original plant 
described by CErtel early in this century, and deposited by him in the Berlin museum. It 
closely resembles Digitalis in action, being a cardiac tonic and a hydragogue diuretic. 



CASCARA AMARGA, Honduras Bark (Unofficial),— is the 
bark of a Mexican tree of the nat. ord. Simarubaceae, which has been 
used with apparent success as an alterative tonic and diuretic in syphilis 
and various chronic skin affections. The use of tobacco and alcohol 
seems to counteract its usefulness. It is certainly a very powerful tonic 
and has been employed by competent observers with uniformly good 
results in syphilis and syphilodermata, chronic liver complaints, chronic 
eczema, chronic nasal catarrh and psoriasis. A Fluid Extract is on the 
market of which the dose is ^ss-j thrice daily. 



1 62 CASCARA SAGRADA CASCARILLA — CASSIA FISTULA. 

CASCARA SAGRADA, Chittem Bark, Sacred Bark (Un- 
official), — is the bark of Rhamnus Purshiana, or California Buckthorn, a 
small tree of the nat. ord. Rhamnaceae growing on the Pacific coast of 
the United States. It contains a Volatile Oil, a neutral crystalline sub- 
stance, several Resins, with tannic, malic and oxalic acids. A Fluid 
Extract is on the market, of which the dose is gss-j, two or three times 
a day. It has been found very serviceable in the treatment of chronic 
constipation, given in gradually diminished doses. It produces large, 
soft and painless evacuations, and the bowels are said to act naturally and 
regularly after its disuse. 

Cascara Cordial is a trade preparation, intended as a remedy for 
constipation, dyspepsia and hemorrhoids, and as a pleasant excipient for 
nauseous and bitter drugs. A similar preparation may be made by com- 
bining the fluid extract with the official Elixir Aurantii in the proportion 
of 3j to ^ij, of which teaspoonful doses or more may be administered. 

Another species of the same genus, Rha?nnus Frangula, is official 
under the title Frangula, which see. 

CASCARILLA, — is the bark of Croton Eluteria, a shrub or small 
tree of the nat. ord. Euphorbiacese, growing in the Bahamas. It occurs 
in grayish-brown quills, having a warm, bitter taste, and a fragrant odor 
when burned. Contains Cascarillin, a crystalline principle, two resinoid 
extracts, aromatic volatile oils, with tannic acid, etc. There are no 
official preparations, but an Infusion (i to 10) or a Tincture (i to 10) 
may be prepared and given in doses of 3J-^j. 

Physiological Action and Therapeutics. 

Cascarilla is an aromatic bitter. It increases appetite and digestion, 
the mucous secretion, the flow of saliva and gastric juice, stimulates the 
intestinal secretions, and acts as a mild astringent by the influence of its 
tannin. Large doses produce nausea, vomiting and diarrhoea, and in 
medicinal doses continued it will set up gastric catarrh and consequently 
indigestion. It has slight antiperiodic powers. 

It has been used with success in epidemic dysentery, flatulent dyspepsia, 
debility, chronic bronchitis, intermittents, and low nervous fevers. It is 
difficult to dispense, as the infusion decomposes quickly, and acids pre- 
cipitate the resin from the tincture. 

CASSIA FISTULA, Purging Cassia,— is the fruit of Cassia 
Fistula, a tree of the nat. ord. Leguminosae, growing in tropical regions 
of Asia, Africa and America. It occurs in long, brown pods which are 
divided into numerous transverse cells, each containing a dark pulp in 
which is a glossy seed. No active principle has been isolated as yet. 
The pulp is the only valuable part of the drug. There are no official 
preparations, but it is one of the ingredients of Confectio Sennae. 



CASTANEA— CATECH U C AULOPHYLLUM. 1 63 

Cassia-pulp is laxative in doses of 3J-ij, and purgative in large quan- 
tities, producing nausea, flatulence and griping. It is rarely prescribed 
alone, owing to its tendency to cause colic and flatulence. 

CASTANEA, Chestnut, — the leaves of Castanea vesca, a stately 
tree of the nat. ord. Cupuliferse, and should be collected while green. 
Chestnut leaves are 5 to 10 inches long and about 2 broad, have a slight 
odor and somewhat of an astringent taste. They contain tannic and 

gallic acids, salts, gum, etc. 

Preparation. 
Extractum Castanece Fluidum, — Dose, ^ss-gij. 

This drug has not been studied as to its physiological actions, if it has 
any. It is classed among the vegetable astringents by reason of its con- 
taining tannin. Its only reputation therapeutically is as a remedy for 
whooping-cough, in which it is said to be very efficacious. An infusion 
or decoction of the leaves has been used in indefinite doses. 

CATECHU, — is an extract prepared from the wood of Acacia Cate- 
chu, a tree of the nat. ord. Leguminosae, native of the East Indies. 
Occurs in irregular masses, dark brown and brittle, nearly inodorous, but 
of astringent and sweetish taste, soluble in alcohol, and partly so in water. 
It contains Caiechutannic Acid 50 per cent., and Catechuic Acid which is 
converted into the former by heat. Dose, gr. j-gss. 

Preparations. 

Tinctura Catechu Composita, — contains Catechu 12, Cinnamon 8, Diluted Alcohol q. s. 
ad 100 parts. Dose, TT\,x-gj. 

Trochisci Catechu, — each troche contains of Catechu 1 grain, mixed with Sugar, 
Tragacanth and Orange-flower water. 

Physiological Action and Therapeutics. 
Catechu is a powerful astringent, acting by virtue of its tannic acid, 
(See ante, page 75, for actions and incompatibles). Its uses depend en- 
tirely on its astringency. In the diarrhoea of children the Tincture with 
Chalk-mixture is very serviceable, and with Opium it is efficient in dysen- 
tery. It is also used as a gargle and mouth-wash in relaxed conditions of 
the pharyngeal mucous membrane, as an injection in leucorrhcea, and to 
control passive hemorrhages, spongy gums, etc. 

CAULOPHYLLUM, Blue Cohosh,— is the rhizome and rootlets 
of Caulophyllum thalict?-oides, a plant of the nat. ord. Berberidaceae 
growing in Canada and the northern United States. Rhizome about 4 
inches long, thick and bent, rootlets numerous and matted, taste sweetish, 
bitter and acrid. Contains Saponin a glucoside, and two resins. Dose, 
gr. v-xx. There are no official preparations. The eclectic preparation 
Caulophyllin is a resinous precipitate obtained by pouring an alcoholic 
extract into water. 



164 cera cerii oxalis. 

Physiological Action and Therapeutics. 
Caulophyllum is a new addition to the pharmacopoeia, and has not yet 
been made the subject of experimental work by reliable observers. It 
was much used by the aborigines of this country in all affections to which 
their women were peculiarly subject, and was known among them by the 
name "squaw-root." It is said to produce intermittent contractions of 
the gravid uterus, to have diuretic, emmenagogue and antispasmodic 
powers ; and is used as a remedy for deficient labor-pains, spasmodic 
after-pains, spasmodic pains in the uterus at any time, spasmodic dys- 
menorrhea, and pains in other organs seemingly in sympathy with uterine 
affections. It has somewhat of a reputation in acute rheumatism of the 
hands and fingers, and as a preparative medicine for labor. 

CERA, Wax, — is a mixture of Myricin, Cerotic Acid and Cerolein, 
is formed by the honey-bee, and exists in the pollen and leaves of many 
plants, particularly in Myrica cerifera, the wax myrtle. That produced 
by the bee is alone official. 

Cera Alba, White Wax, — is yellow wax bleached. 

Cera Flava, Yellow Wax, — is a peculiar concrete substance prepared 
by Apis mellifica, the honey-bee. It is a yellowish solid, of agreeable 
odor and faint, balsamic taste, melting at 145. 4 to 147 F., of sp.gr. 
0.955-0.967, insoluble in water and almost so in cold alcohol, but soluble 
in 35 of ether, 11 of chloroform, boiling alcohol, fixed and volatile oils. 

Preparations. 
Ceratum, Cerate, — consists of White Wax 30, Lard 70. 
Unguentum, Ointment, — consists of Yellow Wax 20, Lard 80. 

Wax is also a constituent of the 7 compound Cerates, 5 of the 25 compound Ointments, 
and 8 of the 17 Plasters. 

Physiological Action and Therapeutics. 

Wax owes its value to its power of resistance to decomposition and to 
many chemical agents. Its fusibility at a moderate degree of heat, and 
its solidity at the temperature of the body, together with its unirritating 
quality, make it a valuable ingredient of the cerates and ointments to 
give them consistence. 

Ceratum and Unguentum may be used as simple protective applica- 
tions. They form the bases of most of the compound preparations so 
named. 

CERII OXALAS, Oxalate of Cerium, Ce 2 (C 2 4 ) 3 .9H 2 0,— is 

a white, slightly granular powder, odorless and tasteless, insoluble in 
water or alcohol, but soluble in hydrochloric acid. Dose, gr. j-x, in 

pill. 

Physiological Action and Therapeutics. 
Oxalate of Cerium is a gastric sedative (like Bismuth), and is thought 



CETACEUM CETRARIA CHAULMOOGRA OIL. 1 65 

to have selective action as a sedative to the motor distribution of the 
pneumogastric nerve. It is considered to be particularly useful in vomit- 
ing of reflex" origin, especially in the vomiting of pregnancy, but it often 
fails, probably because not given in sufficient doses. To be effective at 
least 4 or 5 grains should be given 3 times a day to adults, and no results 
promised until after it has been used several days. It is also recom- 
mended in the vomiting of phthisis and bronchitis, cough with vomiting, 
gastralgia, chorea and diarrhcea. 

CETACEUM, Spermaceti, — is a peculiar, concrete, fatty sub- 
stance obtained from Physeter macrocephalus, the sperm whale. Occurs 
in white, pearly masses, odorless, of bland taste, and neutral reaction, 
becoming rancid in the air, soluble in ether, chloroform, carbon bisul- 
phide and boiling alcohol. Is a constituent of Unguentum Aquae Rosae, 
and Charta Cantharidis. 

Ceratum Cetacei, Spermaceti Cerate, — consists of Spermaceti 10, White Wax 35, 
Olive Oil 55 parts. 

Spermaceti consists of Cetin or Palmitate of Cetyl with several other 
fats in small quantities. Its action is solely that of an emollient, and it 
is rarely used internally. The Cerate is used as a bland ointment in 
blisters, abrasions, and ulcers. 

CETRARIA, Iceland Moss, — is the lichen Cetraria islandica, 
found in northern latitudes. Occurs about 2 to 4 inches long, brown 
above, whitish beneath, taste mucilaginous and bitter. Contains Lichenin 
or lichen starch, which forms as a jelly when the plant is boiled in water; 
— also Cetraric Acid. 

Decoctum Cetrarice, — 5 per cent, strength. Dose, ^ij-iv. 

Cetraria is nutrient, demulcent and feebly tonic. It has a popular 
reputation in pulmonary affections, and is of value in chronic catarrhs, 
chronic bronchitis, purulent discharges from mucous surfaces generally, 
also in chronic diarrhcea and dysentery. 

CHAULMOOGRA OIL (Unofficial),— is a fixed oil expressed 
from the seeds of Gynocardia odorata, an East Indian tree of the nat. ord. 
Bixaceae. It is nauseous and bulky, solid at 62. 6° F., and soluble in 
alcohol, ether, chloroform, etc. Its active principle, Gynocardic Acid, 
is the best preparation for use, and may be given internally in doses of 
gr. ss-iij, or applied as an ointment, gr. xx ad %] of Petrolatum. Dose 
of the oil, gtt. v-x, in capsules. 

Chaulmoogra Oil is credited with a few cures of leprosy, and several 
cases improved by its use both internally and externally. It is recom- 
mended as an external application in scaly eczema, psoriasis, syphilitic 



1 66 CHELIDONIUM CHENOPODIUM CHIMAPHILA. 

skin-diseases, chronic rheumatism, rheumatic arthritis and tabes mesen- 
terica. 

CHELIDONIUM, Celandine, — is the plant Chelidonium majus, 
nat. ord. Papaveraceae, which grows in Europe and N. America about 
rocky places. It has a peculiar, unpleasant odor, and a pungent, acrid 
taste. Contains 2 alkaloids, Chelidonine, C 19 H n N 3 03, and Chelerythrine, 
the latter being identical with Sanguinarine : also Chelidoxanthin, a yel- 
low, crystalline substance, and Chelidonic Acid, supposed to be identical 
with Succinic Acid. Dose of the plant, gr. x-xxx, — of the fresh juice 
ttlv-xx. There are no official preparations. 

Chelidonium used externally is irritant, internally it is a drastic purga- 
tive but an unreliable one. It is also perhaps diuretic, diaphoretic and 
expectorant. In overdoses it is considered poisonous. It is an old 
remedy for jaundice and liver affections, but has been obsolete for some 
time. The fresh juice is a popular application for warts and corns, and 
a tincture in whiskey is used in Indiana as a remedy for phthisis, the 
menstruum being probably the most useful agent. It seems to be of 
real service in simple jaundice, whooping-cough, right-sided pneumonia 
with hepatic involvement, and the catarrhal pneumonia of children. 

CHENOPODIUM, American Wormseed,— is the fruit of 
Chenopodium ambrosioides, var. anthelminticum, a plant of the nat. ord. 
Chenopodiaceae, indigenous in the United States. It is about y 1 ^- inch 
in diameter, and contains a glossy, black seed, has a peculiar, terebin- 
thinate odor, and a pungent, bitter taste. Its active principle is a Vola- 
tile Oil which is official. 

Oleum Chenopodii, — a thin, colorless or yellowish liquid, of aromatic odor and pun- 
gent, bitter taste. Dose, rr^v-xv. 

The Oil is the only preparation used and that rarely, its odor and taste 
being very disagreeable. It increases the cardiac rate, and promotes the 
secretions of the skin, bronchi and kidneys. It is an efficient anthel- 
mintic against the round worm in doses of gtt. x three times a day for 
two days and followed by a cathartic. It seems to possess some tonic 
properties, and certainly is a diffusible stimulant. As such it has been 
used with benefit in chorea, hysteria, flatulent dyspepsia, and chronic 
malaria. 

CHIMAPHILA, Pipsissewa, — the leavesof Chimaphila umbellata, 
or Prince's Pine, an evergreen plant of the nat. ord. Ericaceae, indigenous 
in all parts of the United States. The leaves are about 2 inches long, 
serrate above, wedge-shaped towards the base, having an astringent and 
bitter taste. Contains Chimaphilin, a yellowish crystalline principle, 
Arbutin, also crystalline but colorless, with tannic acid, etc. 



CHINOLINA. 167 

Extractum Chimaphila Fluidiun, — Dose, ^ss-ij. 
Decoctum Chimaphila (Unofficial), — I to 17. Dose, ifj-iij. 

Chimaphila is a tonic, astringent diuretic, belonging to the same group 
as Buchu, Uva Ursi, Pareira and Scoparius. It is probably the most 
active diuretic among them, stimulating all the excretory organs but 
especially the kidneys. It is an agreeable tonic, excites the appetite and 
promotes digestion. The fresh leaves, bruised and applied to the skin, 
are rubefacient and vesicant, showing the presence of some irritant 
principle. 

Chimaphila is a good diuretic in dropsy, and is efficient in several 
forms of chronic kidney disease with albuminuria, and in chronic ca- 
tarrhal affections of the urinary passages, as hematuria, ischuria, dysuria 
and gonorrhoea. It is believed to check the secretion of uric acid, and 
should prove useful in gout and rheumatism. Externally, it has been 
applied to ulcers and tumors with benefit. 

CHINOLINA, Chinoline, Leucoline, C 9 H 7 N (Unofficial), a con- 
stituent of coal-tar oil — but may be obtained from Quinine or Cincho- 
nine by their destructive distillation with potassium hydrate, — and may 
be artificially prepared by heating Anilin or Nitro-benzol with glycerin 
in the presence of a dehydrating agent. Chemically, it is considered to 
be formed by a union of Benzene and Pyridine atoms. (Compare the 
article Cinchona.) It is a colorless, oily liquid, strongly refractive, 
boiling at 460 F. without decomposition, turns dark on exposure to the 
air; soluble in alcohol, ether and carbon disulphide, sparingly so in 
water. It combines, like an alkaloid, with acids to form crystalline salts ; 
all of which, except the tartrate, are very deliquescent. 

Chinolince Tartras, — a white, micaceous, crystalline powder, of pungent odor and 
sharp taste, stable in the air and soluble in water. Dose, gr. v-xx. 

Physiological Action and Therapeutics. 
Chinoline is a valuable antiseptic, and antipyretic, being nearly as 
effective in this respect as Quinine, which it closely resembles in chemical 
character and physiological action. It is one of the most powerful anti- 
pyretics of all the substances which have been discovered in the search 
for an artificial quinine (Hydroquinone, Antipyrin, Pyrocatechin, Resor- 
cin, Thallin, Kairine, etc.). Chinoline has a very disagreeable taste and 
smell, and is irritant in action, hence the tartrate is preferred for medi- 
cinal use. It has been extensively used as an antipyretic in pneumonia, 
typhus, diphtheria, typhoid and other fevers, with varying success. In 
diphtheria, a 5 percent, solution in weak alcohol is painted on the affected 
surface with great benefit. The tartrate has been used beneficially in 
neuralgia and whooping-cough, and as an antiperiodic in intermittent. 



1 68 CHIRATA CHLORAL. 

CHIRATA, Chiretta, — is the Indian plant Ophelia Chirata, nat. 
ord. Gentianacese, occurring in bundles composed of all but the coarser 
woody stems. It is inodorous but intensely bitter, and contains Chiratin 
and Ophelic Acid, two amorphous, bitter principles, but no tannin. 
Dose of the powdered plant, gr. xv-xxx. 

Extr actum Chiratce Fluidum, — made with glycerine and diluted alcohol. Dose, 
TT^xv-xxx. 

Tinctura Chiratce, — io per cent. Dose, gss-ij. 

The action of this plant is that of a simple bitter, like its congener 
Gentian. It is an excellent tonic, in this respect rivalling Cinchona, and 
is used in India as a substitute for the latter. It is laxative and stomachic* 
diminishes flatulency and acidity, and is particularly serviceable in the 
dyspepsia of gouty subjects. As it contains no tannin, it may be admin- 
istered with preparations of Iron. 

CHLORAL, Hydrate of Chloral, C 2 HC1 3 0,H 2 0,— is inaccurately 
named, the hydrate being the official preparation. Chloral, properly 
so-called, is Tri-chlor- aldehyde ', C 2 HC1 3 0, an unstable, oily, colorless 
fluid, formed by the action of Chlorine upon Alcohol, whence its name 
Chlor-al. Its hydrate, the official Chloral, is a colorless, crystalline solid, 
which slowly evaporates on exposure to the air, of aromatic and acrid 
odor, bitter and caustic taste, and neutral reaction. It is freely soluble 
in water, alcohol, ether, glycerin, oils, etc., liquefies when mixed with 
camphor or carbolic acids, melts at 136 F. and is decomposed by alkalies 
into chloroform and a formiate of the alkaline base. Its aqueous solution 
becomes acid, but the alcoholic solution remains neutral. 

Dose varies much with individual susceptibility and with the presence or absence of 
cardiac and pulmonary disease. Death has been caused in several instances by gr. xxx, 
in one case by gr. x, and in another gr. vijss produced alarming symptoms, all being 
adults. On the other hand several hundred grains have been ingested at one time with- 
out lethal effects, and where tolerance has been established by habitual use, ^ij-giij are 
frequently taken without poisonous symptoms. An average dose for a healthy adult is gr. 
xv, for a child gr. j for each year of age up to gr. vj. It is best given in Syrup of Tolu. 

Caution is necessary when prescribed in combination with alcoholic preparations, 
as Chloral Hydrate is then very apt to separate as an alcoholate, especially if the 
Bromides of Potassium or Sodium are used in the same mixture and if the solutions are 
at all concentrated. In this way great danger is incurred of giving a heavy overdose, as 
the alcoholate floats on the surface of the mixture, and the entire Chloral contained therein 
may be taken at a single dose. 

Unofficial Analogues of Chloral. 
Amylene Hydrate, C 5 H 12 0, Di-methyl-ethyl-carbinol, — a tertiary alcohol, occurring 
as a clear, colorless fluid, of peculiar odor, soluble in 8 of water and readily miscible with 
alcohol. It is one of the most valuable hypnotics, in power standing between chloral 
and paraldehyde, but being much more agreeable to the taste and safer than either of 
those agents. Its action is exerted chiefly on the cerebrum in doses sufficient to produce 
profound narcosis ; and in medicinal doses it leaves behind no unpleasant effects, and has 
no perceptible influence on the heart or respiration. By very large dosage the medullary 
centres are paralyzed, including those governing respiration and cardiac action. Dose, 
3J-3JSS. 



CHLORAL. 169 

Cannabini Tannas, Tannate of Cannabin, — (see ante, page 153), — is not more 
reliable than the Extract of Cannabis Indica, though devoid of the exciting qualities of 
the latter preparation. Dose, as a hypnotic, gr. ij-x, the average being gr. v. Fron- 
muller considers it a very useful hypnotic, powerful and not dangerous, not disturbing the 
secretions, nor leaving unpleasant after-effects, if used in proper doses. 

Chloralamid, Chloral Formidate, — is chemically a union of Chloral anhydride (C 2 H 
CI3O) with Formamide (CHO.NH 2 ). It is a proprietary drug, having been both patented 
and trade-marked, wherever possible, by its proprietor and exclusive manufacturer, 
Schering, of Berlin. It occurs as colorless, faintly bitter, odorless crystals, which are de- 
composed in hot water or warm solutions. Soluble in 20 parts of cold water, or in \y 2 
of alcohol ; — rapidly decomposed by caustic alkalies and slowly by alkaline carbonates. 

The Dose is put at from 10 to 60 grains. The average adult hypnotic quantity about 
30 grains, given in a teaspoonful of whiskey or brandy, or in any alcoholic compound ; — 
for example, 30 grains in 2 drachms each of Tinct. Cardamom. Co. and Elixir Simplex, 
as one dose. By some observers a 45 -grain dose is considered the limit of safety and 
equal to 30 grains of Chloral hydrate; by others this amount is considered necessary for 
its certain hypnotic action. Sixty grains have frequently been administered without pro- 
ducing unpleasant symptoms; — but, as Dr. Steele has pointed out, the slow solubility of 
the drug in the watery contents of the stomach must be taken into account, and when 
considering its action, the menstruum and the condition of the gastric mucous membrane 
should be known. 

The Action of Chloralamid is essentially a hypnotic one, and it is extensively advertised 
as the least depressant and most efficient sleep-producer at our command, — without un- 
pleasant after-effects from ordinary doses, except in 2 per cent, of the cases in which used, 
1 per cent, having gastric and the other 1 per cent, having cerebral symptoms; while 
these were always slight unless the dose of 30 grains had been exceeded. The more 
severe and unusual effects (from doses above 30 grains) are vertigo, thirst, nausea, dry 
mouth, vomiting, anorexia, slight delirium, cardiac weakness, rapid and feeble pulse, 
and restlessness. The drug does not seem to have any cumulative action, nor any tend- 
ency to provoke a habit of using it. It is also credited with considerable analgesic power 
in certain conditions (see below), as well as with anti-dyspnceic and anti-hydrotic action. 

Therapeutically the main field of Chloralamid has been in the treatment of insomnia, 
particularly the simple or idiopathic form, and when not due to excitement or severe pain, 
but from nervousness, hysteria, chronic alcoholism, and similar states; also in that ac- 
companying typhoid fever, asthma (both cardiac and bronchial), organic heart disease, 
the opium habit, and diabetes mellitus (Steele). It is less effective in organic nervous 
affections and mental disorders, and is useless in these conditions when the insomnia is 
due to excitement, hallucinations, or severe pain. 

As an analgesic, it has lessened and checked the pains of aneurism, carcinoma of the 
stomach and liver, sarcoma of a rib, erysipelas, rheumatic fever, gall-stone, etc.; — and in 
dysmenorrhea has given entire relief, used just as the painful period approached, in a 
single dose of 30 grains. It has been reported curative of chorea, in doses of gr. 15 thrice 
daily for five days, in a boy of eleven years ; and in a girl who had resisted all other treat- 
ment for the same affection, it was successful in 8 days. 

Compared with Sulphonal, Chloralamid is preferred for all cases in which collapse is 
feared, by reason of its apparent freedom from depressant action on the cardiac centres or 
the respiratory mechanism. In phthisis it has proven efficient against the' most obstinate 
night-sweats, while at the same time securing rest in cases in which the cough was not very 
violent. To secure the best results as a hypnotic, the drug should be given about an 
hour and a half before sleeping-time, in a dilute alcoholic menstruum, and on a stomach 
containing little or no watery fluids to interfere with its solution and absorption. 

Croton-chloral, C 4 H 5 C1 3 0,H 2 0, Butyl-chloral Hydrate (B. P.),— a crystalline body 
formed by acting on Aldehyde with Chlorine. It is sparingly soluble in water (1 in 
100), but is readily so in glycerin (1 in 4). In action it closely resembles Chloral, but is 
feebler, less depressant to the heart, and generally less poisonous, but more disagreeable 
to the taste. It is said to specifically affect the fifth nerve, and to cause anaesthesia over 
its distribution long before producing general anaesthesia (Liebreich). Dose, as hypnotic, 
gr. v -xx. 

Hyoscinae Hydrobromas, Hydrobromate of Hyoscine, — is an efficient hypnotic, 
with the advantage of being tasteless, and having a very small dose (gr. J^), so that it 
may be given in tea, coffee, etc. It is apt to affect the head afterwards, and soon loses its 
power by repetition. In large doses it is a dangerous respiratory depressant. 

Hypnone, C 6 H 5 (CO)(CH 3 ), Phenyl-methyl-acetone, — a member of the Ketones, 
occurring above 70 F. as a colorless, mobile liquid, having a strong almond and orange 



I70 CHLORAL. 

odor. It is insoluble in water or glycerin, and is best given in capsules. It is a hypnotic, 
of only moderate intensity, but said to be especially useful in the insomnia of alcoholism. 
Its use is devoid of danger, and leaves behind no unpleasant effects, except a disagree- 
able odor of the breath, the drug being eliminated by the lungs as well as by the kidneys. 
In very large dosage it has induced coma, followed by paralysis of the heart and respira- 
tion. Dose, TTLv-x, * n capsule, ttLvij to ff\,viij being usually required. 

Methylal, CH 2 (OCH 3 ) 2 , Methylene-di-methyl Ether, — one of the products of the 
oxidation of Methylic Alcohol, occurring as a volatile, mobile liquid of pleasant, aro- 
matic odor and taste, readily soluble in water, alcohol, etc. It is a local anaesthetic, and 
an efficient hypnotic, producing a deep sleep of short duration, with more or less general 
anaesthesia and lowered reflex excitability. It is depressant to the heart, respiration and 
body temperature, but in medicinal doses does not leave any bad after-effects. Dose, per 
orem Ttyv-v, repeated thrice at short intervals. 

Paraldehyde, C 6 H ]2 3 , — a polymeric form of Aldehyde, if represented thus 
(C 2 H 4 0) 3 . Occurs as a strong- smelling, bad-tasting fluid, soluble in 8 parts of water. 
It is a reliable hypnotic of about one-half the power of chloral, leaving behind no 
unpleasant effects except a very disagreeable odor to the breath. In medicinal doses it 
slows and strengthens the heart, but in very large dosage it is paralyzant to both 
heart and respiration. It occasionally causes an erythematous eruption, and may give 
rise to cerebral congestion and vaso- motor paralysis, if used for any long period. Dose, 
5 ss-ijss in water, syrup, etc. 

Sulphonal, (CH 3 ) 2 C(C 2 H 2 S0 2 ) 2 , belongs to the group of Disulphones, and has the 
chemical name Di-ethyl-sulphon-di-methyl-methan. It is a whitish, crystalline substance 
without odor or taste, very -slightly soluble in cold water, more so in warm water, and 
still more so in alcohol, ether, etc. The dose is gr. xv-xlv, in hot soup or milk, coffee, 
tea, etc., administered two hours before the effect is desired. 

Sulphonal is said to have no intoxicant or narcotic action, and no unfavorable effect on 
the heart or Circulation, even in full doses. It is an admirable hypnotic in many cases, 
but its efficacy decreases with use. 

Urethane, NH 2 C0 2 C 2 H 5 , Ethyl Carbamate, — occurs in crystals which are readily 
soluble in water, with scarcely any taste or odor. It is devoid of irritant action, and may 
be administered hypodermically. It is a pure hypnotic, but not so reliable as paralde- 
hyde or chloral ; neither does it affect the circulation nor depress (but rather stimulates) 
the respiration. It acts directly on the cerebrum, causing a sleep which closely resembles 
the normal, and has no unpleasant after-effects. In very large doses it slows the heart, 
lowers the temperature, and induces muscular resolution and general anaesthesia. In 
small animals it effectually antagonizes the action of Strychnine. Dose, gr. xv-gj, an 
average hypnotic dose being gr. xxx ; but it is best given in 5-grain doses repeated fre- 
quently, as a large dose may cause vomiting. 

Physiological Action. 

Chloral is a powerful hypnotic, also an antispasmodic, an antiferment, 
a preventive of the coagulation of fibrin, indirectly an anaesthetic, and 
especially a depressant of the cerebral, medullary and spinal centres and 
of the cardiac muscle. It is more hypnotic than chloroform but less of 
an anaesthetic. Applied to the skin or mucous membranes a 1 per cent, 
solution (gr. v ad §j) is antiseptic, but strong solutions are irritant and 
vesicant, nmy produce sloughing ulcers, and if taken internally may 
excite gastritis with nausea and vomiting. 

After a brief period of stimulation a medicinal dose depresses the heart 
and lowers arterial tension, diminishes oxidation and decreases the body 
temperature. On the brain cells it has a selective action, producing a 
deep sopor very like normal sleep, from which the patient may be awak- 
ened, but immediately falls asleep again, and which is nqt followed by 
headache or depression. This effect is considered by some authorities to 
be the result of cerebral anaemia produced by the drug. In some persons, 



CHLORAL. I/I 

instead of sleep it causes headache, insomnia and delirious excitement. 
It is not an anodyne, as it does not affect the conductivity of the sensory 
nerves, and does not interrupt the transmission of pain; but by over- 
whelming the centres it drowns the consciousness of pain, and is therefore 
only indirectly anaesthetic. A toxic dose produces profound narcotism, 
abolishment of reflexes and sensibility, complete muscular relaxation, and 
a great fall of body temperature. Death may result in the chloral sleep 
from paralysis of the respiratory centre or the cardiac motor ganglia, or 
by sudden failure of the heart-muscle in cases of fatty degeneration or in 
old drunkards. 

The Chloral-habit produces a state of marked anaemia and muscular 
weakness, especially of the legs (DaCosta) ; its subject presenting a weak, 
irritable, often irregular heart, deranged hepatic functions, jaundice, 
bileless stools, perhaps purpura and sloughing of a finger from decreased 
blood-supply. Its votaries are on the border of insanity, excitable, un- 
controllable in speech and action, talking in a silly manner and very 
volubly, and showing a marked loss of power of the limbs, so much so as 
to simulate paralysis thereof. Many cases of insanity have their origin in 
chloralism. 

On the blood its action is to increase the fluidity, crenate the red cor- 
puscles, and to destroy the leucocytes if used in large quantity. It is 
rapidly diffused, and is excreted by the kidneys partly unchanged, but 
chiefly as urochloralic acid, producing some diuresis, — also by the skin, 
causing various eruptions if used for any lengthened period. It has been 
held that the blood, being an alkaline fluid, decomposes it, setting free 
chloroform, but there are many facts against this theory. 

Chloral and Atropine, though antagonistic in their action on the 
spinal cord, both produce motor paralysis, the former by paralyzing the 
cord, the latter by direct paralysis of the motor nerves. 

Antagonists and Incompatibles. 
Atropine antagonizes its cardiac, respiratory and spinal depression, and should be in- 
jected in small doses frequently repeated, until its effects are apparent. Morphine admin- 
istered with Chloral antagonizes the tendency to cardiac failure, while synergistic to the 
hypnotism. While Chloral is the antagonist to Strychnine, opposing the spinal action of 
that drug, the reverse is only true to a very limited extent. Heat is a necessary application, 
to maintain the body-temperature, and artificial respiration should be practiced if required. 
All alkalies are incompatible. 

Therapeutics. 
Chloral Hydrate is of great value as a hypnotic and antispasmodic, but 
must be cautiously used if at all in old alcoholics or persons with weak or 
fatty hearts, atheromatous vessels or advanced pulmonary disease. In 
combination with Potassic Bromide it is much used in asylum and general 
practice, and equally abused, both drugs being active cardiac poisons. It 
is highly serviceable in fevers, when high temperature exists with excite- 
ment, restlessness and a sthenic condition, as it lowers temperature and 



172 CHLORAL BUTYLICUM CHLOROFORMUM. 

prevents the coagulation of fibrin. In the algid stage of cholera and in 
violent cases, of cholera morbus it may be injected hypodermically in 
1 5 -grain doses with extraordinary efficacy. In sea-sickness small doses 
(gr. v) two or three times a day are generally very efficient. In obstetrics 
it is used to relieve suffering, relax the os uteri, palliate convulsions and 
to relieve after-pains. For nocturnal epilepsy a full dose at bedtime is a 
useful palliative. In neuralgia it may be triturated with camphor and 
applied over the course of the affected nerve. Tetanus is best treated by 
chloral and potassic bromide. It is an excellent remedy for infantile 
convulsions and colic, chorea, spasmodic asthma, whooping-cough, laryn- 
gismus stridulus, and the first stage of diphtheria, but not when the heart 
is weak. In acute mania and delirium tremens it is the best hypnotic, 
but has been too incautiously employed. In cancers and ulcers a 25 per 
cent, solution is a good antiseptic and anodyne application. In strych- 
nine poisoning Chloral 1 is the antagonist. It is generally given by the 
mouth in dilute solution with some simple elixir or cinnamon-water, but 
is well absorbed by the rectum. Its hypodermic administration is liable 
to result in great local irritation and even sloughing ulcers. 

The mixture of Chloral and Camphor is a good local application in 
superficial neuralgia, and may be painted over the larynx for spasmodic 
cough. It makes a good remedy for internal use in colic, cholera and 
cholera morbus, especially if combined with Morphine. 

CHLORAL BUTYLICUM, Butyl-chloral Hydrate, Croton- 

chloral, C 4 H 5 C1 3 0,H 2 (Unofficial), — is formed by the action of Chlo- 
rine upon Aldehyde, then adding to the Butyl-Chloral thus produced the 
necessary water. It occurs in crystalline scales, insoluble in chloroform, 
sparingly soluble in water, but freely soluble in alcohol, hot water and 
glycerin. Dose gr. v-xx,'in syrup or pill. But the best method is to give 
5 grains every half-hour until 20 grains have been taken or relief afforded. 

Physiological Action and Therapeutics. 
Croton-chloral so far as is ascertained has an action parallel to that of 
Chloral Hydrate, but feebler and less certain. It is said to have a specific 
paralyzant power over the fifth nerve, and to have no paralyzant effect on 
the heart. It has been used with benefit in various neuralgias, especially 
tic,-douloureux, also in sciatica and dysmenorrhcea. All statements of 
the action and therapeutics of this drug are to be received with hesitation, 
as wide differences are reported by the best authorities. 

CHLOROFORMUM, Chloroform, CHC1 3 or CHCl.Cl— the 
Terchloride of Methyl, or the Chloride of Bichlorinated Methyl (Di-chlor- 
methyl Chloride), — is formed by the substitution of 3 atoms of Chlorine 



CHLOROFORMUM. 173 

for 3 of Hydrogen in Methyl Hydride (marsh-gas, CH 4 ). In practice it 
is obtained from Ethylic Alcohol or Methylated Spirit by the action of 
Chlorinated Lime, or from Chloral by an alkaline hydrate, and is known 
chemically as Normal Chloroform. If prepared from Methylic Alcohol 
(wood-spirit) it is called Methylic Chloroform, and is purified with great 
difficulty. The object of purification is to remove the chlorinated pyro- 
genous oil. Absolute Chloroform has a sp. gr. of 1.500, and decomposes 
easily in sunlight or diffused daylight, but when reduced to a sp. gr. of 
1.485 to 1.490 by alcohol it will keep well. It is official in two forms, 
viz. : — 

Chloroformum Venale, Commercial Chloroform, — is a liquid con- 
taining at least 98 per cent, of Chloroform, and having a sp. gr. not lower 
than 1.470. It contains sundry Hydrocarbons, free Chlorine, Aldehyde 
and Hydrochloric Acid, and is used only for external applications, or to 
make the purified article. It is a constituent of Linimentum Chloroformi. 

Chloroformum Purificatum, Purified Chloroform, — is a heavy, clear, 
colorless, diffusive liquid, of characteristic odor, sweet, burning taste and 
neutral reaction, soluble in 200 of water, freely so in alcohol or ether, 
also in oils, benzol, or benzin. Sp. gr. 1.485 to 1.490 at 59 F., and 
contains ^ to 1 per cent, of alcohol. Dose, internally, tti.ij-xx, f° r 
inhalation about 3J, repeated until the desired effect is produced. 

Preparations. 

Mistura Chloroformi, — contains of Purified Chloroform 8, Camphor 2, fresh Yolk of 
Egg 10, Water 80 parts. Dose, 3J-^j. 

Spiritus Chloroformi, — contains of Purified Chloroform 10, Alcohol 90 parts. Dose, 
n^x-^j, well diluted. 

Linimentum Chloroformi, — Commercial Chloroform 40, Soap Liniment 60 parts. 

Linimentum Chloroformi Compositu?n (Unofficial), — Chloroform ^ j, Oil of Turpentine 
£], Tincture of Opium ^iv, Tincture of Aconite 3 ij. 

Chlorodyne (Unofficial), — a celebrated secret mixture, put forth by Dr. J. Collis 
Browne, of London, and since imitated by many others. It is supposed to contain 
Chloroform, Ether, Morphine, Cannabis Indica, Hydrocyanic Acid. Capsicum, etc., and is 
powerfully anodyne, antispasmodic and narcotic, and therefore highly dangerous in non- 
professional hands. Dose, TTlx-xxx, according to the quantities of Morphine and Chloro- 
form .present, these being the active agents in the preparation. A comparison of the 
principal formulae which have been used in imitation of Browne's Chlorodyne is given in 
the appendix, and will show the wide differences between them. A list of 25 formulae for 
Chlorodyne was published in the Therapeutic Gazette for October, 1883. 

Tinctura Chloroformi et Morphines (B. P.), — has been recently made official as a sub- 
stitute for Chlorodyne. Each dose of 10 minims contains of Chloroform Tr^i^, Ether 
n\,^, Alcohol TTlX' Morphine Hydrochlorate gr. ^, Dilute Hydrocyanic Acid TT\^, 
Oil of Peppermint TTL-g 1 ^-, Fluid Extract of Liquorice Tr^i^, Treacle and Syrup q. s. 

Tinctura Chloroformi Composites (B. P.), — has of Chloroform 2, Alcohol 8, and 
Compound Tincture of Cardamoms 10. Dose, TTLxx-^j. 

Anaesthetic Mixttcres containing Chloroform, — see under yETHER, ante, page 80. 

Some Chlorinated Anesthetic Compounds. 
Ethylene Bichloride, Dutch Liquid, Chloric Ether, C 2 H 4 C1 2 , — is a rapid and powerful 
anaesthetic, probably safer than Chloroform and less so than Ether. It always paralyzes 
the respiratory centre before the heart, so that its effects may be easily watched and con- 
trolled. This is the substance which Guthrie supposed he had obtained when he dis- 
covered Chloroform. 



174- CHLOROFORMUM. 

Ethylidene Chloride, Chlorinated Muriatic Ether, CH 3 ,CHC1 2 , — is a mixture of 
varying sp. gr., and is not inflammable. It closely resembles Chloroform both physically 
and physiologically, but is less depressant to the heart, consequently safer, and recovery 
from its effects is very prompt. 

Methyl Chloride, CH 3 C1, — a colorless gas, slightly soluble in water, of sweetish odor 
and taste, inflammable, burning with a greenish flame. Cold liquefies it, and the liquid 
boils at — 7. 6° F. It is used locally in neuralgiae to produce intense cold, and with re- 
markable success. 

Methylene Bichloride, Dichloro-methane, CH 2 C1 2 , — is an effective anaesthetic which 
it was supposed would displace Chloroform as being much safer. Dr. Richardson intro- 
duced it and Mr. Spencer Wells advocates its use, but though little used as compared 
with other anaesthetics several deaths have occurred from its employment. It kills by 
paralyzing the heart. 

Carbon Tetrachloride, CC1 4 , — is less irritant than Chloroform, but far more dangerous 
to the heart. 

Physiological Action. 

The action of Chloroform is similar to that of Ether (see ante, page 81) 
with several important differences, as follows : It is more irritant to the 
mucous membranes, and if swallowed undiluted it produces violent gastro- 
enteritis, which becomes apparent after the subsidence of the profound 
narcotism which at first follows its ingestion in quantity. A dose of §j 
internally will cause death. It is less of a stimulant than Ether, and more 
depressant to the heart and circulation. It clots blood outside the body, 
making a mass like sealing wax. 

Inhaled for anaesthetic purposes it is considered much more dangerous 
than Ether from its direct paralyzant effect on the heart. Its vapor 
requires admixture with g6)4 per cent, of air to produce anaesthesia with 
safety according to the authorities on the subject. As compared with 
Ether its vapor is less irritant to the air-passages, uninflammable, more 
pleasant, more prompt in action, has a shorter stage of excitement and a 
more profound narcosis, and produces much less vomiting. Its mortality 
is greater, being 1 in 3000, against 1 in 16,000 for Ether, about 500 fatal 
cases being reported, none of which, however, were in obstetrical practice. 

The result of the labors of the Hyderabad Chloroform Committee, 
conducted under the direction of Dr. Lauder Brunton, show that Chloro- 
form and Ether act in the same way upon the heart and respiration, both 
paralyzing the respiratory centre before the heart, — Chloroform acting 
more quickly and more powerfully than Ether in both directions. This 
would necessitate that the person administrating chloroform as an anaes- 
thetic should give his undivided attention to the respiration, the pulse 
being of secondary importance as long as the breathing is normal. Prior 
to this investigation it was taught that death from Chloroform-inhalation 
is almost always sudden and by cardiac paralysis, — from Ether it is slow 
and usually by paralysis of respiration. 

[For modes of death from anaesthetic vapors and the treatment of dan- 
gerous symptoms, see ante, page 82.] 



CHLOROFORMUM. I 75 



Antagonists. 



There is no chemical antidote. If swallowed, the stomach should be evacuated and 
the case treated as one of poisoning by an irritant. Amyl Nitrite by inhalation, and 
Atropine hypodermically, to sustain the heart. 

Therapeutics. 

Chloroform is used for the same condition as is Ether, and is much 
employed in liniments as a rubefacient and anodyne application, as in 
pruritus, rheumatic and neuralgic pains, etc. Internally it is advanta- 
geously administered in true cholera, in which it has been more efficacious 
than any other single remedy, in cholera morbus, vomiting, colic, dys- 
menorrhea, hepatic colic, and other pains of internal and spasmodic 
character. In sciatica, tic-douloureux and other neuralgiae of important 
nerves the deep injection of nrv-xv of pure Chloroform in the vicinity of 
the nerve is highly recommended, though it may'cause dangerous local 
disturbance. The writer has, in several cases of severe supra-orbital neu- 
ralgia, injected two or three minims of Chloroform into the vicinity of 
the supra-orbital nerve just above its foramen of exit, with the most grati- 
fying results, though severe local pain and considerable swelling were 
experienced for several days. The vapor in small quantities inhaled from 
warm water is useful in many neuroses, as hay-fever, spasmodic asthma, 
reflex cough. 

As an Anaesthetic the use of Chloroform is decreasing every year in 
favor of Ether, except for young children and in obstetrical practice. Its 
vapor being four times denser than air, and the rule for its effective use 
requiring fully 96^ per cent, of air with it, its administration according 
to the orthodox fashion requires most careful management, and should 
never be attempted in any but the recumbent posture. An ounce of 
Brandy and a hypodermic injection of Morphine, gr. -J-, with Atropine, 
gr. yj^ given 20 minutes before commencing the inhalation, are means 
of great utility in sustaining the heart and respiration, as well as in ren- 
dering the anaesthesia more profound. No operation, especially on parts 
supplied by the fifth nerve, should be undertaken during partial chloro- 
form anaesthesia, for the reasons given on page 82. 

Syme administered Chloroform in five thousand cases without a single 
death therefrom. He ascribed this excellent record to his adherence to 
the following rule : " Never mind the pulse, never mind the heart, leave 
the pupil to itself, but keep your eyes on the breathing, and if it becomes 
embarrassed to a grave extent, pull the tongue well out with an artery 
forceps. ' ' 

Dr. Sayre administers Chloroform in a manner which is calculated to 
strike terror to the heart of an emotional observer who is impressed by the 
orthodox rule of 96^ per cent, air with 3^ per cent, of the anaesthetic 
as the only safe proportion. Having been made familiar with the prac- 



I76 CHLORUM. 

tice of Dr. Sayre through observance of the method employed by some 
of his pupils, the writer sought for more direct instructions from that dis- 
tinguished surgeon, and received from him a letter from which the fol- 
lowing paragraphs are extracted : — 

" I have employed no other method for more than twenty years, have used it in this 
manner in some thousands of cases without the least appearance of danger, and can 
therefore speak with confidence as to its safety. 

" My plan is simply to anaesthetize the patient with the smallest amount of Chloroform 
Possible ; and as Oxygen is the Antidote to the anaesthetic I exclude all air that is not 
impregnated with the ancesthetic. 

" In this manner a very few inspirations will produce immediate anaesthesia without 
the muscular struggling which always follows when pure air is admitted with the chloro- 
form. I always measure my dose with the same care as if I were administering Arsenic, 
Strychnine, Corrosive Sublimate, or any other potent agent; and then I know what I am 
doing. If by accident there should be some peculiarity about the patient, making him 
unduly susceptible, a few artificial respirations would soon remove the influence of the few 
drops which had been inhaled, and thus all danger can be avoided. Five, ten, or twenty 
drops of Chloroform administered in this manner is all that is requisite to produce imme- 
diate and profound anaesthesia. I have explained my method hundreds of times at my 
clinical lectures in Bellevue Hospital, many of which have been published at different 
times in different medical journals by various persons who have made stenographic re- 
ports of my lectures. In the ' Transactions of the International Medical Congress,' held 
in Phdadelphia in 1876, is a verbatim report of my remarks on this subject made while 
I was performing an exsection of the hip-joint in the hospital before the Congress." 

I remain yours truly, 

Lewis A. Sayre. 

The writer can add his testimony to that of the above letter respecting 
the thorough anaesthetic effect and freedom from unpleasant symptoms 
observed in a large number of cases in which Chloroform was administered 
in the manner described under his observation during the past six years. 
As to the safety of this method over the ordinary way no conclusion can 
be reached without the results of many thousands of examples in the 
hands of many different observers. 



CHLORUM, Chlorine, CI, — is a greenish-yellow gas having a 
suffocating odor and belonging to the group of Halogen elements, so 
named (from a'A?, the sea) because its most important members, Chlorine, 
Bromine and Iodine, are derived from the ocean, Chlorine being obtained 
from sea-salt, Bromine from sea-water, and Iodine from sea-weed. Chlo- 
rine itself is not official, but is represented in medicine by 2 Chlorates 
and 8 Chlorides (of Potassium, Sodium, Ammonium, Calcium, Iron, 
Gold, Zinc and Mercury), which are described under the titles of their 
respective bases ; also by Hydrochloric Acid, Chloral, Chloroform, etc., 
and by the following preparations which furnish it. 

Preparations. 

Aqua Chlori, Chlorine Water, — is an aqueous solution of Chlorine, containing at least 
0.4 per cent, of the gas ; and is prepared by heating together Black Oxide of Manganese 
10 parts and Hydrochloric Acid 40 parts, then saturating 400 of distilled Water with the 
gas so obtained. It is a clear, greenish-yellow liquid, of suffocating odor and disagree- 



CHLORUM. 177 

able taste. Dose, gj-^ss, well diluted, as a lotion or spray; internally, tt\x-xx in 
water. 

Chlorine Water may be extemporaneously prepared by mixing in a mortar Chlorate of 
Potassium 40 grains and Hydrochloric Acid ]/ 2 ounce, and adding a pint of distilled 
water by agitation during the evolution of the vapors. If done in a closed vessel danger 
may arise from the explosive gas, C1 2 4 , which is liberated at the same time. It should 
be quickly bottled. 

Calx Chlorata, Chlorinated Lime, Chloride of Lime,-^is a compound resulting from 
the action of Chlorine upon Calcium Hydrate, and containing at least 25 per cent, of 
available Chlorine. It is obtained by exposing slaked Lime to the action of Chlorine gas 
as long as the latter is absorbed, and should not be confounded with Chloride of Calcium 
(see ante, page 147). It occurs as a whitish, dry powder or friable lumps, gradually 
decomposing in the air, of saline, disagreeable taste and a feeble Chlorine odor, partially 
soluble in water and in alcohol, and when dissolved in dilute Hydrochloric acid gives off 
Chlorine gas. Dose, gr. iij-vj in water; for external use a 1 to 3 per cent, solution. 
Liquor Calcis Chloratce, B. P., is a solution of I pound in I gallon of water. 

Liquor Soda Chloratce, Solution of Chlorinated Soda, Labarraque's Solution, — a pale- 
greenish liquid, of faint Chlorine odor, and alkaline taste and reaction; prepared by 
adding together watery solutions of Sodium Carbonate 100 parts and Calx Chlorata 80, 
each in 400 parts of water, then adding Water up to 1000. Contains Sodium Hypo- 
chlorite and Chloride. Dose, TT\x - 3J in 20 parts of water. 

Physiological Action. 
Chlorine is actively irritant to the skin and mucous membranes. Locally 
applied it produces heat, burning and even vesication. Inhaled in any 
quantity it causes cough, sneezing and spasm of the glottis, also inflam- 
mation of the air-passages and of the lungs. It is the most powerful of 
all disinfectants and deodorants, also an antiseptic and antifermentative 
agent of the highest activity. Its power in all these respects is due to its 
affinity for hydrogen, decomposing all bodies in which hydrogen enters 
as a molecular constituent, forming chlorhydric acid and setting oxygen 
free in its nascent form (ozone). Used internally it has the same local 
action on the parts with which it comes in contact, and on reaching the 
stomach in dilute solution it is converted into hydrochloric acid and 
chlorides, losing all further action on the body in its own character. 

Antidotes. 

Ammoniacal vapors inhaled after Chlorine from Ammonium Chloride. Ammonium 
Sulphide has a similar reaction, but should be inhaled in great moderation. Albumen 
is the antidote if Chlorine preparations have been taken into the stomach, and a little 
Aqua Ammoniae, sufficiently diluted, may also be administered with advantage. 

Therapeutics. 
The chlorinated preparations are used as disinfectants and deodorizers 
of rooms, drains and discharges from the body. They are rarely used 
about the person or clothing of patients by reason of the irritation pro- 
duced by them when inhaled, and their power to destroy the color of 
fabrics. In dilute solution they are well employed as local applications 
in aphthae, gangrene, scarlet fever and diphtheria, in which their princi- 
pal action is to destroy fetor. The same may be said of their use in 
sloughing ulcers and gangrenous wounds, foul discharges, etc., as they are 



I78 CHONDRUS CHRYSAROBINUM. 

rarely employed about the person in sufficient strength to have any de- 
structive effect on disease -germs. A strong solution of Chlorinated Soda 
is a good application to bites of serpents and insects, to prevent infection 
by the syphilitic poison, and to wash the hands after contact with infec- 
tious material. 

A combination of Potassium Chlorate and Tinctura Ferri Chloridi, 
makes a solution of Chlorine, Euchlorine, Potassium Chloride and Ferric 
Chloride, when diluted with water, and gives one of the best and most 
innocuous solutions of antiseptics. It makes an excellent gargle for sore 
throats, simple or diphtheritic. Glycerin should never be added to it, as 
the resulting mixture will be liable to explode violently. 

These preparations have been administered internally in septic diseases, 
low fevers, etc., but without producing any marked beneficial results. 

To disinfect unoccupied rooms all means of exit should be stopped up, 
then a pound of Chlorinated Lime sewed loosely in a strong canvas bag 
is immersed in a mixture of a pint and a half of common muriatic acid 
with 4^ pints of water, and left 24 hours. 

CHONDRUS, Irish Moss, — consists of two sea-algae, Chondrus 
crispus and Chondrus mammilosus, dried and bleached. Is horny, trans- 
Jucent, pale yellowish-white, swelling in water, of sea-weed odor and 
mucilaginous, saline taste. On boiling with 30 parts of water for ten 
minutes it yields a solution which gelatinizes on cooling. It contains 90 
per cent, of mucilage with traces of Iodine and Bromine, also 1 per cent, 
of Nitrogen. There are no official preparations. A jelly or blanc mange 
may be prepared by boiling ^ij in gxxxiv of water for an hour, straining 
and adding giij of sugar while hot. Dose, indefinite. 

Physiological Action and Therapeutics. 
Irish Moss is a demulcent and nutrient substance of some slight value 
in bronchial and catarrhal affections. Having no starch in its composi- 
tion it is not so valuable as Iceland moss (Cetraria) as an article of food 
for the sick. 

CHRYSAROBINUM, Chrysarobin,— is a mixture of proximate 
principles extracted from Goa-powder, a substance found in cavities 
formed by decay in the wood of the trunk of Andira Araroba, a Brazil- 
ian tree of the nat. ord. Leguminosse. It is commonly misnamed 
11 Chrysophanic Acid " (which is one of the constituents of Rheum) — 
though easily converted into that substance. Occurs as an orange-yellow 
powder, odorless and tasteless, nearly insoluble in water and alcohol, but 
readily soluble in ether, solutions of alkalies and sulphuric acid. % Dose, 
gr. }i-gx. xx. 



CIMICIFUGA. 179 

Preparation. 
Unguentum Chrysarobini, — Chrysarobin 10, Benzoinated Lard 90 parts. Should be 
diluted for average use from 3 to 5 times. 

Physiological Action and Therapeutics. 
In 20-grain doses Chrysarobin is a gastro-intestinal irritant, producing 
large, watery, bilious stools, with repeated vomiting but not much nausea. 
Locally it produces diffuse dermatitis often followed by follicular and fu- 
runcular inflammation. It stains the skin a dark yellowish-brown color, 
which may be removed by a weak solution of chlorinated lime. The use 
of this remedy is confined to superficial parasitic skin diseases of vegeta- 
ble origin, and for psoriasis, in the latter affection it being the best 
remedy known. It maybe used in weak ointment locally, and internally 
in yi -grain doses. 

CIMICIFUGA, Black Snake-root, Black Cohosh,— is the 

rhizome and rootlets of Cimicifuga racemosa, a plant of the nat. ord. 
Ranunculaceae, native in the United States. Rhizome horizontal, 2 inches 
long or more, about 1 inch thick, with numerous upright or curved 
branches. Rootlets numerous, containing a ligneous cord which branches 
into four or five rays. Contains a Volatile (9/7 when fresh, resin, tannic 
and gallic acids, also an acrid, crystallizable, neutral principle. Cimi- 
cifugin or Macrotin is an impure resin obtained by precipitation from a 
concentrated tincture by the addition of water. The active principle has 

not been isolated. 

Preparations of the Fresh Root. 
Extractum Cimicifugce Fluidum, — alcoholic. Dose, TTLv-xxx. 
Tinctura Cimicifugce, — 20 per cent. Dose, tt^xv-^j. 
Macrotin (Unofficial), — Dose, gr. ]/z—\). 

Physiological Action. 
Cimicifuga is stomachic, antispasmodic, aphrodisiac, diaphoretic, diu- 
retic and expectorant. Its taste is bitter and nauseous, resembling that 
of Opium. It acts on the heart and circulation similarly to Digitalis, and 
on unstriped muscular fibre like Ergot, but is much feebler in activity 
than either of these agents. Small doses stimulate digestion and secre- 
tion, the generative function and the menstrual flow, and especially the 
secretions of the bronchial mucous membrane and the kidneys. Full 
doses slow the heart while increasing its force, raise arterial tension and 
stimulate uterine contraction. Large doses dilate the pupils and produce 
dimness of vision, vertigo, intense headache, nausea, vomiting, and in 
some persons soporific and anodyne effects. 

Therapeutics. 
Cimicifuga closely resembles Digitalis in action, but it is safer, and 
should be more frequently used when the latter drug is indicated. In 



l80 CINCHONA. 

cardiac diseases it is very efficient, especially in weak or fatty heart where 
Digitalis would be dangerous. It is a good stomachic tonic, particularly 
in the irritable dyspepsia of alcoholism. As an expectorant it is used in 
acute and chronic bronchitis. It is a good nerve-tonic, in delirium tre- 
mens, and in functional impotence it is remarkably efficient. In rheuma- 
tism of the localized muscular variety, as lumbago, torticollis, pleuro- 
dynia, intercostal rheumatism, etc., it is one of the most efficacious 
remedies, having a strong affinity for the muscular system. Neuralgias of 
various kinds are benefited by it, particularly ovarian neuralgia. Chorea 
about the age of puberty is one of the affections in which it is most effi- 
cient, and the same may be said of the hysterical form of this disease. 

Many uterine disorders are remarkably benefited by Cimicifuga, such 
as amenorrhcea, neuralgic and congestive dysmenorrhcea, subinvolution, 
spinal irritation due to some obscure sympathetic or neuralgic affection 
of the womb, sympathetic pains and neuralgias arising from the so-called 
irritable womb, passive menorrhagia, etc. In obstetrics it gives excel- 
lent results when used to initiate uterine contractions, check hemorrhage, 
allay afterpains and nervousness after delivery. In puerperal mania and 
peritonitis its good effects are frequently remarkable, and in puerperal 
hypochondriasis it is strongly recommended by very high authority. 



CINCHONA, Peruvian Bark. — The Cinchona tree belongs to the 
nat. ord. Rubiacese and is a native of the eastern slope of the Andes, but 
has been largely planted in India, Ceylon, Java and Burmah, with the 
result of improving the quinine-yielding value of many species by culti- 
vation. In late years the test of appearance has given way to that of 
assay in judging of the various barks of commerce, and only those are 
official which yield 3 per cent, of total alkaloids of which at least 2 per 
cent, must be Quinine. Yellow bark contains most Quinine (as high as 
9 per cent, having been obtained from one specimen), pale bark contains 
most Cinchonine and least Quinine, while red bark contains these alka- 
loids in about equal proportions. The Columbian varieties afford the 
largest percentage of Cinchonidine. 

The principal varieties of the sub-order Cinchonese, the barks of 
which are found in commerce and used by manufacturers of the alka- 
loids, are — 

Cinchona Calisaya, Yellow Bark, — from Peru, Bolivia and India. 
Cinchona Succiruba, Red Bark, — from Ecuador, Java and Ceylon. 
Cinchona Condaminea, Pale Bark, — from Ecuador and Peru. 
Cinchona Pitayensis, Pitaya Bark, — from New Granada. 
Cinchona Micrantha, Gray Bark, — from Peru and Bolivia. 

Altogether there are some 31 species acknowledged by botanists, and 
the list is constantly increasing, from the tendency of the different trees 



CINCHONA. 15 1 

to hybridize. Several trees formerly acknowledged as Cinchonas are now 
placed in the genus Cascarilla, but their barks are to be found on the 
market. Cuprea bark is from trees of the genus Remijia, growing in 
Columbia; it contains Quinine and a peculiar alkaloid, Cinchonamine , 
but no Cinchonidine. 

Official Species. 
Cinchona, — is the bark of any species of Cinchona which contains at 
least 3 per cent, of its peculiar alkaloid, as determined by assay according 
to a prescribed rule. 

Cinchona Flava, Yellow Cinchona, Calisaya Bark, — is the bark of Cinchona Calisaya, 
containing at least 2 per cent of quinine. Occurs in tawny-yellow flat pieces or quills, 
ridged exteriorly, finely striated on inner surface, breaking with a transverse fracture 
showing numerous rigid fibres in bundles or radial rows. 

Cinchona Rubra, Red Cinchona, — the bark of C. succiruba, containing at least 2 per 
cent, of Quinine. Occurs in brown-red quills and fiat pieces of various sizes, with ridges 
and warts on outer surface, coarsely striated on inner surface. 

Bark may be administered in doses of gr. x.-^j, but it is never used now in substance, 
being too bulky and disagreeable. 

Composition of Cinchona. 
The bark contains 21 natural alkaloids (of which 4 are official), 8 arti- 
ficial alkaloids, 2 simple acids, 2 tannic acids, a resinoid and coloring- 
matter, as follows: — 

Quinine, C 20 H 24 N 2 O 2 , — a strong base, fluorescent, the most valuable of all the alka- 
loids; heated with glycerin to 374° F., it is converted into the isomeric base Quinicine. 

Quinidine, C 20 H 2i N 2 O 2 , — isomeric with Quinine, fluorescent, probably the most 
powerful as an antiperiodic, but existing in very small quantity. 

Cinchonine, C 20 H 24 N 2 O, — the least active of the official four, having about half the 
therapeutic power of Quinine. Not fluorescent. 

Cinchonidine, C 90 H 24 N 2 O, — isomeric with Cinchonine, not fluorescent, one of the 
most powerful of the alkaloids. 

Kinic and Kinovic Acids, — are combined in the bark with the alkaloids. The former 
is used to make a Kinate of Quinine, and the latter occurs in non-official pharmacy as 
Kinovate of Lime, an ingredient in Deloudre's Extract, which is used in Europe and. 
India for dysentery. 

Kino-tannic and Kinovo-tannic Acids, — give to bark its peculiar and powerful astrin- 
gent qualities. They have not been fully studied. 

Kinovin, — is a bitter, amorphous resinoid, which is resolvable into Kinovic Acid and 
sugar. It i? soluble in alcohol, but not in water. 

Cinchona Red, — a reddish-brown, insipid, inodorous substance. 

[The other alkaloids are of no interest medicinally.] 

Preparations of the Bark. 

Extractum Cinchona, — made from Yellow Cinchona. Dose. gr. j-v. 

Extractutji Cinchonce Fluidum, — from Yellow Cinchona. Dose, rr^x-^j. 

Tinctura Cinchonce, — Yellow Cinchona, strength 20 per cent. Dose, 3 ^s-ij. 

Tinctura Cinchonce Composita, — made from Red Cinchona, strength 10 per cent. 
Contains Bitter Orange-peel 8, and Serpentaria 2 per cent. Dose, ^j-^ss. 

Infusum Cinchonce, — made from any official bark. Cinchona 6, Aromatic Sulphuric 
Acid I, Water 93 parts. Is the only official infusion containing this acid. Dose, 3J-^j 
or more. 

Huxham's Tincture of Bark, 1788 (Unofficial), is still used. Red Cinchona ^iv, 
Orange peel "£ iij, Serpentaria gr. lxxx, Spanish Saffron gr. clx, Cochineal gr. lxxx, Brandy 
J xl, digested for 4 days, expressed and filtered. Dose, ^ss-ij. 



1 82 CINCHONA. 

Quinine and its Sails. 

Quinina, Quinine, C 20 H 24 N 2 O 2 .3H 2 O, — a white, amorphous or minutely crystalline 
powder, of alkaline reaction and very bitter taste, soluble in 1600 of water and 6 of alcohol 
at 59 F., in 25 of ether, 5 of chloroform, and readily in dilute acids. Dose, gr. j-xx, or 
xl in special cases. Is insoluble in saliva. 

Quinince Sulphas, Sulphate of Quinine (C 20 H 24 N 2 O 2 ) 2 .H 2 SO 4 .7H 2 O, — very light, 
snow white, fragile crystals, of very bitter, persistent taste, soluble in 700 of water and 
65 of alcohol at 59 F., in 30 of boiling water, 3 of boiling alcohol, also in acidulated 
water. Dose, gr. j-xx, or even gr. xl in special cases. 

Quinines Bisulphas, Bisulphate of Quinine, C 20 H 24 N 2 O 2 .H 2 SO 4 .7lI 2 O, — clear, color- 
less, efflorescent crystals or small needles, of very bitter taste and strongly acid reaction, 
soluble in 10 of water with blue efflorescence, and in 32 of alcohol, at 59 F. Dose, gr. 
j-xxx, or even gr. lx in special cases. 

Quinince Hydrobromas, Hydrobromate of Quinine, C 20 H 24 N 2 O 2 HBr.2H 2 O, — colorless 
needles, of very bitter taste, soluble in 16 of water and in 3 of alcohol at 59 F., and in 
I of boiling water or alcohol. Is the best salt for hypodermic use, 3 j of water dissolving 
gr. iv, which may be injected every 4 hours without causing irritation. Dose, gr. j-xx. 

Quinince Hydrochloras, Muriate of Quinine, C 20 H 24 N 2 O 4 HC1.2H 2 O, — white needles 
in tufts, of very bitter taste, soluble in 34 of water and 3 of alcohol at 59 F., in 1 of 
boiling water or alcohol. Is used hypodermically. Dose, gr. j-xx. An excellent salt 
which should be more generally used ; 5 to 10 gr. doses are antipyretic. 

Quinince Valerianas, Valerianate of Quinine, C 20 H 24 N 2 O 2 C 5 H 10 O 2 .H 2 O, — white, pearly 
crystals, of valerianic odor and bitter taste, soluble in 100 of water and in 5 of alcohol 
at 59 F. Dose, gr. j-iij. It is the only salt of Quinine supposed to be affected by the 
constituent acid. 

Quinince Hydrochloras Carbamidala, Carbamide Hydrochlorate of Quinine (Unofficial), 
— is a new compound salt of Quinine and Urea, soluble in equal parts of water and there- 
fore admirably adapted for hypodermic administration in a 50 per cent, solution. It is 
almost unirritating to the tissues, and is given subcutaneously in doses of gr. j-iij. 

Chininum Amorphum Boricum, Amorphous Borate of Quinine (Unofficial), — is a new 
preparation, soluble in an equal quantity of water, and claimed by its introducers to be 
equally as satisfactory as any other Quinine salt, and much better borne by the stomach 
than any other one. It is also said to cause little or no congestion of the membrana tym- 
pani. 

Tinctura Pyrexialis, Warburg's Tincture (Unofficial), — is a celebrated preparation, 
formerly secret, but published in 1875 D y tne originator, whose formula is as follows: — 
Be . Aloes soc. ft) j ; Rad. rhei (chinens), Sem. angelicas, Confec. Damocratis,* aa ^ iv ; 
Rad. helenii (s. enulae), Croci sativi, Sem. fceniculi, Cretae, prep., aa % ij ; Rad. gentianae, 
Rad. zedoariae, Pip. cubebae, Myrrhae elect., Camphorae, Bolet. laricis, aa ^j. Digest the 
whole with 500 oz. of proof spirit in a water- bath for 12 hours, express, add ^x Bisul- 
phate of Quinine, dissolve by aid of a water-bath, cool and filter. Dose, 3J, in two 
. doses 3 hours apart. Hager's modification of the original formula is — rjt . Quininae sulph. 
part, j, Spt. camphorae part, ij, Elix. proprietatis (Tinct. aloes et myrrhae) part, xxij, Alco- 
holis part. xvj. The evidence published in favor of this preparation goes to show that its 
power does not wholly lie in the quinine, camphor, aloes or rhubarb, but in some of the 
aromatic plants contained in it. 

Other Official Alkaloids and their Preparations. 

Cinchonina, Cinchonine, C 20 H 24 N 2 O, — white, lustrous prisms or needles, of bitter 
after-taste, almost insoluble in water, readily so in dilute acids and 1 10 of alcohol at 59 
F. Dose, gr. j-xxx or more. 

Cinchonince Sulphas, Sulphate of Cinchonine (C 20 H 24 N 2 O) 2 H 2 SO 4 .2H 2 O, — white, 
shining prisms, of very bitter taste, soluble in 70 of water and in 6 of alcohol at 59° F., 
and readily soluble in dilute acids. Dose, gr. v-xxx or more. 

Cinchonidince Sulphas, Sulphate of Cinchonidine (C 20 H 24 N 2 O) 2 H 2 SO 4 .3H 2 O, — 
white, silky crystals, of bitter taste, soluble in loo of water and in 71 of alcohol at 59 
F., freely soluble in acidulated water. Dose, gr. j-xx or more. 

Quinidince Sulphas, Sulphate of Quinidine (C 20 H 24 N 2 O 2 ) 2 H 2 SO 4 .2H 2 O, — white, 

* For the formula for this ingredient see the article on Confections in the section on 
Extemporaneous Pharmacy, Part II. 



CINCHONA. I83 

silky needles, of bitter taste, soluble in 100 of water and in 8 of alcohol, readily in acidu- 
lated water, at 59 F. Dose, gr. j-xx or more. It is not so bitter as Quinine, is less 
expensive, and is a valuable antipyretic and antiperiodic. 

Chinoidinum, Chinoidin, Quinoidin, — a mixture of alkaloids, mostly amorphous, 
obtained as a by-product in the manufacture of the crystallizable alkaloids from Cinchona. 
A black solid when cold, plastic when warmed, of bitter taste, almost insoluble in water, 
freely soluble in alcohol and in dilute acids. It contains the 4 alkaloids in amorphous 
condition, and has about l / z the therapeutic power of Quinine. Dose, gr. v-xxx or more. 

Non-Official Preparations. 

Quinquinina, or Quinetum, — is an Indian preparation containing the total alkaloids 
extracted from bark by acidulated water, then precipitated by soda and dried. In India 
it is called " febrifuge." 

Cinchonidince Salicylas, Salicylate of Cinchonidine, — has anti-malarial power only 
inferior to the salts of Quinine. 



Substitutes for Quinine. 

The synthetical production of Quinine has been the "philosopher's 
stone " of the modern chemists, who have prosecuted with untiring energy 
the search for an artificial product possessing all its properties. Though 
in this they have as yet been unsuccessful, they have discovered several 
organic bodies, which closely resemble each other and also quinine, both 
in chemical constitution and physiological action. These substances 
belong to the aromatic series of carbon compounds, all of which are de- 
rivatives of Benzene or Benzol, C 6 H 6 , the Hydride of the organic radical 
Phenyl, C 6 H 5 . The distinctive action of the lower members of this series 
is their antiseptic and antipyretic powers, — as that of the fatty series of 
carbon compounds is stimulant and anmsthetic (Brunton). Many of these 
agents are obtained from coal-tar oil (petroleum) by fractional distilla- 
tion, etc., — and they are all derivatives of Benzene (Benzol), either 
directly or from some of the products formed therefrom, by substitution ; 
various radicals replacing the different constituent atoms of H and C. 

Thus, by the ring-arrangement of atoms peculiar to this series, there are formed from 
Benzene (C 6 H 6 ), the following substances, viz. — 

Phenol, or Carbolic Acid, C 6 H 5 OH — by replacing H by OH, (hydroxyl). 

Pyrocatechin, or Ortho- \ CgH 4 (OH) 2 . 

Rescorcin, or Mela- > di-hydroxy-benzene, — by replacing 2H by 2OH. 

Hydroquinone, or Para- J C 6 H 4 (OH) 2 . 

Pyrogallol, Pyrogallic Acid, Pri-hydroxybenzene C 6 H 3 (OH) 3 , — 3H by 3OH. 

Ar?iido-benzene, or Anilin, C 6 H 5 .NH 2 — by replacing H by NH 2 (amidogen). 

Nitro- benzene, C 6 H 5 .N0 2 — by replacing H by N0 2 (nitroxyl). 

Benzoic Acid, C 6 H 5 CO.OH— by replacing H by CO.OH (carboxyl). 

Salicylic Acid, HC.H 5 3 — by replacing 2H by OH and CO.OH. 

Naphthaline, C ]0 H 8 — by uniting two Benzines in an over-lapping ring. 

Pyridine, C 5 H-N — by replacing tetrad C by triad N. 

Chinoline, C 9 H 7 N — uniting Benzene (C 6 H 6 ) and Pyridine (C 5 H 5 N). 
Derived from Chinoline is the hypothetical base. 

Chinicine or Quinicine, C 9 H 9 N 2 , — represented in Antipyrine. 

Also Kairine, Thalline, and other compounds. 

The most important of these are Antipyrine, Acetanilide, Resorcin. 



154 CINCHONA. 

Chinoline and Naphthaline, which are respectively described in separate 
articles. Others of the same class are the following, viz. — 

Some Unofficial Antipyretics. 

Kairina, Kairine (Hydrochlorate of Oxy-ethyl-chinoline-hydride), C 10 H ]3 NO.HC1. 
H 2 0, — is an artificial alkaloid prepared from Chinoline, belonging to the phenol group 
of carbon compounds, and a powerful antipyretic in 8-grain doses hourly. It stains the 
urine a deep green, and has not proven fatal though 220 doses have been administered 
in one case. In some cases of typhus it has caused cyanosis and collapse. It produces 
profuse sweating and vomiting, and the subsequent rise of temperature after its antipyretic 
influence has worn off is generally ushered in by a severe rigor. It is by many authorities 
considered to be the most certain, most powerful and most rapid antipyretic drug we 
possess, though this claim is now disputed by the advocates of Antipyrine. It occurs in 
white crystals, which are freely soluble in water, but is best given in wafer paper or cap- 
sules. Dose, gr. iij-xxx. 

Kairolina, Kairoline (Sulphate of Tetra-hydromethyl-chinoline), — is antipyretic, but 
much less efficient than Kairine. 

Thalline (Parachinanisols), — is a synthetically prepared alkaloid, having the chemical 
name Tetra-hydro-paramethyl-oxy-chinoline. It occurs as a colorless powder which is 
soluble in water, and enters into combination with acids, forming salts, of which the 
tartrate and sulphate are the most eligible, especially the latter. The dose of Thalline or 
its Sulphate ranges from gr. ij to gr. xv, a mean average dose being about 5 grains, given 
in the form of compressed tablets. Thalline is an antipyretic of very great power, doses 
of 5 to 12 grains lowering the temperature in typhoid fever 4 to 5 in 2 hours' time, the 
effect lasting nearly 3 hours. In tuberculosis similar results were obtained. Large doses, 
however, produce very profuse sweating and a dangerous degree of depression ; so that 
this agent is not a favorite remedy for hyperpyrexia. 

Hydroquinone (Para-di-hydroxy-benzene) C 6 H 4 (OH) 2 , — is isomeric with Resorcin 
(see ante, page 183). It crystallizes in rhombic, colorless prisms which are slightly 
soluble in water, readily so in alcohol and in ether, and is obtained from Arbutin, a glu- 
coside constituent of Uva Ursi and other Ericaceae. It is an efficient antipyretic, without 
injurious effects so far as observed, but its influence is only temporary. The action of 
this drug on animals is summarized in the N. Y. Medical Record for August 15th, 1885, 
and its influence on pyrexia elucidated in the same journal for May 30th, 1885. Dose, 
as an antipyretic, gr. xv-xx, best given in alcohol. Gr. xl have been given without dis- 
agreeable effects. 

Pyrocateckin, Catechol (Ortho-di-hydroxy-benzene), C 6 H 4 (OH) 2 , — is also isomeric 
with Resorcin, and is one of the acid constituents of coal tar, also obtained from wood-tar 
and from kinic acid. It is a good antipyretic, but much inferior to Quinine or Resorcin. 

Phenacetine (Acetphenetidine), — a white and glossy, crystalline powder, in chemical 
constituent analogous to Acetanilide. It is tasteless, and but slightly soluble in water, 
more so in glycerin, and still more so in alcohol and in lactic acid. It is a very efficient 
antipyretic and antineuralgic, with no disagreeable after effects. The dose is about one- 
half that of Antipyrine, or gr. x-xx. See under Phenacetine. 

Pheno-resorcin, — is a mixture of Carbolic Acid 67 with Resorcin 33 and Water 10, 
forming a liquid which mixes readily with water. It is supposed to combine the virtues 
of both its ingredients. 

Physiological Action. 
The action of Cinchona in sufficient dose is generally that of its alka- 
loid Quinine, except that bark is decidedly astringent, more of a gastric 
irritant, and by reason of its bulk its active principles are more slowly 
absorbed. In large doses (gij) the powdered bark has produced flatu- 
lence and eructation, and in many well-authenticated instances has pro- 
duced a well-marked febrile paroxysm, beginning with chill, then fever 
and headache, which gradually subsided in slight perspiration. So also, 
Quinine, while incapable of producing intermittent fever in a healthy 



CINCHONA. 185 

person, will, if taken in large doses unnecessarily, throw the nervous sys- 
tem into high commotion, and if untimely used by a malarial subject 
may reproduce the paroxysm with greater or less severity. 

Cinchona is an astringent bitter and a stomachic tonic. At first it 
promotes appetite, digestion, the flow of saliva and of gastric juice; 
long-continued it sets up a gastric catarrh, impeding digestion and 
causing constipation. 

Quinine is a bitter tonic, antiseptic, antiperiodic, antimiasmatic and 
antipyretic, a diminisher of reflex action, a protoplasmic poison, a cardiac 
depressant and perhaps an oxytocic. It is rapidly diffused and slowly 
excreted, being found in the Urine in 15 minutes after its administration 
and for two or three days afterwards. Its action on the stomach is simi- 
lar to that of cinchona. It arrests the movements of the white blood- 
corpuscles though increasing their number, and prevents acetification and 
decay of the blood. It is actively destructive of lowly organized life, a 
solution of 1 to 500 being fatal to infusoria and fungi, while one of double 
this strength prevents alcoholic fermentation and checks putrefactive de- 
composition. The heart and arterial tension are somewhat stimulated 
by small doses, but depressed by large ones (gr. xl-lxxx), which slow and 
enfeeble the pulse by direct action on the cardiac ganglia. The brain is 
rendered hyperaemic and exhilarated by small or moderate doses, but 
large ones produce a sense of fulness and constriction in the head, cere- 
bral anaemia, pallor, tinnitus aurium, vertigo, staggering gait, amaurosis 
and deafness, great headache, dilated pupils, delirium, coma, and in 
animals convulsions. The eyes and ears are very rarely injured perma- 
nently. These symptoms collectively are termed Cinchonism. It reduces 
the size of the spleen when enlarged, and lowers the temperature of 
pyrexia, though it does not depress the body temperature in health. 
Large doses lower the reflex function of the spinal cord. In some sub- 
jects it produces sexual excitement, in others cutaneous eruptions some- 
times followed by desquamation. It lessens the excretion of uric acid, 
but not that of urea, and is a uterine stimulant in labor, but its power 
to initiate uterine contractions is a much debated question. 

Quinidine and Cinchonidine correspond in action with Quinine both 
qualitatively and quantitatively, the latter however producing less severe 
head symptoms. 

Cinchonine also corresponds in effect, but is much the least active of 
the four alkaloids. It is said to produce greater headache, and much pre- 
cordial pain and muscular weakness, but to have little effect on sight or 

hearing. 

Antagonists and Inco77ipatibles. 

Morphine antagonizes its cerebral action. Atropine its nervous, cardiac and antipyretic 

powers. Free Tannic Acid is incompatible with the Infusion of Cinchona. Iodine 

preparations, Alkalies, Alkaline Carbonates and Earths, are incompatible with solutions of 

the alkaloids, the first-named forming insoluble compounds, the latter precipitating them. 



1 86 CINCHONA. 

Therapeutics. 

Cinchona is used as a tonic and has many applications. The Infusion 
or Compound Tincture with a mineral acid is" extremely serviceable in 
atonic dyspepsia, gastric catarrh of alcoholics, adynamia, convalescence, 
asthma, chronic bronchitis, and generally in weak subjects of flabby flesh 
and perspiring skin. 

Quinine finds its principal field of action in the malarial diseases, over 
which its power is that of a specific. In intermittents, a ten-grain dose 
of the sulphate should be given in the sweating stage and again 5 hours 
before the expected time of the next paroxysm. In the intervals Arsenic 
is better used, as Quinine will cause a daily exacerbation of temperature 
if long continued. In remittents 20- to 30-grain doses should be admin- 
istered once or twice a day until the temperature is reduced to the normal 
point. In pernicious remittents large doses (gr. xxx to lx) are necessary 
to the safety of the patient. In chronic malarial poisoning Quinine has 
considerable power, but Chinoidin is more effective. Small doses of 
Quinine (gr. ij-iij per diem) are efficient as a prophylactic against 
malaria. 

As an antipyretic Quinine is used with the best results, especially in 
typhus, typhoid, variola, pneumonia and acute rheumatism. Inflamma- 
tions may, at their inception, be aborted by 15- or 20-grain doses, com- 
bined with Morphine, which in this respect is synergistic to Quinine. 
Acute tonsillitis and acute catarrh may sometimes be aborted by a full 
dose. In surgical fevers, pyaemia and exhausting suppurative conditions, 
also in septicaemia, hectic fever, and before surgical operations, Quinine 
is much employed. Neuralgias of malarial origin are amenable to it, as 
also neuralgia of the ophthalmic division of the fifth nerve. In eruptive 
fevers, especially scarlet fevers, erysipelas and measles, it is advantageously 
administered throughout their course. In some skin diseases, particularly 
erythema nodosum, it is quite efficient, also in whooping-cough and hay- 
fever. In the latter affection a solution of gr. vj to the ^ of the neutral 
hydrochlorate is a very useful local application. 

Antipyresis has of late received considerable attention, particularly in 
the German hospitals. The most certain and safe of all antipyretics is 
undoubtedly the cold bath, but it is not always the most practicable, 
especially in private practice. Internal antipyretics are therefore of great 
value, and of these the safest and best is Quinine, next in order being 
Antipyrine. 

Warburg's Tincture has obtained a very high reputation in the 
hands of Indian army-surgeons in the treatment of remittent and other 
malarial fevers of the most malignant types, in malarial neuralgiae, acute 
nervous exhaustion and sudden collapse without organic disease. The 
most pronounced testimony to its value is that of Dr. Maclean {Med. Times 



CINCHONA. 187 

and Gazette, Nov., 1875), whose authority will not be questioned by the 
most captious. He affirms that the influence of this combination to arrest 
an exacerbation of remittent fever is far more powerful than that of Qui- 
nine alone. The remedy has become much less of a favorite since its 
originator was induced to make public the secret of its composition. 

Administration . 

The persistently bitter taste of Quinine and its salts is best obviated by administering 
them in pill form, made with glycerin as an excipient, or by using Liquorice, Eriodyction 
or Chocolate to cover the taste if given in solution or powder. The taste is extremely 
well covered by using as a vehicle a combination of Glycyrrhizin and Fluid Extract of 
Eriodyction, named " Veloutine" but the Quinine must be suspended therein by the aid 
of mucilage, as when an acid is used to dissolve it the bitter taste cannot be disguised. 

For hypodermic use the best salt is the Hydrobromate, it being the most soluble, — 
gr. xij in Jj of distilled water gives gr. j in Y(\v. The Carbamide Hydrochlorate is 
coming into favor for hypodermic administration by reason of its solubility and freedom 
from irritating qualities. 



CINNAMOMUM, Cinnamon, — is the inner bark of the shoots 
of Cinnamomum Zeylanicum (Ceylon), or the bark of the shoots of 
several species of Cinna??iomum (nat. ord. Lauracea?) grown in China 
(Cassia Bark). The former occurs in light, yellowish-brown quills, con- 
sisting of several pieces rolled together, each very thin, while the Chinese 
variety comes in single quills of irregular form and rougher texture. The 
taste is warm and aromatic, and the odor very fragrant. The active prin- 
ciple is a Volatile Oil, and it also contains a resin, tannic and cinnamic 
acids. Dose, gr. x-xx. 

Preparations. 

Oleum Cinnamomi, — is the volatile oil, a yellowish- colored liquid of sp. gr. 1. 040 to 
I.060, becomes dark by age, of slightly acid reaction. The oil of Chinese Cinnamon is 
not so agreeable in odor or taste. Dose, gtt. j-v. 

Aqua Cinnamomi, Cinnamon-Water, — has of the oil 2 parts in 1000, percolated through 
cotton. Dose, indefinite. 

Spiritus Cinnamomi,— contains 10 per cent, of the oil. Dose, n\v-xxx. 

Tindura Cinnamomi, — contains 10 per cent, of the powdered bark. Dose, gss-ij. 

Pulvis Aromatic us, Aromatic powder, — Cinnamon 35, Ginger 35, Cardamom 15, 
Nutmeg 15, rubbed together in fine powder. Dose, gr. x-xxx. 

Extractutn Aromaticum Fluidum, — has of Aromatic Powder 100 grammes, Alcohol 
q. s. ad 100 cubic centimeters. Dose, n\x-xxx. 

Cinnamon is an agreeable carminative, somewhat astringent and stimu- 
lant, also highly aromatic and antiseptic. The oil is not astringent but 
is a pleasant stimulant to the nervous and vascular system, and is by some 
believed to exercise a specific action on the uterus, particularly as a 
hemostatic. 

The various preparations are in general use as flavoring excipients, and 
the aqua is a pleasant vehicle for extemporaneous prescriptions. The 
bark and its preparations are used to check diarrhoea in combination with 
opium, chalk, or some vegetable infusion. The oil is a good stimulant 
in flatulence, paralysis of the tongue, cramp of the stomach, enteralgia, 



1 88 COCCUS COLCHICUM. 

etc, and is sometimes used to check nausea and vomiting. Cinnamon 
was formerly used with success in uterine hemorrhage, generally in com- 
bination with sulphuric acid, which of itself is an efficient uterine hemo- 
static. It has lately been employed in France as an internal germicide, 
with great satisfaction ; and has given particularly good results in the 
treatment of typhoid fever, against the supposed bacillus of which disease 
it is believed, by its advocates, to have specific and destructive powers. 



COCCUS, Cochineal, — is the dried female of Coccus cacti, an 
insect of the order Hemiptera, which feeds on the cactus plants of Mexico 
and Central America. Occurs in ovate, plano-convex form, of a purple- 
gray or purple-black color, yielding when crushed a dark-red powder, 
which contains Carminic Acid, or Carmine, the red coloring-matter, 
which is soluble in water and alcohol, but not in oils. Cochineal is an 
ingredient of Tinctura Cardamomi Composita, and is used in pharmacy 
solely as a coloring material. 

The only therapeutic use of Cochineal is in whooping-cough and neu- 
ralgia, in which affections it is supposed to have considerable influence, 
especially in the former. Its dose to an infant is about gr. ^3 thrice daily. 



COLCHICUM, Meadow Saffron, — is the corm and seed of the 
Colchicum autumnale, a European plant of the nat. ord. Melanthaceae. 
It contains an intensely bitter, poisonous alkaloid, Colchicine, C n H 19 N0 5 , 
which by the action of acetic and mineral acids is converted into Col- 
chicine and a resin, — also tannic and gallic acids, resin, starch, sugar, 
etc. It is official in two forms, namely — 

Colchici Radix, Colchicum Root, — the corm, about 1 inch long, 
white internally, grooved on one side, inodorous, taste sweetish, bitter 
and acrid. Is less active than the seed. Dose, gr. ij-viij. Contains of 
Colchicine, 0.45 per 1000. 

Colchici Semen, Colchicum Seed, — about -^ inch thick, sub-globular, 
resembling black mustard seed but larger, very hard and tough, inodor- 
ous, of bitter and acrid taste. Dose, gr. j-v. Contains of Colchicine, 

3.35 per 1000. 

Preparations. 

Extractum Colchici Radicis, — made with Acetic Acid 35 parts to 100 of the root, and 
sufficient water. Dose, gr. ^-ij. 

Extractum Colchici Radicis Eluidum, — Dose, mjj-x. 

Extractum Colchici Seminis Fluidum, — Dose, TnJ-v. 

Vinum Colchici Radicis, — strength 40 per cent. Dose. n\v-xv. 

Vinum Colchici Seminis, — strength 15 percent. Dose, TT^x-xxx. 

Tinctura Colchici, — from the seed, strength 15 per cent. Dose, TTLx-xxx. 

Colchuina, Colchicine, C 17 H 19 N0 5 (Unofficial), — a white or yellowish, amorphous 
powder, of saffron-like odor and bitter taste, soluble in water and in alcohol. Dose, gr. 



COLOCYNTHIS. 1 89 

Laborde and Houde condemn all preparations made with acetic acid, also those made 
from the tubers and all wines. The best preparation is Colchicine, in granules or in a 
wine ; or a strong tincture made from fresh seed with the shell on, the latter containing a 
very volatile but active oil. Of this seed g] to }4 pint of highest proof alcohol, standing 
for 2 weeks. Of this 3 v to water q. s. ad 0}4, of which the dose is ^ ss every 4 hours 
night and day, avoiding acids, until nausea, vomiting and purging set in. 

Physiological Action. 
Colchicum is emetic, diuretic and diaphoretic, a drastic purgative, a 
gastro-intestinal irritant and a cardiac depressant. In small doses it 
increases secretion, especially the urine and the sweat. In full doses its 
action is emeto-cathartic, producing profuse watery discharges, great 
nausea and extreme muscular feebleness. In large doses it is a powerful 
irritant of the gastro-intestinal tract, causing severe griping, choleraic dis- 
charges, lowered arterial tension and depression of the heart by reflex 
action over the distribution of the pneumogastric, — then great prostration, 
convulsions and collapse, death occurring from exhaustion, with con- 
sciousness preserved until carbonic acid narcosis sets in. On the excretion 
of uric acid and urea its influence is very much disputed, but it probably 
increases the flow of bile, and certainly unloads the portal circulation. 

Antagonistics and Incompatibles. 

Tannic Acid to retard absorption. Emetics and cathartics, also warm demulcent drinks 
freely. Morphine hypodermically to antagonize the cardiac depression, also Alcohol. 

Therapeutics. 
Colchicum is a specific palliative in gout of acute form, in which it 
should be given with an alkali, and kept short of emeto-catharsis. It 
does not prevent relapses, and its power in this disorder is weakened by 
repetition. In ascites from obstructive disease of the liver it is most 
effective, given in full doses to establish a profuse drain, with opium to 
sustain the heart. In acute cerebral congestion and in portal congestions 
it is well given as a drastic purgative. It is often used with marked 
success in acute rheumatism, but frequently fails, and in no case should 
it be continued long in this affection. It has been used with good results 
in the treatment of gonorrhoea and chordee. The alkaloid is probably 
the best preparation for general use, and is admittedly superior to the 
other preparations in acute gout. 



COLOCYNTHIS, Colocynth,— is the fruit of Citrulhis Colocyn- 
this, deprived of its rind. The plant is a native of Spain and Asiatic 
Turkey and belongs to the nat. ord. Cucurbitaceae, the fruit being of the 
size of a small orange, white, light, spongy, inodorous, very bitter, con- 
taining many flat, brown seeds which should be rejected before the pulp 
is used. Its active principle is Colocynthin, CseHg^s, an amorphous but 



I9O CONIUM. 

crystallizable bitter glucoside, readily soluble in water. It also contains 

Colocynthein, a resin, and Colocynthitin, which is a tasteless, crystalline 

powder, soluble in ether but not in water, and devoid of purgative 

action. 

Preparations. 

Extractum Colocyntkidis, — alcoholic. Dose, gr. ^-ij. 

Extractum Colocyntkidis Compositum, — contains of the preceding 16 parts, Aloes 50, 
Cardamom 6, Resin of Scammony 14, Soap 14, Alcohol 10. Dose, gr. v-xx. 

Pilules Calharlicce Composite, Compound Carthartic Pills, — each has of the preceding 
gr. 1.3, Abstract of Jalap gr. j, Calomel gr. j, Gamboge gr. j^. Dose, j-iij pills. 

Lavillt's Anti-Gout Remedy, — is a proprietary medicine prepared in France and pur- 
porting to be " a mixture of prepared Kino-colocynthine." The published formula is as 
follows: Active principle of Colocynth 2^, Quinine and Cinchonine 5, Spanish Wine 
800, Alcohol 100, Water to 1000 parts ; but there is good reason for believing that it 
contains Colchicine instead of Colocynthin. 

Physiological Action. 

Colocynth is classed among the tonic-astringent and resin-bearing 
purgatives. In moderate doses it increases peristalsis and the intestinal 
glandular secretions, producing bilious, watery evacuations with much 
colicky griping pain. Its purgative action is specific, and may be ob- 
tained by its application to the skin over the abdomen. In large doses it 
is a violent irritant of the gastro-intestinal tract, and has frequently pro- 
duced fatal gastro-enteritis. It is popularly supposed to be abortifacient, 
but this is only true of quantities sufficient to endanger life. It is an 
indirect diuretic. 

Therapeutics. 

Colocynth is too severe an agent to be administered alone for consti- 
pation, but it makes a useful factor in compound purgatives, as the com- 
pound cathartic pills. In cerebral congestion it may be used to produce 
rapid derivation, and in ascites to set up a profuse drain from the intes- 
tinal canal. In certain cases of chlorotic amenorrhoea it stimulates the 
pelvic nerves and vessels with excellent results. There seems to be abun- 
dant evidence that in very small doses (r^-gV-yV of a tincture) colocynth 
is an efficient remedy in colic, sciatica, ovarian and other neuralgias, as 
well as in the pain of glaucoma. These actions may be due to its two 
non-purgative principles, which may prove to possess powers not hereto- 
fore suspected, an example of which is seen in the recently-discovered 
cardiac influence of Convallaria, a drug until recently only known as a 
purgative and a diuretic. 

CONIUM, Hemlock, — is the full-grown fruit, gathered while green, 
of Conium maculatum, the spotted hemlock (nat. ord. Umbelliferae). It 
is smaller than anise-fruit, of a gray-green color, slight odor and taste, 
and contains 3 alkaloids, namely, — Coniine, C 8 H 15 N, liquid and volatile, 
Methyl-coni'ine, CgH^NCHg, and Conhydrtne, C 8 H 17 NO, solid and vola- 



CONIUM. I9I 

tilizable ; — also Comic acid and a volatile oil. Paraconiine is an artificial 
substance produced by the reaction between Butyric Aldehyd and an 
alcoholic solution of Ammonia, and isomeric with Coniine but not iden- 
tical with it. The leaves of Conium are no longer official. 

Preparations. 

Abstractum Conn, — made from 260 parts of Conium, 6 of Dilute HC1 acid, Sugar of 
Milk and Alcohol to make 100 parts; each grain representing 2 grains of the powdered 
drug. Dose, gr. ss-iij. 

Extractum Conii Alcokolicum, — each grain represents a grain of the crude drug. 
Dose, gr. ij-v-xl. 

Extraction Conii Fluidum, — of the same strength as the alcoholic extract. Dose, 
mjj-v-xl. 

Tinctura Conii, — strength 15 per cent. Dose, rrfx-^j, beginning with the 10-minim 
dose and gradually increasing until physiological effects are manifest. 

Coniina Coniine, C 8 H 15 N (Unofficial), — an oily, limpid, volatile liquid, of acrid taste, 
alkaline reaction, and an odor compared to that of the urine of mice. It is quickly 
decomposed by heat, and if exposed to the air soon becomes inert. Dose, gr. ^— JL, or 
in minim-doses, TlbjQ-ij. Is too irritant for hypodermic use, unless carefully neutralized 
by acetic acid. The Hydrobromate in watery solution of gr. viij to the ^ , of this nrx-}/£, 
is a good form for subcutaneous or stomachal administration, and may be given in doses 
of gr. T X 2 to gr. j, as it is not actively toxic. 

All tlie preparations of Conium are uncertain in action, particularly the extract and 
abstract, as the active principle is very volatile. Any specimen must be carefully tested 
before deciding on its dosage, and if the powerful mouse-like odor of the drug be absent, 
it is probably worthless. 

Physiological Action. 

The special action of Conium and Coniine is the production of motor 
paralysis without loss of consciousness or sensation. It paralyzes the 
motor nerves, the action commencing at the peripheral end-organs and 
extending upwards, involving the nerve-trunks and finally the centres, 
but the muscular irritability remains unaffected. Methyl- Coniine acts 
similarly but reversely, affecting first the motor columns of the cord. 
The sensory nerves are not affected, but the general sensibility is, a feel- 
ing of numbness being experienced in the extremities. 

Gastric irritation is usually the first sensation produced by a full dose of 
Conium, nausea and vomiting being its symptoms. Then weakness of 
the legs, numbness and fatigue, drooping eyelids, diplopia, slightly 
dilated pupils, vertigo, impaired utterance, slow and labored breathing, 
and if the dose be a lethal one, paralysis of the voluntary muscles, those 
of the lower limbs being first affected, speech and vision are lost, and 
finally death occurs from paralysis of the muscles of respiration. The 
heart is not affected and the mind remains clear, but torpid and indiffer- 
ent, until carbonic acid narcosis sets in. 

Muscular movement counteracts the effects of the drug to a very great 
extent. 

Conium is believed to have been the state poison of the Athenians, by 
tne juice of which Socrates and Phocion died. 



192 CONVALLARIA MAJALIS. 

Antagonists and Incompatibles. 

Nux Vomica and its alkaloids, Picrotoxin and other tetanizers are antagonistic. 
Tannic acid and caustic alkalies are chemically incompatible. 

Therapeutics. 
Conium is especially indicated in diseases characterized by excessive 
motor activity. Large doses are required as some physiological action is 
necessary. Children bear 'it well, their constant activity preventing its 
full action. In chorea it palliates by depressing the motor nervous sys- 
tem. In acute mania and delirium tremens to quiet motor excitement 
and prevent exhaustion, it is remarkably efficient, especially when given 
conjointly with Morphine. When pain and spasm are present, it will 
prove a useful agent ; and in tetanus, blepharospasm, asthma, whooping- 
cough, and other spasmodic affections it is frequently used with great 
benefit. The pain of cancer seems to be especially amenable to its influ- 
ence when locally applied, and Conime-vapor is an admirable palliative 
of the tickling cough of phthisis and the irritability of the air-passages 
in acute bronchitis. In pneumonia and pleurisy the hypodermic use of 
Conii'ne to afford the organs rest by inducing a paretic state of the respira- 
tory muscles has been followed by a marked decrease in the temperature 
and pulse-rate. 

CONVALLARIA MAJALIS, Lily of the Valley (Unofficial), 
— is a stemless perennial of the nat. ord. Liliaceae, indigenous to Europe, 
Northern Asia and the Southeastern portion of the United States. Ail 
parts of the plant are used, but the preparations vary in action according 
to the quantity of the Resin present, it being emeto-cathartic. Convalla- 
ria contains two glucosides, namely, Convallamarin, on which" the cardiac 
action depends, and Convallarin, a crystalline, purgative principle, insol- 
uble in water ; — also an acrid Resin which probably contains the latter 

glucoside. 

Preparations. 

Kxtr actum Convallarice (Unofficial), prepared from the flowers and stalks with y^ of 
the leaves and root ; is a black solid, freely soluble in water and alcohol. Dose, gr. ij-x. 

Extractum Convallarice Fluidum (Unofficial), — as found in the shops is an alcoholic 
preparation of the whole plant, and is likely to contain Convallarin, which is not present 
in aqueous preparations, being insoluble in water. Dose, n^ij-x. 

Infusum Convallarin (Unofficial), — prepared from the flowers, leaves and stems 25 , 
in water 75. Dose, ^ss-ij. 

Convallamarinum, Convallamarin, C 23 H 44 12 (Unofficial), — an amorphous, white, 
bitter powder, freely soluble in water and in alcohol, but insoluble in ether. Dose, gr. 

Physiological Action. 
Convallaria has long been known as a decided cathartic and a prompt 
and powerful diuretic, but its cardiac action has only lately excited atten- 
tion, and it is now considered a close analogue of Digitalis, while free 



COPAIBA. 193 

from the cumulative action which makes the latter drug so frequently a 
dangerous remedy. 

Preparations of the root have a powerful emeto-cathartic action, prob- 
ably due to a preponderance of the resin. Those freed from this ingre- 
dient correspond in action with Convallamarin, stimulate the appetite 
without impairing digestion, increase peristalsis without producing cathar- 
sis, slow the heart and raise the arterial tension, also slowing and deepen- 
ing respiration. Lethal doses at first produce irregularity of the cardiac 
action and spasm of the respiratory muscles, high arterial tension and a 
very rapid pulse, — followed by lowered blood-pressure, very slow and 
deep breathing, and finally arrest of the heart in systole. Its mode of 
action is by direct stimulation of the pneumogastric, the motor and 
sensory nerves retain their irritability, the muscles preserve their contrac- 
tility, and the cerebral functions and the pupil are unaffected. 

Convallarin is a drastic purgative in 3-grain doses. Convalla- 
marin is an emetic even in small quantity, and the powdered root is 
sternutatory. 

Therapeutics. 
Convallaria is a heart-tonic like Digitalis, and is indicated in the same 
class of cases as is that drug, with the advantage that having no cumula- 
tive action it is not dangerous to the heart in medicinal doses, and does 
not disturb the stomach or the functions of the cerebro-spinal axis. In 
doses of gr. xv-xxv of the extract it slows the action of the heart and 
increases the force of its contractions, raises arterial tension, augments 
the force and volume of the respiration, and produces prompt diuresis 
without altering the composition of the urine. It is a most valuable 
remedy in mitral stenosis or insufficiency with venous stasis, dilatation of 
the heart, palpitation, vehement cardiac action or disordered rhythm, 
and in all valvular affections accompanied by dropsy and a weak heart. 
It has also been used with benefit in pneumonia, typhoid fever and renal 
dropsy. Its action is maintained for several days after its use has been 
suspended. 



COPAIBA, Balsam of Copaiba, — is the oleoresin, of Copaifera 
Langs dor ffii, and other species of Copaifera, a S. American tree of the 
nat. ord. Leguminosse, growing chiefly in the valley of the Amazon. It 
is a translucent, viscid liquid, of yellow color, aromatic odor, acrid and 
bitter taste, not fluorescent, soluble in alcohol and benzol. Is not a bal- 
sam as it contains no cinnamic acid. Its constituents are a Volatile Oil 
and a Resin in about equal proportions, the latter containing nearly 99 
per cent, of Copaibic Acid. Dose, tt^x-^j. 
J 3 



194 CORIANDRUM. 

Preparations. 

Oleum Copaiba, C 10 H 16 , — the volatile oil, a pale yellow liquid, of sp. gr. 0.890, of 
bitter taste and neutral reaction, soluble in an equal weight of alcohol. Dose, TT^x-xv. 

Resina Copaiba, — is the residue left after distilling off the volatile oil from Copaiba, a 
yellowish, brittle body, of acid reaction, soluble in alcohol, benzol or amylic alcohol. 
Consists mainly of Copaibic Acid, which is crystallizable, also 1 y z per cent, of a viscid 
resin. Dose, gr. j-v. 

Massa Copaiba, — consists of Copaiba 94, fresh Magnesia 6 parts, mixed and set aside 
to concrete into a pilular mass. Dose, Tt\,x-gj. 

Mistura Copaiba Composita^ Lafayette's Mixture (Unofficial), — R. Copaibse Zvij,01. 
Cubebse 3J, Glyceriti Vitelli ^vij. Triturate and add gradually while triturating Syrupi 
Aq. Menth. Piperitae ^ijss. Then add with constant stirring Liq. Potassae J ss, Tr. 
Cardamomi Co. Jjij, Spt. Etheris Nitrosi Jss, Aq. Menthse Pip, q. s. ad ^viij. Dose, 

Physiological Action. 

Copaiba is a stimulant diuretic, diaphoretic, expectorant, and a gastro- 
intestinal irritant. Its taste is bitter and nauseous. In the stomach it 
causes heat, unpleasant eructations, heaviness, frequently anorexia and 
diarrhoea, and if continued for any length of time gastro-intestinal catarrh 
and desquamative nephritis may result. The oil and resin diffuse into the 
blood and are excreted by the bronchial mucous membrane, skin and 
kidneys, producing increased secretion at the points of elimination. 
The various secretions have the odor of the drug, especially the urine. 
In medium doses it increases the quantity of urine and its solid con- 
stituents, but large doses will cause scanty urine, containing albumen, 
casts and blood, with pain in the loins and other signs of renal con- 
gestion. On the skin it often produces itching and several forms of 
eruption. 

Therapeutics. 

Copaiba has been largely used in gonorrhoea after the acute symptoms 
have subsided, also in chronic cystitis, acute and chronic bronchitis, and 
in dropsies, particularly ascites. In all these affections it is a useful rem- 
edy, but its nauseous taste and irritant effects on the stomach are driving 
it out of fashion, especially in private practice. One eminent surgeon de- 
clares that not only is it useless in gonorrhoea but that it does more harm 
than good, often prolonging the disease beyond its natural limit. In pso- 
riasis and urticaria, and in cutaneous affections characterized by torpid 
peripheral circulation, this drug has been administered internally with 
excellent results. In long-standing cystitis in the female Copaiba has 
been injected into the bladder with great benefit. The resin is the most 
active ingredient, especially for diuretic purposes. 



CORIANDRUM, Coriander,— is the fruit of Coriandrum sativum, 
a European plant of the nat. ord. Umbelliferse. It is a minute, globular, 
brownish-yellow body, finely ribbed, of aromatic odor and taste, and 
contains a volatile and a fixed oil. Dose, gr. x-xx. 



CORNUS COTO. 195 

Preparation. 
Oleum Coriandri, — the volatile oil. Dose, rryj-v. 

Physiological Action and Therapeutics. 
Coriander is stimulant, aromatic and carminative. It is used almost 
wholly as a flavoring to other remedies, or as a corrective against the 
griping effects of certain purgatives. Its flavor covers the taste of Senna 
and Rhubarb, and it is an ingredient of the official Confectio Sennae. 

CORNUS, Dog-wood, — is the bark of the root of Cornus florida, 
a small tree of the nat. ord. Cornacese, indigenous in the U. S. Occurs 
in reddish-brown, curved pieces, of astringent, bitter taste, and contains 
a bitter principle named Cormn, which is crystallizable and soluble in 
water and alcohol ; also a resin and tannic acid. 

Preparation. 

Extractum Cornus Fluidum, — Dose, tt\x— g). 

1 

Physiological Action and Therapeutics. 
Cornus is a simple bitter, having stomachic and other qualities similar 
to those of Calumba (which see). In addition it is possessed of con- 
siderable antiperiodic power, and has a good deal of reputation in the 
Southern States as a remedy in malarial fever, the physicians of that sec- 
tion considering it as next to Quinine in efficiency. Heat destroys its 
active principle, consequently a decoction is a useless preparation. 

COTO, Coto Bark (Unofficial), — is the bark of some unknown tree 
growing in Bolivia, from whence it comes in brownish pieces of aromatic 
odor and acrid, bitter taste. It contains an acrid, bitter principle, of 
yellow color, crystalline and soluble in hot water and alcohol, named 
Cotoin, C 22 H 18 6 ; also Piperonylic Acid, C 8 H 6 4 , and a volatile oil, resin, 
etc., but no tannin. Dose, gr. j-xv. 

Paracoto Bark, or False Coto, — is thicker than the true bark, has a 
fainter odor and taste, and is marked by whitish furrows on its surface. 
Its principle, Paracotoin, C 19 H 12 6 , has a strong similarity to Cotoin 
therapeutically, but is less active. 

A fluid extract of the official strength is prepared, also a tincture (10 per cent.), which 
may be administered in doses of from mj-xx. Cotoin is used in doses of gr. j-iv, and 
Paracotoin in somewhat larger quantities. 

The physiological action of Coto has not been studied, all that is 
known about it being that it is decidedly irritant to the skin and mucous 
membranes. After its internal administration the urine takes a dark-red 
color with Nitric Acid. Ferric Chloride blackens a dilute solution of 
Cotoin, but has no reaction with Paracotoin. 



I90 CREASOTUM. 

The bark and both principles are highly recommended in diarrhoeas 
of various forms, especially those of phthisis, typhoid fever, and cholera. 
In Asiatic cholera Paracotoin has been used hypodermically in 3-grain 
doses with success. Where there is any tendency to acute inflammation 
of the gastro-intestinal tract this agent must be used with caution. 
Small doses of the tincture (try-v) are said to be very effective in the 
diarrhoea of children. 



CREASOTUM, Creasote,— is a product of the distillation of 
wood-tar, chiefly consisting of the four phenols, Guiacol, Creasol, Methyl- 
creasol and Phlorol, in varying proportions. It is a nearly colorless, in- 
flammable, oily liquid, of smoky odor, caustic taste and neutral reaction, 
soluble in 80 of water at 59 F., in 12 of boiling water, and in all pro- 
portions in alcohol, ether, chloroform and acetic acid. It does not 
coagulate albumen (?) or collodion, Carbolic Acid does. It was named 
from its remarkably preservative power over meat creas, flesh, and sohzoh, 
preserve. Much of the commercial Creasote is an impure Carbolic Acid, 
or a heavy oil distilled from coal-tar and containing Carbolic and Cresylic 
Acids. Dose, ttjj-iij, well diluted. 

Aqua Creasoti, — a I per cent, solution, containing rr\W T 4 Q in each fluidounce. Dose, 

Morson's Beechwood Creasote, — is best for internal use. Dose, Try every 3 hours, in 
wine or whiskey, well diluted. 

Creasote is expectorant, astringent, antiseptic, styptic, escharotic, an- 
aesthetic and narcotic. Its action is practically the same as that of Car- 
bolic Acid (see ante, page 61), especially upon the heart, respiration and 
nervous system, but differs from that of the latter in not causing convul- 
sions, and in increasing the coagulability of the blood. It is eliminated 
by the kidneys and bronchial mucous membrane, which it stimulates, 
being quite a good expectorant. In small doses it seems to have a selec- 
tive sedative influence on the terminal nerve-filaments in the gastric 
mucous membrane. In large doses it is a powerful poison, resembling 
Carbolic Acid in its symptoms, except that its nervous effects are even 
more marked. It explodes when combined with Oxide of Silver in pill, 
unless previously diluted with an inert powder. 

Being a very complex substance of varying composition Creasote as a 
therapeutic agent has been almost entirely supplanted by Carbolic Acid. 
It is used internally with success in reflex nausea and vomiting, as from 
sea-sickness, pregnancy, cholera, etc., also as an aseptic and expectorant 
in chronic basilar cavity, in which it seems to have greater efficacy than 
any other remedy. As an astringent it has been employed in intestinal 
hemorrhage, gonorrhoea and gleet, and generally in the same affections as 
Carbolic Acid. Externally it is a good application in eczema, pruritus, 



CREOLIN CROCUS CUBEBA. I97 

ulcers and scaly skin diseases, and it effectually relieves the pain of an 
exposed dental nerve if applied thereto. It is a good agent by inhalation 
in chronic bronchitis and gangrene of the lung, and it has lately been 
administered internally in phthisis with decided benefit. 

CREOLIN (Unofficial), — is a coal-tar product of uncertain compo- 
sition, occurring as a semi-fluid, black substance, of the consistence of 
honey. It forms a white cloud when added to water, with which, how- 
ever, it is miscible, as an emulsion, up to about 10 or 12 per cent, 
strength. The Solutions in general use vary from y^ to 2 per cent. ; the 
Ointments to 5 per cent., and Creolin Gauze is prepared of 10 per cent, 
strength of the drug. 

Creolin was highly vaunted, by Professor v. Esmarch and other authorities, as the 
ideal antiseptic for external use, being possessed of great germicidal power, and a most 
efficient deodorant and disinfectant, while its absorption caused no toxic results whatever. 
Experience has justified these claims in the main, but the drug has, however, given rise 
to serious symptoms, when used to excess. As a vaginal wash, in puerperal cases, the 2 
per cent, solution is reported as fully equal to sublimate solutions, while better as a de- 
odorant, and free from danger by absorption. The weaker solutions have given satis- 
faction as local applications in the treatment of otorrhcea, nasal ulcers, rhinitis (1 to 1000), 
blepharitis, keratitis, etc. ; and in female cystitis a I per cent, solution as a vesical wash, 
gradually increased to 2 per cent, is highly praised by Parvin. The Ointments and 
Gauze are used for wounds and other solutions of continuity, in the same manner as car- 
bolized preparations, and with better satisfaction, Creolin being less volatile than Carbolic 
Acid, and of a more agreeable, though powerful, odor. 

CROCUS, Saffron, — the stigmas of Crocus sativus, a plant of the 
nat. ord. Iridacese, cultivated in Europe, containing a volatile oil and 
coloring matter. Occurs as separate stigmas or three attached to the style, 
of orange-brown color, peculiar, aromatic odor, and bitter taste. So- 
called American Saffron is not Crocus but the flowers of Carthamus tinc- 
torius. True Saffron is expensive, as it requires about 60,000 flowers to 
furnish' one pound of the stigmas. Dose, gr. v-xx, in infusion. 

Tinctura Croci, — 10 per cent. Dose, ^j-ij. 

Saffron Tea, so much used in domestic practice, is an infusion of Carthamus tinc- 
torius, or Safflower. 

Crocus is a stimulant aromatic, having some antispasmodic and anodyne 
qualities. The hot infusion produces diaphoresis, probably by virtue of 
the hot water alone. It is said to have caused death with narcotic symp- 
toms. On the continent of Europe it is employed as a stimulant and 
emmenagogue, but in this country its only use is as a coloring agent. 
The miscalled Saffron Tea noted above is used in domestic practice for 
measles and other exanthemata. 



CUBEBA, Cubeb, — is the unripe fruit of Cubeba officinalis, a plant 
of the nat. ord. Piperaceae, cultivated in Java. Occurs as a blackish-gray, 
wrinkled, globular body, about the size and shape of black pepper, of 



I98 CUPRUM. 

strong, spicy odor, and aromatic, pungent taste. Contains a Volatile Oil, 
which is official, an acrid resin composed in part of Cubebic Acid, also a 
fatty oil, gum, and Cubebin, which is an insoluble, neutral, odorless and 
tasteless body. The volatile oil may be separated into Cubebene a cam- 
phor, and Cubeben a liquid portion. The active principles are the volatile 
oil and the cubebic acid, both of which are contained in the oleoresin. 
Cubeb should be kept whole and not pulverized until wanted for use. 
Dose of the powdered drug, gr. x-^ij. 

Extractum Cubebce Fluidum, — Alcoholic. Dose, ff^v-xxx. 

Tinctura Cubebce, — 10 per cent. Dose, rr^x-^iij. 

Oleoresina Cubebce, — extracted by ether. Dose, TT^v-xxx. 

Trochisci Cubebce, — each contains of the Oleoresin gr. ^, Oil of Sassafras gr. 0.15, 
Extract of Glycyrrhiza gr. iv, Acacia gr. ij, and Syrup of Tolu q. s. to form a mass. 
Dose, j-iij. 

Oleum Cubebce, C 15 H 24 , — is the volatile oil, a colorless or pale greenish-yellow liquid, 
of sp. gr. 0.920, warm, aromatic taste, odor of cubeb and a neutral reaction. Is soluble 
in an equal weight of alcohol. Dose, TT\,v-xx. 

Cubeb belongs to the pepper family, and like black pepper is an 
aromatic stomachic and a stimulant diuretic in small or medium doses, 
but large doses derange digestion and may act as a gastro-intestinal irri- 
tant. Its constituents are eliminated by the bronchial mucous membrane, 
the skin and the kidneys, stimulating and disinfecting the genito-urinary 
passages, increasing the bronchial mucus, sweat and urine, and frequently 
causing an urticarial or vesicular eruption. It increases the action of the 
heart and of the vascular system, stimulates the venereal appetite, and 
promotes the menstrual discharge. 

Cubeb is particularly useful in affections of the bladder and urethra. 
It is used in the acute stage of gonorrhoea, chronic cystitis, prostator- 
rhcea and chronic bronchitis with excellent results. The powder is a 
good application in hay-fever, chronic nasal catarrh and follicular pharyn- 
gitis, blown on to the mucous membrane by an insufflator. It may also 
be smoked in cigarettes with temporary relief in cases of acute nasal 
catarrh with "stuffed" nasal passages. In some subjects the continued 
, use of cubeb produces nausea, hemorrhoids, hematuria and severe head- 
ache. The troches are a useful preparation in chronic irritability of the 
fauces, pharynx and air-passages, and are much employed by singers and 
public speakers for their tonic effect on these parts and for the relief or 
prevention of hoarseness. 



CUPRUM, Copper, Cu, — is not official, but two of its salts are, 
namely the Acetate and the Sulphate. The metal itself is inert, but in 
combination it is actively poisonous. Copper has been found in the 
normal human blood in very minute quantity. 



CUPRUM. I99 

Satis and Preparations of Copper. 

Cupri Acetas, Acetate of Copper, Cu(C 2 H 3 2 ) 2 .H 2 0, — forms green, prismatic crys- 
tals, efflorescent, of nauseous, metallic taste and acid reaction, soluble in 15 of water and 
135 of alcohol at 59 F. Its aqueous solution is of a blue color. JDose, gr. jq-% . 

Cupri Sulphas, Sulphate of Copper, CuS0 4 .5H 2 0, — blue, translucent crystals, efflor- 
escent, of nauseous, metallic taste and acid reaction, very soluble in water, insoluble in 
alcohol. Its solution is blue by transmitted light, green by reflected light. Dose, as an 
emetic, gr. ij-v, every 10 or 15 minutes, — as a tonic, gr. Ye-Yz- 

Solution of Potassio-Cupric Tartrate, Fehling's Solution (Unofficial), used as a reagent 
for glucose, may be made as follows, — Dissolve 70 grains of Sulphate of Copper in 400 
minims of Distilled Water. Also Dissolve 488 grains of Rochelle Salt (Pot. et Sodii Tart), 
in 1600 minims Solution of Soda (Liq. Sodae), sp. gr. 1. 12. When required for use pour 
the copper solution into the other, and add distilled water to make 2720 minims ( ^ $%.) 

Cuprum Ani7noniatum, Ammoniated Copper (Unofficial), — is made by triturating 3 
parts of Ammonium Carbonate with 4 of Cupric Sulphate until effervescence has ceased, 
then drying. A deep azure blue powder, of ammoniacal odor, a styptic, metallic taste, 
and alkaline reaction, soluble in water. Dose, gr. l /e>-]. 

Cupri Arsenis, Arsenite of Copper, See ante, page 119. 

Physiological Action. 

The salts of Copper are gastro-intestinal irritants, producing a metallic 
taste, nausea with greenish vomited matter, purging of blood and mucus, 
constricted fauces, depressed heart action, hurried respiration and fever. 
Or, as with Arsenic, gastro-enteritis may not occur, but instead profound 
nervous symptoms, as headache, defective coordination, coma and con- 
vulsions. The symptoms of chronic poisoning are bronchial irritation 
and catarrh, gastro-intestinal catarrh, colic with diarrhoea [Lead produces 
colic with constipation], dysentery, nausea, emaciation, anaemia, saliva- 
tion, and a green line (sulphide) along the margin of the gums in those 
who do not clean their teeth. The nervous symptoms above mentioned 
are also usually well marked. The liver becomes atrophied from irrita- 
tion of its connective tissue and fatty degeneration of the hepatic cells. 
The lungs are congested, even pneumonic consolidation may be set up, 
the metal seeming to have affinity for the parenchyma of these organs. 
These effects are often produced by the inhalation of cuprous fumes, and 
by eating acid fruits cooked in a copper vessel. 

Sulphate of Copper is a simple, irritant emetic, producing prompt 
and continued vomiting with but little nausea or depression. In small 
doses it is a nerve-tonic and astringent to the gastro-intestinal tract. 
Externally applied in solution it is a useful stimulant and astringent to 
diseased mucous surfaces, and is mildly caustic if used in substance. The 
Acetate is possessed of the same general action as above described. Its 
local action is stimulant and escharotic. The impure acetate (verdigris) 
is a violent irritant poison. Ammoniated Copper has no special action 
other than above noted. 

Antagonists and Antidotes. 

Ferro-cyanide of Potassium is the antidote to Copper salts, but albumen or magnesia 
may'be used. Any chemical antidote should be followed by prompt evacuation of the 
stomach, then Opium and demulcents for gastro-enteritis, and Potassium Iodide even to 
saturation of the system. Alkalies and their carbonates, lime water, iodides, mineral 
salts except the sulphates, are all incompatible. 



200 . CURARE. 

Therapeutics. 

The Sulphate is a prompt and efficient emetic, and is so used in croup 
and narcotic poisoning. In phosphorus poisoning it forms a comparatively 
insoluble phosphide of copper besides producing emesis. Fifteen or 
twenty grains may be dissolved in giv of water, and a teaspoonful or 
more, according to age, given every ten minutes until vomiting is pro- 
duced. In acute diarrhoea and chronic dysentery it is the best metallic 
astringent in doses of gr. -^ to ■£% with Opium, and in gastro-intestinal 
catarrh it is equally efficient. Locally, it is used with benefit in throat 
affections, gonorrhoea, granular lids and corneal ulcers, indolent granula- 
tions and chronic inflammations of mucous membranes. In most of these 
affections weak solutions (gr. yi to ^ to the ^) are best, but in granular 
conjunctivitis the smooth crystal may be rubbed quickly over the surface 
once daily. 

In various nervous diseases, as epilepsy, chorea, hysteria, etc., the salts 
of copper are sometimes beneficial, the Ammoniated Copper being con T 
sidered the most efficient preparation in these cases. In Germany a tinc- 
ture of the Acetate was official and has been used successfully in the 
treatment of pneumonia. Ammoniated Copper has lately been highly 
recommended for facial neuralgia, but requires pushing to the production 
of some physiological action. 

Ointments or lotions of the Acetate are useful applications in eczema, 
herpes, tinea sycosis, mentagra and herpes circinatus. 

Filiate' s Solution has been successfully used as a local injection for the 
cure of caries. It is composed of Sulphate of Copper, Sulphate of Zinc 
of each 15 parts, Liquor Plumbi Subacetatis 30, Vinegar 200. The solu- 
tion is thoroughly injected into the sinuses leading to the carious bone. 

CURARE, Woorara (Unofficial), is a vegetable extract obtained 
from various members of the Strychnos family and from Paulinia curare 
and other plants.' It is used in S. America as an arrow-poison under 
various names, as Caroval, Vao, etc. Its active principle is the crystal- 
lizable alkaloid Curai'ine, which contains no oxygen. 

The dose of Curare is gr. -£§-\ hypodermically,— of Curarine, gr. g^oT^o hypoder- 
mically, or gr. T ^o~?o by the stomach, but as the samples vary greatly in activity they 
should first be tried on some inferior animal before being administered to man. 

Physiological Action. 
Curare is a paralyzer of the voluntary muscles, affecting them through 
the end-organs of the motor nerves. It does not at first act upon the 
brain or spinal cord, but if life be prolonged by artificial respiration the 
cord, sensory nerves and even the muscular tissue all become affected. 
The heart, at first quickened, becomes depressed, and the blood-pressure 



CYDONIUM. 20 1 

is lowered, the eyelids droop, the eye-balls protrude, vision is disordered, 
intestinal peristalsis and sensibility to stimuli are greatly increased, and 
an artificial glycosuria (curare-diabetes) is set up. The limbs are paralyzed 
first, death occurring by paralysis of respiration. The absorption of the 
drug by the stomach is very slow, as its active principle passes with diffi- 
culty through animal membranes, and its elimination, which takes place 
by the kidneys, being more rapid and complete than that of any other 
agent, no marked effect may be produced when administered internally. 
When hypodermically injected its action is very prompt. The urine of a 
curarized animal will poison another, and that of the second will paralyze 
a third. 

As compared with other motor depressants Curarine and Coniine para- 
lyze the end-organs of the motor nerves, Gelsemine and Methyl-coniine 
paralyze the motor centres. 

Antagonists and Incompaiibles. 

Strychnine^ though from a member of the same family, is antagonistic as to the action 
on the heart and respiration. So also is Atropine. Artificial respiration is the most 
efficient antagonist, maintaining life until elimination occurs. Evacuation of the bladder 
repeatedly is important to prevent reabsorption. The caustic alkalies destroy Curarine as 
they do all other alkaloids. 

Therapeutics. 

Curare is chiefly used for experimental purposes on the lower animals. 
It has an historical interest from its having been the means by which Ber- 
nard demonstrated the existence of muscular contractility as an essential 
endowment of that tissue. It has been used with some success in spas- 
modic nervous affections, particularly in tetanus, both idiopathic and 
traumatic, in hydrophobia, chorea and epilepsy. It does not promise 
well as a therapeutic agent, but two undoubted cases of hydrophobia are 
reported by high authority as cured by this drug. 



CYDONIUM, Quince Seed, — is the seed of Cydonia vulgaris, a 
tree of the nat. ord. Rosacese, native in Crete and Austria, and cultivated 
elsewhere. The seeds are about ^ inch long, triangularly compressed, 
covered with a whitish epithelium, and in water they swell up forming a 
mucilaginous mass. The mucilage is the only constituent of importance 
and is contained in the epithelial cells. It has been named Cydonin, and 
considered to be a compound of gum and cellulose. 

Preparation. 

Mucilago Cydonii, — prepared by macerating 2 parts of Cydonium in 1 00 of Distilled 
Water. Dose, indefinite. 



202 CYPRIPEDIUM DAMIANA. 

Physiological Action and Therapeutics. 
Cydonium is of value for its mucilage, which is used as a- bland, de- 
mulcent application in conjunctivitis, abrasions of the skin, fissures of the 
mucous membranes, and as a vehicle for injections in gonorrhoea. In- 
ternally it may be used as a soothing remedy for the throat, stomach, or 
intestines. The preparation known as Bandoline, used as a hair-dressing, 
is identical with the mucilage of Cydonium. 

CYPRIPEDIUM, Ladies' Slipper,— is the rhizome and rootlets 
of Cypripedium pubescens, and of C. parviflorum, the Moccasin-plant, or 
American Valerian (nat. ord. Orchidaceae). Is dark or orange-brown in 
color, of strong, heavy odor, and bitter, pungent taste. It contains a 
volatile oil, a volatile acid, resins and tannin. 

Preparations. 

Extractum Cypripedii Eluidum, — Dose, TTVx-xxx. 

Cypripedin (Unofficial), — is an impure alcoholic extract. Dose, gr. ss-iij. 

Physiological Action and Therapeutics. 

Cypripedium is antispasmodic, tonic, stimulant and diaphoretic, pos- 
sessing the same general properties as Valerian, whence one of its common 
names. 

It is a popular remedy in some parts of the U. S. for nervous hyper- 
aesthesia unaccompanied by organic lesion, especially morbid sensibility 
of the eye. It is reported to have even cured epilepsy, and to be highly 
useful in neuralgia, hysteria, nervous headache and insomnia. 

DAMIANA (Unofficial), — the leaves of Turnera aphrodisiaca, a 
plant of the nat. ord. Turneraceae, growing in Mexico and Lower Cali- 
fornia. Several varieties of so-called Damiana are in the market, but the 
true leaf is of a light-green color, small, lanceolate, and dentate along the 
margin. It contains a volatile oil and a resin. Dose, §j daily. 

Preparations. 

Extractum Damiana (Unofficial), — Dose, gr. ij-x. 
Extractuffi Damiance Fluidum (Unofficial),— Dose, tiLx-^j. 

Physiological Action and Therapeutics. 

Damiana is said to be a powerful aphrodisiac in cases of sexual atony, 
but the published reports of its use since its introduction vary greatly as 
to its efficacy. It is probably a stimulant diuretic, a bitter tonic, and a 
purgative in sufficient doses. 

Besides its use as an aphrodisiac Damiana has been administered with 
benefit in some forms of cerebral exhaustion and general atony of the 



DATURA TATULA DIGITALIS. 203 

nervous system, also in sick headaches and in some few cases of paralysis. 
It forms the chief stock in trade of the numerous charlatans who fill the 
daily papers with advertisements of " manhood-restorers." 

DATURA TATULA (Unofficial),— is an indigenous plant of the 
nat. ord. Solanaceae, resembling Stramonium very closely, with which it 
generally agrees in its physiological action and therapeutics. It is distin- 
guished by its purple stem, purple flowers and anthers, and the darker 
green of its leaves. It probably contains the alkaloid Daturine (see 
Stramonium), — and has been smoked in asthma, in a few cases giving 
continued relief when Stramonium had failed to render any service. 

DIGITALIS, Fox-glove, — Digitalis consists of the leaves, col- 
lected from plants of the second year's growth, of Digitalis purpurea, 
the Purple Foxglove, a plant of the nat. ord. Scrophulariaceae, which 
grows wild in Europe, and is cultivated in this country, often in private 
gardens for its beautiful spike of purple flowers, and largely by the Shakers 
for the drug market. 

The British Phar. directs that the official drug shall consist of " the dried leaf, collected 
from the wild, indigenous plant, when about two-thirds of the flowers are expanded." 
Much of the leaf found in our shops is of very poor quality, a large proportion being 
inert; but whether this is due to our Phar. not restricting the official drug to the wild 
plant, or to careless treatment in gathering and drying, is not definitely known. When, 
however, the leaves are imperfectly dried, a process of decomposition sets in, which 
destroys the active principles, and may produce new and poisonous ones. A similar 
decomposition is said to occur whenever the tincture of Digitalis is mixed with watery 
or syrupy solutions. Certain it is, at any rate, that Digitalis is one of the most unreliable 
drugs, in respect to the physiological activity of any particular sample or preparation. 
The seeds are known to contain the active principle in much greater proportion than the 
leaves, but they are never used. 

The active principle of Digitalis has been designated by the term Digi- 
talin (Digitalinum), under which name a substance was official in the 
U. S. and Br. Phar. and a process was given therein for its extraction, until 
their last revision, when it was struck from both lists. It was an amor- 
phous product, of complex composition, and did not represent Digitalis. 

In 187 1 Nativelle received the Orfila prize from the French Academy for the discovery 
of a crystalline principle in Digitalis, which he named Digitaline. This was supposed 
to be the active principle of the plant, until Roucher, (1872) and Schmiedeberg, (1875) 
found it to be a complex body, consisting of a mixture of Digitoxin and Digitalin. 
Schmiedeberg's latest analysis is now accepted as the mo>t accurate determination yet 
obtained of this vexed question. He enumerates five principles at least as contained in 
Digitalis, viz.: — (1) Digitalin, amorphous, insoluble in water, but readily soluble in 
alcohol; the active ingredient of Homolle's French Digitaline and the Digitalin of the 
U. S. and Br. Pharmacopoeias; — (2) Digitoxin, insoluble in water and sparingly soluble 
in alcohol ; the most active of all, and the principal constituent of Nativelle's prize Digi- 
taline ; — (3) Digitaleln, soluble in both water and alcohol ; — (4) Digitonin, readily soluble 
in water, sparingly so in alcohol ;- active, but acts like Saponin, forming a solution which 
froths easily and antagonizes the other three; — (5) Digitin, which seems to be entirely 



204 DIGITALIS. 

inert. The first three are cardiac poisons, the fourth antagonizes them ; and all five are 
non-nitrogenous, and except Digitoxin, are glucosides. 

Preparations. 

These vary greatly in results, by reason of the different solubilities and actions of the 
active principles. 

Digitalis, Folia Digitalis, Digitalis Leaves. Dose, gr. ss-iij. 

Abstractum Digitalis, Abstract of Digitalis. Dose, gr. }(-\). 

Extractum Digitalis, Extract of Digitalis, — Al. 2, Aq. I. Dose, l /e-yz- 

Extr. Digitalis Fluidum, Fl. Ext. of Digitalis, — Al. 3, Aq. I. Dose, TT\j-iij. 

Tinctura Digitalis, Tincture of Digitalis, — 15 per cent. Dose, rr\,v-gj. 

Infusum Digitalis, Infusion of Digitalis, — 1^ percent. Dose, ^ss-j. Is flavored 
with Cinnamon, and has 7 *^ per cent, of Alcohol. 

Digitalinum, Digitalin, — the complex product of the process in the U. S. and Br. 
Phar., but no longer official. Dose, gr. ■^q—^-q. 

Note on the Preparations. — Of the above, the Tincture and Fluid Extract, being 
alcoholic preparations, contain a large proportion of Digitalin and Digitalein, with a small 
proportion of Digitonin; the Digitoxin going to the bottom as an insoluble precipitate. 
The Infusion contains a larger proportion of Digitonin than of the others, some Digita- 
lein, and little or no Digitoxin or Digitalin. It is the best for diuretic action, the Tinc- 
ture for acting upon the heart; but to obtain the action of the plant itself, the powdered 
leaves must be used in pill or capsule. 

Physiological Action. 

Digitalis is a cardiac tonic and a vascular stimulant, an excito-motor, 
also emetic, diuretic, hemostatic, anaphrodisiac, and paralyzant. In 
over-doses it irritates the mucous membranes, causing sneezing, severe 
gastric disturbances, nausea, vomiting, colic and purging, the discharges 
being of a grass-green color. It lowers temperature, probably by lessen- 
ing the blood-supply to the tissues, produces headache, irregularity of the 
heart's action, vertigo and an appearance of vibratory fringes of color 
around objects. 

The Heart is slowed by Digitalis, but its force is at the same time 
increased. The drug stimulates the cardiac motor ganglia, the inhibitory 
apparatus, and the vaso-motor centres, contracting the arterioles ; and 
thereby greatly raising the arterial tension. Full doses continued exhaust 
the irritability of the motor ganglia and paralyze the cardiac muscle itself. 
The recumbent posture must be maintained when Digitalis is given for its 
full cardiac effects. Its general effect on striped muscular tissue is to 
lessen the contractile power, causing great weakness and languor. Under 
it, the excretion of urea is at first increased, but soon decidedly dimin- 
ished. It lessens the sexualappetite and impairs the venereal function. 

It has been conclusively shown that in many cases of pneumonia 
Digitalis failed to influence the pulse, the result probably of the partial 
paralyzant influence of high body temperature upon the vagus centre 
and endings in the heart, thus weakening the inhibitory apparatus to such 
a degree that the drug awakens no responsive increase of inhibition. In 
cases with but moderately high pyrexia the characteristic action of the 
drug is not interfered with. 

The Diuretic Action of Digitalis is due to its peculiar influence upon 



DIGITALIS. 205 

the general and renal circulation, it increasing the force of the ventricu- 
lar contractions, while at the same time one of its constituents, Digitalin, 
contracts the blood-vessels of the body, and two others, Digitoxin and 
Digitalein, dilate the renal arteries. The effect of this combined action is 
to greatly raise the arterial tension and the blood-pressure in the glomeruli, 
their afferent vessels being contracted ; — while the rapidity of the renal 
circulation is increased and its volume augmented by the greater force of 
the heart-beat and the dilatation of the afferent vessels. No other drug 
known has this double power, and therefore, so far as vascular action is 
concerned, Digitalis is the ideal diuretic. Still, while its power to pro- 
duce diuresis in cardiac disease is unquestioned, most observers deny that 
it has any such power in health. 

Lethal Doses lessen the reflexes by stimulation of Setschenow's centre, 
and paralyze the muscles and the peripheral nerves, motor and sensory. 
Respiration, at first slowed, becomes rapid and feeble; cyanosis, coma 
and convulsions follow, and death by sudden paralysis of the heart, 
which is arrested in systole. 

Compared with Aconite, both it and Digitalis slow the heart, but 
otherwise their actions are antagonistic. Aconite at first stimulates and soon 
relaxes inhibition and depresses the cardiac motor ganglia, — Digitalis in- 
creases inhibition and stimulates the motor apparatus. Both drugs finally 
paralyze the cardiac ganglia, Aconite by direct depression, Digitalis by 
over-stimulation. Both depress the cardiac muscle. Under Aconite the 
heart is arrested in diastole, under Digitalis in systole. The arterial ten- 
sion is lowered by Aconite, raised by Digitalis. Aconite acts quickly, 
Digitalis very slowly, — a fact which makes the latter drug of little value 
in poisoning by the former. 

During the use of this drug for any length of time the motor apparatus 
of the heart is so nearly paralyzed by over-stimulation that on suddenly 
assuming the erect position the cardiac energy may fail, more especially 
if the doses are administered too closely together to admit of the elimi- 
nation of one before the ingestion of the next. This is the explanation 
of the so-called cumulative action of Digitalis, which is not now generally 
recognized in the sense in which the term was formerly applied. Another 
explanation is that it may stop its own excretion, by arresting the renal 
circulation and the secretion of urine through extreme contraction of the 
renal vessels, and thus may really accumulate in the blood. 

Antidotes, Antagonists and Incompatibles. 

Tannic Acid is the chemical antidote, but as the tannate is not inert the stomach 
should be evacuated. Aconite is the best antagonist to the effects of large doses, Opium 
to those of its long- continued use. Saponin and Senegin are considered to be its most 
complete physiological antagonists. Incompatibles are Cinchona, Sulphate of Iron, Tinc- 
ture of the Chloride of Iron, and Acetate of Lead, also syrupy and watery solutions 
which may decompose the active principles of the plant. 



206 digitalis. 

Therapeutics of Digitalis. 

The chief use of Digitalis in disease is based on its property as a heart 
tonic. Its great sphere is in mitral disease, when the heart is rapid and 
feeble, it moderating pulmonary hyperemia and engorgement by giving 
the auricle time to empty itself through the obstructed orifice. In aortic 
disease it gives relief when the compensatory hypertrophy has not set in, 
otherwise it is contraindicated. It is particularly useful in dilatation of 
the right side of the heart with incompetence of. the tricuspid. The 
rational symptoms which indicate its use are — rapid and feeble cardiac 
action, low arterial tension, cough, dyspnoea, pulsating jugulars, a dusky 
face, scanty and high-colored urine and general dropsy. In the irritable 
heart of soldiers Digitalis is frequently curative, and palpitation, cardiac 
failure, and venous engorgement are well treated by it. It should not be 
used in simple hypertrophy when compensatory, aortic stenosis with com- 
pensatory hypertrophy, pericarditis or fatty heart, except temporarily for 
some special indication. It is a useful remedy in dropsy, both cardiac 
and renal, in the first stage of pneumonia and other inflammations, in the 
early stage of scarlet fever and when the kidneys strike work in that 
disease, in exophthalmic goitre, congestive headaches, and hemicrania, in 
mania, delirium tremens and other congestive conditions of the brain. 

Its contractile power over the arteries may so predominate as to arrest 
the renal circulation completely, and stop the secretion of urine (Brun- 
ton.) On this account it is well to administer at the same time an agent 
which causes dilatation of the renal vessels, as Sodium Nitrite. As a 
hemostatic it may be used in hemorrhage from a large surface, in the 
hemorrhagic diathesis, hemoptysis, and menorrhagia. As an antipyretic 
it has been much used in fevers, but a reaction is setting in against this 
employment of so powerful a heart-depressant. In rheumatic fever it 
lowers the temperature, shortens the duration of the disease, and is par- 
ticularly indicated for any cardiac complications. In spermatorrhoea of 
the plethoric it may be well combined with Potassium Bromide, and when 
this affection is complicated with an atonic condition, shown by feeble 
erections, frequent emissions and cold feet and hands, it is a serviceable 
anaphrodisiac. Finally, Digitalis is said by high authority to be particularly 
adapted to blondes and persons of sanguine and indolent temperament. 

When the cardiac action of Digitalis is desired, the tincture should be 
employed, given on sugar or bread, prohibiting the ingestion of any 
aqueous fluid within 20 minutes either before or after swallowing it. If 
the diuretic action is required, the proper preparation is the infusion, 
which contains a much larger proportion of Digitonin than of the other 
principles. This agent, acting upon the renal apparatus and antagonizing 
the action of the other three, is freely soluble in water, but sparingly so in 
alcohol. On the other hand, Digitalin, to which the cardiac action of 



DIOSCOREA DITA BARK DROSERA DUBOISIA. 207 

the drug is chiefly due, is almost insoluble in water, but readily soluble 
in alcohol. 



DIOSCOREA, Wild Yam, Colic-root (Unofficial),— is the rhi- 
zome of Dioscorea villosa, a creeping plant of the nat. ord. Dioscoracese, 
indigenous to the eastern U. S. It contains an acrid resin, and is re- 
ported to be expectorant and diaphoretic in action, as well as stimulating 
to the intestinal canal, and in large doses to cause general neuralgic pains 
with erotic excitement. It is used with great success in bilious colic; 
and in the cramps of cholera morbus, spasmodic hiccough, dysmenorrhcea 
and nocturnal emissions of sthenic type it is said to be very efficient. A 
powdered extract named Dioscorein is on the market, of which the dose 
is gr. j-iv. A fluid extract made according to the pharmacopceial rule 
may be administered in doses of rr^xv-xxx. 



DITA BARK (Unofficial), — is the bark of Alstonia scholaris, a tree 
of the nat. ord. Apocynaceae, growing in the Philippine Islands. It con- 
tains two active alkaloids, Ditaine and Ditamine, the former of which 
has an action identical with that of Curare. The bark is cdnsidered tonic 
and antiperiodic, and is used in the East as a remedy for intermittents. 
It may be given in doses of 3J-iv, in powder or as fluid extract. 



DROSERA, Sundew (Unofficial),— A fluid extract of Drosera 
rotundifolia, the round-leaved Sundew, is said to have been successfully 
used in phthisis pulmonalis. It is certainly a most useful agent in whoop- 
ing-cough and other spasmodic coughs ; especially when marked by vio- 
lent paroxysms, the cough being loud and harsh, and followed by bleed- 
ing from the nose or mouth, and perhaps by vomiting of the contents of 
the stomach. The expressed juice has been applied to warts and corns, 
for the purpose of curing them. Dose of the fluid extract, n^v-xx. 



DUBOISIA' (Unofficial), — is the leaf of Duboisia myoporoides, an 
Australian tree of the order Solanaceae. It contains a poisonous alka- 
loid, Duboisine, which is believed to be identical with Hyoscyamine, 
and strongly resembles Atropine. 

Preparations. 

Extractum Duboisice (Unofficial), — Dose, gr. J/^-X- 

Tinctura Duboisice (Unofficial), — Dose, rt^v-xx. 

Duboisince Sulphas (Langenberg's), Unofficial, — Dose, gr. Ybo~~io' 



208 DULCAMARA. 

Physiological Action. 
The actions of Duboisia are in all respects similar to those of its con- 
gener, Belladonna, except that Duboisine is more soluble in water than 
Atropine, is less irritating to mucous membranes, and more prompt in 
mydriatic action, but its effects are of shorter duration. It is also less of 
a cerebral excitant and more of a calmative and hypnotic. On man its 
action is said by some authorities to be more powerful than that of Atro- 
pine, but less powerful on frogs. 

Antagonists and Incompatibles. 
These are the same as for Belladonna, for which see ante, p. 130. 

Therapeutics. 
Duboisine has not been much used except by ophthalmologists who 
employ it as a mild mydriatic. Its advantages over Atropine in ocular 
therapeutics are its more rapid action in paralyzing accommodation and 
effecting mydriasis, the shorter duration of its effects and its slight irrita- 
tion of the conjunctiva. It has been well employed in puerperal mania, 
and may be used in place of Atropine in many conditions, especially the 
night-sweats of phthisis, respiratory neuroses and cardiac failure. It is an 
efficient antagonist to Morphine. 



DULCAMARA, Bittersweet, — the young branches of Solatium 
Dulcamara, or Woody Night-shade, a shrub of the nat. ord. Solanaceae, 
growing in Europe and N. America. Occurs in. short sections ^ inch 
thick, covered with a pale green bark, of slight odor, and taste at first 
bitter, afterwards sweet. It contains the glucoside Dulcamarin, a pecu- 
liar principle named Picroglycion, and the alkaloid Solanine, which exists 
in the stems of other species of Solanum, viz. — S. tuberosum (potato), S. 
Lycopersicum (tomato), and S. nigrum (black nightshade). Solanine is 
of bitter taste, alkaline reaction, crystalline in minute prisms soluble in 
125 of boiling alcohol but very insoluble in water. It is a narcotic 
poison, but exists in very small quantity in the plant. 

Preparations. 

Extr actum Dulcamara Fluidum, — Dose, ^j. 

Decoctum Dulcamarce (Unofficial), — may be made of the official 10 per cent, strength 
and given in doses of ^ j-ij. 

Physiological Action. 
Dulcamara is but imperfectly understood. In overdoses it has pro- 
duced nausea and vomiting, vertigo, convulsive muscular movements, 
pruritus and erythematous eruptions on the skin, languid circulation with 
a dusky color of the face and hands. In children who have eaten the 



ELATERINUM. 2C>9 

berries there have been observed signs of severe enteralgia, abdominal 
tenderness, nausea, thirst, heat in the throat and chest, great prostration, 
rapid pulse, quick and painful respiration. In very large doses it is a 
narcotic poison, causing paralysis by depression of the central nervous 
system, with lowered activity of the heart and respiration. It is believed 
by some authorities to be anaphrodisiac, diaphoretic and diuretic. 

Therapeutics. 
Dulcamara was formerly used in a variety of affections, as herpetic 
diseases, chronic rheumatism, gout, jaundice, etc. It is now chiefly 
employed in obstinate scaly skin diseases, as psoriasis and pityriasis, in 
which it is unquestionably serviceable. It is also serviceable in the diar- 
rhoea of children when produced by exposure to cold and damp, in 
mania with strong venereal propensities, chronic bronchitis and whooping- 
cough. As a diaphoretic it has been used with benefit in rheumatic and 
venereal disorders, and is often beneficial in nasal, pulmonary and vesical 
catarrhs. It is said to be particularly useful in affections of a rheumatic 
or catarrhal nature when caused by exposure to damp weather. 



ELATERINUM, Elaterin, C 20 H 28 O 5 ,— is a neutral principle ex- 
tracted from Elaterium, a substance deposited by the juice of the fruit of 
Ecballium Elaterium, or Squirting Cucumber, a cultivated European 
plant of the nat. ord. Cucurbitaceae. Elaterium is no longer official by 
reason of its variable quality. Elaterin occurs in small, colorless scales 
or prisms, of bitter taste and neutral reaction, insoluble in water, soluble 
in 125 of alcohol and in solutions of the alkalies. Dose, gr. g^ - ^ * 

Preparation. 

Trituratio Elaterini, — Elaterin 10, Sugar of Milk 90 parts, thoroughly mixed by 
trituration. Dose, gr. ss-j. 

Physiological Action and Therapeutics. 

Elaterin is the most powerful of the hydragogue cathartics, causing 
profuse, watery stools, and when given in large doses great prostration 
and gastro-intestinal irritation, nausea and vomiting. On the lower ani- 
mals it does not produce purgation, but profoundly impresses the nervous 
system, causing irregular breathing, convulsions and death. 

Its chief use is to produce free watery discharges in ascites, anasarca, 
uraemia and cerebral disorders, but while the most efficient agent we 
possess for this purpose it must be used with great caution in the aged and 
feeble, as it is very depressant. 



2IO ERGOTA. 

ERGOTA, Ergot, Ergot of Rye, — is the sclerotium (compact 
mycelium or spawn, intermediate fibrous stage) of Claviceps purpurea 
(nat. ord. Fungi), growing within the flower and replacing the grain of 
Secale cereale, Rye (nat. ord. Graminacese). It occurs in fusiform, 
curved, grain-like bodies, about an inch long, three-furrowed, obtuse at 
the ends, of purplish-black color, peculiar and heavy odor, and oily, dis- 
agreeable taste. It should be preserved in a dry place, and should not 
be kept longer than a year. Dose, gr.. x-3j. 

Composition of Ergot. 
The composition of Ergot and the nomenclature of its supposed con- 
stituents is a subject upon which there exists a great diversity of opinion, 
and about which there is nothing settled. The following synopsis gives 
the views of the different persons who have examined into the matter. 

Wenzell (1864) named two alkaloids, Ecboline and Ergotine, which he claimed to be 
the active principles, and to be combined with Ergotic Acid, a volatile body yielding 
crystallizable salts. He also claimed the presence of Trimethylamine as a Phosphate. 

Tanret (1877) isolated a crystallized alkaloid, which he named Ergotinine, 
C 35 H 40 N 4 O 6 (dose, gr. gV'To)' a ^ so a volatile camphoraceous substance. 

Dragendorff and his pupils (1 875-1 879) stated the active principles to be two in 
number, Sclerotinic Acid, a very powerful body, yellow-brown, amorphous, tasteless and 
well adapted for hypodermic use in doses of gr. 2V~tV ano - Scieromucin, a colloid sub- 
stance, also quite active. Besides these they held that Ergot contained various coloring 
matters (Sclererythrin, Scleroxanthin, etc.), also a non-drying Oil, a peculiar sugar 
(Mykose), a number of alkaloids (Trimethylamine, etc.), and other principles, all inert. 

Kobert (1885) announces that Ergot contains three active principles, viz., Ergotinic 
Acid, the chief constituent of Sclerotinic Acid, having no ecbolic action, but affecting the 
nervous system, the heart and the respiration ; — Sphacelinic Acid, which is non-nitrogen- 
ous and soluble in alcohol, stimulates the vaso-motor centre and is the active agent in 
producing gangrenous ergotism ; — Cornntine, an alkaloid, produces convulsions and peri- 
staltic contradictions of the uterus, and is the active agent in causing convulsive ergotism. 

Tanret's Ergotinine has been proven to have no action on the uterus. 
The Ergotin of Bonjean, Wiggers and Tanret is not a fixed compound, 
but a mixture. The Ecboline of Wiggers is also a mixture. Sclerotinic 
Acid is said by many authorities to act on the uterus, but this is positively 
denied by many others. It is probably a very uncertain preparation. 
For the Ergotin of commerce see below. 

Preparations. 

Extractum Ergotcz Fluidum, — prepared with diluted Hydrochloric Acid, Alcohol and 
Water. Dose, 3 ss-ij. 

Extractum ErgotcB, Extract of Ergot, commonly called Ergotin, — is prepared by 
evaporating 5 parts of the fluid extract at a temperature not above 122 F., until reduced 
to I part. Dose, gr. ij-xx. 

Vinum Ergotce, — strength 15 per cent. Dose, gj-jfj. Is made by an improved 
method and is more reliable than that formerly official. 

Ergotin (Unofficial), is the name of several watery extracts found on the market, 
and varying much in action both from each other and from the parent drug. That made 



ERGOTA. 2 I I 

by Squibb is about the same strength as the official extract, and represents the general 
powers of Ergot. It may be used hypodermically in doses of gr. j^-gv. v. The Ergotin 
of Bonjean is also an aqueous extract, but is very variable in quality and frequently inert. 
Wiggers' Ergotin is insoluble in the ordinary menstrua, and inert on the vascular appa- 
ratus, but causes colic and gastro-enteritis. 



Physiological Action. 

Ergot is an excito-motor and a hemostatic, chiefly affecting the spinal 
cord, circulation, respiration, intestinal and uterine muscular fibres. Its 
principal actions are the production of an artificial anaemia, and tetanic 
contraction of unstriped muscular fibre. Its phenomena are divided into 
two sets, named respectively Acute and Chronic Ergotism, according as 
the drug is administered in large doses, or in small quantity for a consid- 
erable length of time. 

Acute Ergotism. In large doses Ergot acts as .a gastro- intestinal 
irritant, causing nausea and vomiting, gastralgia, colic, thirst, difficult 
micturition and purging. It slows the heart, raises the arterial tension 
greatly, dilates the pupils and produces pallor, vertigo and frontal head- 
ache. Its action on the circulation is due to its inducing arterial anaemia, 
but whether this is done by contraction of the arterioles through direct 
action on their muscular fibres or by central stimulation of the vaso-motor 
system, or by producing active venous dilatation, thus draining the arte- 
rial system, is a much disputed question. It certainly stimulates the con- 
traction of unstriped muscular fibre, especially affecting the sphincters 
and the uterus, causing continuous labor pains and tonic contraction of 
the sphincter vesicae, making micturition difficult if not impossible. It 
also produces cerebral and spinal anaemia, coldness of the surface, tetanic 
spasms and violent convulsions, but very large doses (several ounces) are 
necessary to such results. As much as ^iij of the fluid extract has been 
given daily for a week or more, without producing any marked effect. 

Chronic Ergotism occurs in two forms, (i) the Convulsive, (2) the 
Gangre?ious, — either usually excluding the other. The convulsions are 
tetanoid spasms of the flexor muscles, the uterus, the intestinal fibres, and 
the muscles of respiration, ending in coma and death by asphyxia. The 
gangrenous form begins with coldness and numbness of the limbs, formi- 
cation of the skin all over the body, loss of sensibility and abolishment 
of the special senses, bullae of blood and ichor, followed by dry or moist 
gangrene of the lower extremities, buttocks and other parts, epileptiform 
convulsions, coma and death. Autopsies show changes in the posterior 
columns of the cord, resulting probably from the spinal anaemia. 

Experiments with the various derivatives of Ergot show that no one 
of its constituents represents the power of the drug itself. Those which 
come nearest to it in action are the Ergotinine of Tanret and Sclerotinic 
Acid. 



2 1 2 ERGOTA. 

Antagonists and Incompatibles. 

Amyl Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia antagonize its action 
on the circulation. Caustic alkalies and metallic salts are chemically incompatible. 



Therapeutics. 

Ergot has a wide field of application. Its most familiar use is to pro- 
mote uterine contraction in labor, but as the contractions produced by it 
are continuous instead of the natural intermittent ones, it is highly dan- 
gerous when there is any obstacle in front of the child, the probable 
results being rupture of the uterus, paralysis of the foetal heart, and severe 
laceration of the perineum. At the end of the second stage, when the 
head is born, is the best time for its use (if employed in labor at all), in 
order to promote firm uterine contraction, thereby guarding against post- 
partum hemorrhage, and promoting the expulsion of the placenta. The 
tendency, however, of obstetrical teaching, is against its employment at 
all in labor ; while, in practice, the teaspoonful of Ergot is almost in- 
variably administered as soon as possible after the child is born. In 
many uterine affections, as chronic metritis, subinvolution, congestive 
dysmenorrhcea, menorrhagia, fibroids and polypi, Ergot is well em- 
ployed, producing firm contraction of the womb and promoting absorp- 
tion of inflammatory products. It is extremely useful in amenorrhcea 
due to plethora, and in the atonic form of spermatorrhoea. In con- 
junctivitis, gonorrhoea, and inflammations of mucous membranes gen- 
erally, it is of striking benefit, if used both locally and internally. It 
is also an excellent remedy in acute and chronic dysentery, chronic diar- 
rhoea, atonic hemorrhages of arterial type, mania due to cerebral hyper- 
semia, headache and migraine of congestive form, myelitis, spinal con- 
gestion, cerebro-spinal meningitis, splenic enlargement, lax sphincters of 
rectum and bladder, and in incontinence of urine from paralysis of the 
sphincter vesicas. Hemorrhoids are well treated by its local application, 
but here it should not be used internally as it promotes venous congestion. 
In aneurism it aids coagulation by slowing the blood-current, and in car- 
diac hypertrophy without valvular lesion it acts well by slowing the heart. 
In diabetes insipidus full doses of Ergot are often curative, and it has 
been used with benefit in diabetes mellitus. 

Hypodermically, the aqueous extract dissolved in water and free from 
alcohol or any other irritating substance, is in many cases much more 
prompt in action than when given per orem, especially if injected near to 
the seat of the affection. This is particularly true in post-partum and 
other hemorrhages, prolapse of the rectum, chronic metritis and subinvo- 
lution of the womb, uterine fibroids, varicocele and varicose veins. When 
so administered it will frequently so contract the sphincter of the bladder 
as to produce retention of urine, and require the use of the catheter. 



ERIGERON ERIODYCTION ERYTHROXYLON. 2 I 3 

ERIGERON, Fleabane (Unofficial), — is the flowering plant Eri- 
geron canadense, a weed of the nat. ord. Composite, growing in N. 
America. It contains a Volatile Oil, which is official, also tannic acid 
and a bitter extractive. 

Oleum Erigerontis, Oil of Fleabane, — a pale yellow liquid, of sp. gr. about 0.850, 
becoming darker by age and exposure to air, of peculiar and persistent odor, pungent 
taste and neutral reaction, readily soluble in alcohol. Dose, TT^x-^ss. 

Oil of Erigeron has the same action as Oil of Turpentine but is less 
irritant and less efficient. It has considerable reputation as a hemostatic, 
especially in menorrhagia and intestinal hemorrhage of passive form, as 
in typhoid fever. It is also used with benefit in diarrhoea and dysentery, 
and in hemoptysis without fever or other evidence of irritation it is a 
very valuable remedy. 



ERIODYCTION, Yerba Santa (Unofficial),— the leaves of Erio- 
dyction glutinosicm, a Californian shrub of the nat. ord. Hydrophyllaceae. 
They are from 2 to 4 inches long, shining green as if varnished on the 
upper surface, white and hairy beneath, of fragrant odor, aromatic taste, 
and contain an acrid Resin and an aromatic Volatile Oil. 

Extractum Eriodyctii Fluidum (Unofficial), — Dose, Wbxv-gj. 
Extractum Eriodyctii (Unofficial), — Dose, gr. ij-x. 

Eriodyction is expectorant, and covers the taste of Quinine in a re- 
markable manner, for which purpose it is combined in mixture with Gly- 
cyrrhizin, under the title "Veloutine," as a proprietary preparation (see 
ante, page 187). It is used with fair success in bronchial and laryngeal 
affections, also in asthma. Combined in syrup with Grindelia it is very 
efficient for coughs. 

ERYTHROXYLON, Coca, Cuca,— the leaves of Erythroxylon 
Coca, a small shrub of the nat. ord. Erythroxylaceas, indigenous to the 
mountains of Peru and Bolivia, and extensively cultivated in those and 
other S. American States. It has numerous purplish-brown branches ; 
small, yellowish, 5-petalous flowers, and a scarlet-red, oblong fruit, con- 
taining a single seed. The leaf resembles a large tea-leaf, being 2 to 3 
inches long, oval-shaped, obtuse at the apex, reticulate on both sides, 
with a prominent midrib, on either side of which is seen a curved line on 
the leaf from base to apex ; odor tea-like, taste slightly bitter and aro- 
matic. It contains a crystalline alkaloid Cocaine, C 17 H 21 N0 4 , which when 
heated with HC1 is split up into Benzoic Acid, Methylic Alcohol and 
another alkaloid, Ecgo?iine. Other constituents are a volatile liquid 
alkaloid, of herring-brine odor, alkaline reaction and burning taste, named 



214 ERYTHROXYLON. 

Hygrine, an aromatic Oil, and Coca-tannic Acid. Coca should not be 
confounded with Cocoa, the seed of the chocolate-tree, Theobroma Cacao. 
Dose of the leaves, 3J-iv. 

Preparations, 

Extractum Erythroxyli Fluidum, — Dose, ^ss-ij. Leaves of good quality are so 
difficult to be obtained that Dr. Squibb, the well-known pharmaceutist, recently omitted 
the fluid extract from his trade-list, with the explanation that " it is impossible to get Coca 
of proper quality for medical use." 

Cocaina, Cocaine, C 17 H 21 N0 4 (Unofficial), — crystalline, colorless and of bitter taste, 
very soluble in ether, almost insoluble in water or alcohol, and of decided basic proper- 
ties, combining with acids to form salts. It exists in the leaves in very small quantity, 
viz. — from 0.02 to 0.04 per cent. Dose, gr. ^-ij. 

Cocaince Hydrochloras, Hydrochlorate of Cocaine, C 17 H 21 N0 4 C1 (Unofficial), — more 
properly Chloride of Cocaine, — is used in aqueous solutions of 2 to 5 per cent, as a local 
anaesthetic to mucous surfaces or by subcutaneous injection. Dose, internally, gr. ^-ij. 

Cocaince O/eas, Oleate of Cocaine (Unofficial), — a 10 per cent, solution of the alka- 
loid in Oleic Acid, for external use. 

Wines, Lozenges, Elixirs. Glyceroles, Pastes, etc., of Coca are being manufactured and 
marketed in great variety. The Citrate and Salicylate of Cocaine are recent products of 
the laboratory and may be obtained in the shops. 

Physiological Action. 

Coca is an aromatic bitter tonic, a diuretic and a cerebral and nervous 
stimulant, though locally used one of the most efficient nerve sedatives. 
Small doses improve digestion, stimulate respiration, increase the heart's 
action after a brief depression, raise the arterial tension, and increase the 
excitability of the sensory nerves. It stimulates the brain by increasing 
its blood-supply, producing wakefulness, a sense of well-being, and a 
marked diminution of the senses of fatigue, hunger and thirst. Under 
its daily use a considerable amount of labor and want of sleep can be 
borne without suffering. Though diuretic, it lessens the quantity of urea 
eliminated by checking the processes of waste. Very large doses produce 
impaired coordination, hallucinations and delirium. 

Cocaine acts upon the lower animals similarly to Caffeine: It tetanizes 
frogs, and in large doses paralyzes their sensory nerves and the posterior 
columns of the spinal cord. It kills rabbits and dogs by paralysis of the 
respiratory centre. In proper doses it raises arterial tension by stimu- 
lating the vaso-motor centres and the cardiac motor system. 

On man, in small doses Cocaine is a cerebral, cardiac, respiratory and 
nervous stimulant, and a diuretic. It improves digestion, stimulates res- 
piration, increases the heart's action, raises the arterial tension, and exalts 
the irritability of the sensory nerves. It stimulates the brain by increas- 
ing its blood-supply, producing wakefulness and marked diminution of the 
senses of fatigue and hunger. Though decidedly diuretic, it lessens the 
quantity of urea, by checking the processes of waste, thus acting as an 
indirect nutrient, and enabling the body to maintain its energy on a 
lessened supply of food. It increases the cutaneous circulation, flushing the 
surface, exciting perspiration, and a sense of heat, and does actually raise 



ERYTHROXYLON. 21 5 

the body-temperature. It dilates the pupil, both when locally applied 
and when taken systemically, — and stimulates intestinal peristalsis as well 
as the evacuation of the bladder in a few minutes after its ingestion. 

An Overdose produces symptoms of cardiac and respiratory embarrass- 
ment in a very short time. The pulse, at first quick and forcible, be- 
comes small, rapid and intermitting; — the heart apparently standing 
still in systole once in every 10 or 12 beats. Respiration is slow and 
shallow, and a sense of " tightness " about the chest is very marked ; — 
the skin grows cold and clammy, and the subject is seized with a sense 
of impending dissolution. Death occurs in animals by paralysis of res- 
piration, — but in man there seems to be a tetanoid spasm of the cardiac 
muscle, which is equally dangerous to life. Other symptoms are impair- 
ment of coordination, hallucinations and delirium. Lethal Doses paralyze 
the intra-cardiac motor ganglia, the posterior columns of the cord and the 
sensory nerves, and the respiratory centre. 

As a Local Anozsthetic the power of Cocaine is very great over a limited 
area. Applied to such structures as the Schneiderian membrane, mucous 
covering of the glans penis ; or injected hypodermically in other locations, 
it blanches the structures and causes a profound but temporary anaesthesia 
throughout a small space. Applied to the tongue it temporarily destroys 
both taste and tactile sensibility ; — to the ocular conjunctiva, it produces 
profound anaesthesia of that membrane, together with dilatation of the 
pupil, partial paralysis of accommodation, enlargement of the palpebral 
fissure, slight lachrymation, and sometimes temporary ptosis. This pro- 
found degree of anaesthesia is thought by some to be caused by its para- 
lyzing the terminal twigs of the sensory nerves, — by others to be due to 
vaso-motor action rendering the nerves bloodless and therefore unable to 
transmit sensory impressions. It produces mydriasis by stimulation of 
the ends of the sympathetic in the iris, and does not affect the third 
nerve or the sympathetic centre. 

In general action, Cocaine resembles Atropine very closely, especially 
in its influence upon the pulse and blood-pressure, the respiration, pupils, 
salivary- and sweat-glands and intestinal peristalsis. In its symptoms, 
both from large and small doses, it exactly parallels Sparteine, another 
cardio-inhibitory depressant. 

Antagonists. 

Amyl Nitrite combats the earliest symptoms of cardiac depression, — then Alcohol and 
Opium as stimulants to the heart, also Artificial Respiration. The most direct antago- 
nist is Chloral,' so also are Chloroform and Ether. Morphine is also directly antagonistic 
at almost all points. 

The Cocaine- Habit. 

COCAINISM, or the Cocaine-habit, is now presenting itself to observation, numerous 
instances of persons addicted to its excessive use being met with. Loss of digestive 
power, absolute insomnia, enfeeblement of the intellect, great emaciation, ascites, general 
marasmus, nausea, decay of the teeth, an excessively fetid breath, amblyopia, visual hal- 
lucinations and complete anorexia form a consensus of symptoms which rival the worst 



2l6 ERYTHROXYLON. 

effects of the opium habit. Some observers report the most extraordinary mental 
changes resulting from Cocainism, and exceeding those produced by any other drug. 
The most intense selfishness, utter disregard of all social and domestic duties, the most 
debasing habits, complete destruction of all noble qualities, and a general condition of 
depravity, are some of the results which are being charged to this drug. The habit is 
acquired, in almost all cases, by persons previously addicted to the use of Morphine, who 
go to Cocaine in the hope of finding help in their struggle against the tyranny of the 
former drug. In this hope, however, they are always disappointed, especially when the 
drugs are in their own hands. The victim soon finds that one of these agents antago- 
nizes the other to a great extent, while, at the same time, it sets up peculiar troubles of 
its own : and that there is a constant need of more Morphine to counteract the Cocaine- 
symptoms, and of more Cocaine to antagonize the increased amount of Morphine. The 
result of any such attempt will be that one who is only using a moderate daily amount 
of Morphine, will, if Cocaine be added, soon be using a very great amount of Morphine, 
as well as of Cocaine, and "the last state of that man is worse than the first." 

Therapeutics. 

Coca-leaves are chewed by the Peruvians for the purpose of sustaining 
them during arduous labors and long journeys, and were so highly 
esteemed as to have been represented on the coat-of-arms of that nation, 
by whom they are used much as we do tea, coffee or tobacco. This 
example was imitated by Weston the pedestrian, who is said to have been 
detected chewing the coca-leaf during one of his protracted walks. 
Cocaine is a useful stimulant to the brain and the nervous system in 
many morbid conditions, particularly cerebral and spinal anaemia, neuras- 
thenia, melancholia, hysterical and hypochondriacal insanity, and in 
protracted mental depression with suicidal tendency. It may be employed 
with benefit in wasting diseases to retard waste and to stimulate digestion, 
in convalescence from fevers and other acute maladies, and in migraine 
and neuralgia due to depression of the nervous system. It is very bene- 
ficial in some cases of the vomiting of pregnancy, in stomatitis and gastral- 
gia, and in functional impotence due to general atony of the system. 

A wine of the leaves is thought by singers and speakers to relieve hoarse- 
ness, to tense the vocal cords and improve the timbre of the voice. Coca- 
leaves may be smoked in cigars or cigarettes to obtain the exhilarating 
effects of the drug, and for the relief of asthma, hay-fever and many 
irritable throat affections. The Oleate of Cocaine is an efficient palliative 
application to painful hemorrhoids, fissures of the anus, burns, boils, and 
irritable ulcers ; also in pruritus pudendi et ani and skin diseases attended 
with intolerable itching. 

Hydrochlorate of Cocaine has achieved notoriety as a local anaes- 
thetic, and promises to be of the greatest value in many operations on the 
eye and ear, nasal passages, uterus and urethra. A 2 to 4 per cent, solu- 
tion is brushed lightly over the mucous surface or injected into the ure- 
thral canal, the application being repeated within 5 or 10 minutes if 
profound local anaesthesia is required. After about fifteen minutes any 
superficial operation may be performed without giving the slightest pain. 
Its anaesthetic action is so entirely local and generally free from unpleas- 



EUCALYPTUS. 2 1 7 

ant after-effects that it is considered the most efficient and desirable agent 
of the kind which is known. It has been used in the same manner with 
decided benefit in congestion of the nasal passages from acute catarrh 
and hay-fever ; and has been applied to the cervix uteri to relieve the first 
pains of labor, to the ear for tinnitus aurium, and by inhalation to 
strengthen the vocal cords, relieve hoarseness and cough, and to improve 
the quality of the voice. It is injected hypodermically around the pre- 
puce to prevent pain during circumcision, into the vicinity of the supra- 
orbital and infra-orbital foramina to cut short neuralgia of those nerves, 
and into hemorrhoids previous to their ligation. It may be injected into 
the bladder before lithotrity, into the urethra before the passage of sounds 
or catheters or to relieve chordee, and it is an excellent application to the 
gums of teething infants. To be efficient it must reach the terminal fila- 
ments of the "sensory nerves in sufficient concentration. Rhus poisoning, 
by either the oak or ivy, is promptly controlled by the application of a 5 
per cent, solution of oleate, freely over the affected surface. It gives 
instant relief from the burning and itching, and speedily reduces the 
dermatitis. 

As a Mydriatic for ophthalmological use, Cocaine has peculiar qualities 
which make it the most serviceable of the class. The dilatation produced 
by it is great, is quickly attained, lasts only 12 to 20 hours, is promptly 
overcome by the application of Eserine, and is not accompanied by much 
photophobia. The latter is due to the fact that the cocainized pupil is 
not rigidly dilated (as with Atropine), but reacts to light. The accom- 
modation, moreover, is greatly reduced, but not entirely paralyzed, and 
is quickly regained. 

As an Antagonist Cocaine is of especial value in narcotic poisoning by 
Chloral or Opiates, where depression of the cardiac and respiratory cen- 
tres exists. It is also indicated in chronic depressant poisoning from the 
Bromides, and in spinal paralyses. In these cases it has all the advantages 
of Strychnine without its poisonous character. It has no value in the 
proper treatment of Morphinism except to antagonize certain heart 
symptoms, for which purpose it should be administered only by the phy- 
sician in charge of the case ; and never, by him, as a regular remedy, at 
regular intervals of time. 

EUCALYPTUS,— the leaves collected from rather old trees, of 
Eucalyptus globulus, or Blue Gum-tree (nat. ord. Myrtaceae), a native of 
Australia, now grown in California, Italy, etc. The leaves are 6 to 12 
inches long, gray-green, lanceolately scythe-shaped, studded with oil- 
glands ; of camphoraceous odor and bitter, aromatic taste. They contain 
tannic acid, a resin, a fatty acid and a Volatile Oil. The latter consists 
of three different oils which distil over at different temperatures, the first 



2 I 8 EUCALYPTUS. 

product being named Eucalyptol, C 12 H 20 O, which by the action of Phos- 
phoric Acid is converted into Eucalyptene, a substance allied to Cymene, 
and Eucalyptolen. 

Preparations. 

Extractum Eucalypti Eluidum, — alcoholic. Dose, TILx- gj. 

Oleum Eucalypti, — the volatile oil, distilled from various species of Eucalyptus, that 
from E. amygdalina being considered wanting in Eucalyptol. Dose, TtVv-xxx in capsules 
or emulsions. 

Tinctura Eucalypti (Unofficial), — Dose, ^ss-ij. 

Physiological Action. 

The taste of Eucalyptus is warm, aromatic, bitter and camphoraceous. 
It increases the flow of saliva, the gastric juice and the intestinal secre- 
tions, and in small doses promotes appetite and digestion, increases the 
heart's action and lowers arterial tension. In large doses it produces 
eructations, indigestion, diarrhoea, nausea and vomiting, lowered tempera- 
ture, great muscular weakness, and if continued will irritate and congest 
the kidneys, and induce a feverish state with symptoms of cerebral con- 
gestion, and great constitutional disturbance. Toxic doses are fatal by 
paralysis of respiration through direct action on the spinal cord. 

It is powerfully antiseptic, and destructive to low forms of life, a stimu- 
lating expectorant and an efficient diaphoretic. By some authorities it is 
believed to reduce the size of an enlarged spleen, and to possess anti- 
malarial properties by absorbing noxious germs as well as by draining the 
soil of its water, and by its aseptic emanations purifying the atmosphere 
in its vicinity. It is largely cultivated in malarial districts for these 
properties, and is reported to have rendered habitable a portion of the 
deadly Roman Campagna. 

Eucalyptus is eliminated by the skin, bronchial mucous membrane 
and the kidneys, imparts its odor to the breath and the urine, and is more 
or less irritant at the points of its elimination. 

Therapeutics. 
Eucalyptus is an efficient stomachic in atonic dyspepsia, chronic gastric 
and intestinal catarrh, and in conditions of the intestinal canal which 
favor the development of worms. In chronic catarrhal conditions of the 
genito-urinary organs, the broncho-pulmonary mucous membrane, and 
especially the bladder, it is very useful, acting as a stimulant and disinfec- 
tant to the mucous membranes. It is equally beneficial in chronic bron- 
chitis and bronchorrhoea, in cachectic states generally, and in convales- 
cence from acute diseases. In hysteria, chorea and asthma it is beneficial, 
in the latter affection being advantageously smoked in cigarettes with 
Stramonium or Belladonna Leaves. In malaria as a reconstructant it is 
better than Quinine, and it has considerable utility in obstinate intermit- 
tents where it is desirable to stop the use of Cinchona preparations. As 



EUONYMUS EUPATORIUM. 2I9 

an antiseptic it is highly valuable in dilute solution for application to ulcers, 
and as a substitute for Carbolic Acid on gauze in the antiseptic treatment 
of wounds. It is also used in dilute solution locally as a stimulating dis- 
infectant in stomatitis and in the subacute stages of pharyngitis and ton- 
sillitis. An aqueous preparation is highly recommended as a vehicle for 
alkaloids in solution for hypodermic use, to prevent the development of 
the penicillium which rapidly destroys the alkaloid present. 



EUON.YMUS, Wahoo, — is the bark of Euonymus atropurpureus ', 
a shrub of the nat. ord. Celastracese, growing in the U. S. Occurs in 
quills or curved pieces, about y 1 -^ inch thick, of ashy-gray color and acrid, 
sweetish taste. It contains an amorphous, bitter principle named Euony- 
min, also Resins, Euonic Acid, and Asparagin, fixed oil, etc. 

Extractum Euonymi, — Dose, gr. j-v. 

Etionymin (Unofficial), — the eclectic preparation, consists of the fixed oil and resin, 
and is given in doses of gr. ss— v. 

Euonymus is classed with Rhubarb, Jalap, Aloes, etc., as a tonic- 
astringent and resin-bearing purgative. It is said to be also diuretic and 
expectorant, and a very efficient cholagogue. Its cathartic action is 
similar to that of Rhubarb but milder. It has been employed with bene- 
fit in some cases of dropsy, also in habitual constipation, torpid liver, 
and pulmonary affections. In overdoses it will set up considerable gastro- 
intestinal irritation. 



EUPATORIUM, Thorough-wort, Boneset,— the leaves and 
flowering tops of Eupatorium perfoliatum, an American plant of the nat. 
ord. Compositae, having lanceolate leaves, two united at the base, each 4 
to 6 inches long, of weak, aromatic odor and bitter, astringent taste. It 
contains a neutral, bitter principle, named Eupatorin, tannic acid, a 
volatile oil, etc. 

Extracti Eupatorii Eluidum, — Dose, ^x-^j. 

Boneset is a bitter tonic and efficient diaphoretic, also in full doses 
emetic and aperient. It has been supposed to have antiperiodic and 
tseniafuge powers. A warm infusion (Boneset tea) is a popular diapho- 
retic in remittent and typhoid fevers, and at the onset of an attack ot 
acute catarrh or general cold. As a bitter tonic it may be used with 
advantage in dyspepsia and general debility. Its common name is 
derived from its supposed power to relieve the bone pains of dengue or 
the " break-bone fever." 

Another variety of Eupatorium, E. purpureum, or Gravel-root, is 
reputed to have decided power over the uric acid diathesis. 



220 EUPHRASIA FEL BOVIS FERRUM. 

EUPHRASIA, Eye-bright, — is a small annual plant of the nat. 
ord. Strophulariacese, growing in Europe and the U. S., odorless, of 
astringent taste, and containing Euphrastic Acid, tannin, etc. It was 
formerly of great repute in various eye-affections, and may be of utility as 
a mild astringent in catarrhal conjunctivitis. Its chief value, however, is 
to abort an attack of acute nasal catarrh with lachrymation, for which 
purpose a few drops of the tincture every two hours is remarkably effi- 
cient. In hay-fever also it is of decided utility in mitigating the catarrhal 
symptoms, and in the acute coryza of measles it will be found an excel- 
lent remedy. A tincture (i to 9) of the fresh plant should be used, and 
given in doses of ttlj— v. 



FEL BOVIS, Ox-gall,— the fresh gall or bile of Bos Taurus, is a 
dark-green, viscid liquid, of peculiar odor, bitter taste, and neutral or 
faintly alkaline reaction. Sp. gr. 1.018 to 1.028. It contains Glyco- 
cholate of Sodium, Taurocholate of Sodium, Cholesterin and coloring 
matter. 

Preparations. 

Fel Bovis Inspissatum, Inspissated Ox-gall, — 100 parts of fresh Ox-gall evaporated to 
15 parts, after straining. Dose, gr. v-xv. 

Pel Bovis Purification, Purified Ox-gall, — 3 of Ox- gall and I of Alcohol evaporated 
to pilular consistence, after standing 24 hours, decanting, filtering, etc. Dose, gr. v-xv. 

Physiological Action and Therapeutics. 

Bile is tonic, antiseptic and purgative. It assists in the emulsification of 
fats, and stimulates the absorbent powers of the mucous membrane. In 
the stomach it neutralizes the gastric juice, precipitating the pepsin, and 
is apt to cause nausea and vomiting. Recently it is found to act well in 
stimulating the resolution of hypertrophies when locally applied to the 
part, as the mammae, tonsils, pannus, etc. It is used as a laxative in 
constipation when the natural secretion of bile is deficient, but has no 
advantage over other purgatives. 



FERRUM, Iron, Fe, — is metallic Iron in the form of fine, bright 
and non-elastic wire. 

Ferrum Reductum, Reduced Iron, — consists of metallic Iron in fine 
powder, obtained by reducing the Sesquioxide by hydrogen at a dull red 
heat. It is a very fine, gray-black, lustreless powder, odorless, tasteless, 
and insoluble in water and alcohol, but soluble in dilute sulphuric acid 
with the evolution of nearly odorless hydrogen gas. Dose, gr. j-v, after 
meals. 



FERRUM. 221 

Iron Compounds and their Preparations. 

Liquor Ferri Acetatis, — is an aqueous solution of Ferric Acetate, containing 33 per 
cent, of the anhydrous salt. A dark red-brown transparent liquid of acetous odor, sweet- 
ish and faintly styptic taste, reaction slightly acid. Action, — stimulant, ferruginous, little 
if any astringency. Used to prepare the following tincture. 

Tinctura Ferri Acetatis, — has of the preceding 50 parts, Alcohol 30, Acetic Ether 20. 
A clear, dark red-brown liquid, of acetous odor, acidulous and slightly astringent taste, 
and slight acid reaction. Miscible with water in all proportions. Dose, rr\ x — ^ ij . 

Syriipi Ferri Bromidi, — is a syrupy liquid containing 10 per cent, of Ferrous Bro- 
mide, FeBr 2 . A pale green, odorless liquid, of sweet ferruginous taste and neutral reac- 
tion. Action, — a sedative chalybeate tonic, especially recommended in nervous disorders, 
and by Da Costa in chorea. Irritant in large doses. Dose, TTLv-xxx. 

Ferri Carbonas Saccharatus, — has at least 15 per cent, of ferrous carbonate. A green- 
ish-gray powder, of sweetish taste at first, changing to ferruginous. Partially soluble in 
water, but soluble in dilute hydrochloric acid with evolution of CO.,. Action, — slightly 
stimulant to digestive tract. Dose, gr. ij— x with food. 

Massa Ferri Carbonatis, — Vallet's Mass, — Sulphate of Iron 100, Carbonate of Sodium 
no, Honey 38, Sugar 25, Syrup, Distilled Water, each q. s. ad 100 parts. Has 42 per 
cent, of ferrous carbonate. Action, — non-astringent, unirntating, ferruginous tonic. Dose, 
gr. iij-v after food. 

Mistura Ferri Composita, Griffith's Mixture, — Sulphate of Iron 6, Myrrh 18, Sugar 18, 
Carbonate Potassium 8, Spirit of Lavender 50, Rose water 900 parts. Is really a solu- 
tion of the carbonate, with sulphate of potassium to suspend the iron salt. Is an excel- 
lent mixture, but disagreeable. Dose, ^ ss. 

Pilulce Ferri Composita, Griffith's Pills, — Sulphate of Iron gr. 3^, Carbonate of Sodium 
gr. %{, Myrrh gr. jss, Syrup q. s. in each pill answering in composition to the preceding. 
Dose, ij— vj. 

Ferri Chloridu?n, Perchloride of Iron, Fe 2 Cl 6 .i2H 2 0, — orange-yellow, deliquescent, 
crystalline pieces, of styptic taste and acid reaction, freely soluble in water, alcohol or 
ether. Action, — strongly astringent, hemostatic. Never used internally. 

Liquor Ferri Chloridi, — an aqueous solution of the preceding, containing 37.8 per 
cent, of the anhydrous salt, with some free HC1 acid. Action, — strongly astringent and 
styptic. Rarely used internally. Dose, TT^ij— x, well diluted. 

Tinctura Ferri Chloridi, — has of the preceding 35 parts in 65 of Alcohol. A bright, 
brownish liquid, of ethereal odor, styptic taste and acid reaction. Is used in Mistura 
Ferri et Ammonii Acetatis. One of the best preparations of iron. Action, — ferruginous 
tonic. Dose, tt\v-xx, in water, syrup or glycerin. 

Ferri Citras, Fe 2 (C 6 H 5 7 ) 2 .6H. 1 0, — garnet-red, transparent scales, slowly soluble in 
water, not in alcohol. Action, — mildly stimulant. Dose, gr. ij-v. Formed by evapor- 
ating the following : — 

Liquor Ferri Citratis, — is an aqueous solution of the preceding, containing about ZSVz 
per cent, of the anhydrous salt. A dark-brown liquid, of slightly ferruginous taste and 
acid reaction. Action, — as Ferri Citras. Dose, TTLv-xv. 

Vinum Ferri Citratis, — made from the Citrate of Iron and Ammonium 4, Tincture of 
Sweet Orange-peel 12, Syrup 12, stronger White Wine 72 parts. An iron elixir. Dose, 

3HJ- 

Ferri Hypophosphis, Fe 2 (H. 2 P0 2 ) 6 , Ferric Hypophosphite, — a white or grayish-white 
powder, odorless, tasteless, slightly soluble in .water, freely so in HC1 acid or in a solu- 
tion of sodium citrate. Action, ferruginous tonic. Dose, gr. v-x. 

Ferri Iodidum Saccharatum, — a yellowish- white powder, very hygroscopic, odorless, 
of sweetish, ferruginous taste, and slightly acid reaction, soluble in 7 of water at 59 F., 
insoluble in alcohol. Action, — ferruginous tonic. Dose, gr. v-xxv in pill or elixir. 

PUuIcb Ferri fodidi, — made with Reduced Iron, Iodine, Licorice, Sugar, Acacia and 
Water, covered with a coating of Balsam of Tolu in Ether. " Blancard's Pills" only 
differ from these by being covered with a coating of reduced iron to protect the interior 
from oxidation, but it also protects them from the solvent action of the gastric juice. 
Dose, 1 or 2 pills ter in die. 

Syrupus Ferri fodidi, — is a syrupy liquid containing 10 per cent, of ferrous iodide. A 
transparent, pale-green liquid, of sweet, ferruginous taste and neutral reaction. Action, — 
ferruginous tonic. Dose, rr\v-xxx. 

Ferri Lactas, Fe(C 3 H 5 3 ) 2 .3H 2 0, Ferrous Lactate, — pale, greenish-white, crystalline 
grains, soluble in 40 of water at 59 F., freely in citrate of sodium, almost insoluble in 



222 FERRUM. 

alcohol. Action, — feebly ferruginous tonic. Dose, gr. j-iij in pill or syrup. Is a con- 
stituent of Syrupus Hypophosphitum cum Ferro. 

Liquor Ferri Nitratis, — is an aqueous solution of Ferric Nitrate, Fe 2 (N0 3 ) 6 , contain- 
ing about 6 per cent, of the anhydrous salt. A transparent, amber- colored liquid, of acid, 
styptic taste, and acid reaction. Action, — medium as to irritation, astringent and hemos- 
tatic. Dose, n\v-xv, well diluted. 

Ferri Oxa/is, Ferrous Oxalate, FeC 2 4 .H 2 0, — a pale yellow, crystalline powder, very 
slightly soluble in water. Dose, gr. ij in a pill. 

Ferri Oxidum Hydratum, Ferric Hydrate, Fe (HO) 6 , is a brown-red magma wholly 
soluble in HC1 acid without effervescence. Should be freshly prepared from the Solution 
of Tersulphate of Iron io parts and Water of Ammonia 8 parts. Is the chemical anti- 
dote for Arsenic. Dose, a teaspoon ful in water frequently repeated. The solutions should 
be kept ready for use. 

Ferri Oxidum Hydratum cum Magnesia, — is made by mixing when required for use 
(i) Solution of Tersulphate of Iron iooo grains, Water, 2000 grains. (2) Magnesia 150 
grains, Water ( ^xxxij. This should be administered as directed under the preceding 
head. It is more convenient and a more efficient antidote for Arsenic than the simple 
ferric hydrate, as the excess of the alkaline precipitant is non- irritant and is itself an anti- 
dote to arsenic. 

Emplastrum Ferri, Strengthening Plaster, — has of Hydrated Oxide of Iron, dried, 10 
parts, Canada Turpentine 10, Burgundy Pitch 10, Lead Plaster 70. 

Trochisci Ferri, — each has of Hydrated Oxide of Iron, dried, gr. v, Vanilla gr. T L, 
Sugar, and Mucilage of Tragacanth. Dose, j-iij, ter die. 

Ferri Phosphas, — Bright-green, transparent scales, of acidulous, saline taste, soluble in 
water, not in alcohol. Used as an adjuvant to laxative pills to prevent the after reaction- 
ary constipation. Dose, gr. v-x. Made by reaction between the Citrate of Iron and the 
Phosphate of Sodium. 

Ferri Pyrophosphas, — Green, transparent scales, of acidulous taste, soluble in water 
but not in alcohol. Is almost tasteless and unirritating, and non-constipative. Dose, 
gr. ij-v. Made by reaction between the Citrate of Iron and the Pyrophosphate of 
Sodium. 

Ferri Sulphas, Ferrous Sulphate, FeS0 4 .7H 2 0, — large, pale bluish-green prisms, efflo- 
rescent, of saline, styptic taste, and acid reaction, soluble in 1.8 of water at 59 F., 
insoluble in alcohol. Is chiefly used to make the Dried Sulphate and other preparations. 

Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate, FeS0 4 .H 2 0, — a grayish-white 
powder, nearly soluble in water, consisting of the preceding salt, heated gradually to 300 
F., until it ceases to lose weight. The most astringent and irritating ferrous salt, but an 
excellent one in small doses. Is a constituent of Pil. Aloes et Ferri. Dose, gr. ss-ij in pill. 

Ferri Sulphas Prcecipitatus, Precipitated Ferrous Sulphate, FeS0 4 .7H 2 0, — is the 
same salt as above described, precipitated by Alcohol from solution in dilute sulphuric 
acid. Dose, gr. ss-ij. 

Liquor Ferri Subsulphatis, Monsel's Solution, — is an aqueous solution of Basic Ferric 
Sulphate, Fe 4 0(S0 4 ) 5 , containing 43.7 per cent, of the salt. A dark reddish-brown, 
almost syrupy liquid, of very astringent but not caustic taste, and acid reaction, mixing 
with water or alcohol in all proportions without decomposition. Is but slightly irritating 
and powerfully astringent, chiefly used locally as an astringent and hemostatic, but may 
be given internally in doses of mjij-x, well diluted. 

Liquor Ferri Tersidphatis, — is an aqueous solution of Normal Ferric Sulphate, 
Fe 2 (S0 4 ) 3 , containing 28.7 per cent, of th'e salt. Has the same properties as described 
for the preceding, but a less sp. gr. Is used to make other preparations of Iron. 

Ferri Valerianas, Fe 2 (C 5 H 9 2 ) 6 , — a dark, tile red, amorphous powder, of faint, 
valerianic odor, and mildly styptic taste, insoluble in cold water, decomposed by hot 
water, readily soluble in alcohol. Of doubtful value as a valerianate. Dose, gr. j-iij in 
pill. 

Preparations of Compound Lron Salts. 

Ferri et Ammonii Citras, Ammonio-ferric Citrate, — prepared from Solution of Citrate 
of Iron 3 parts, Water of Ammonia 1, mixed and evaporated. Transparent, garnet-red 
scales, deliquescent, soluble readily in water, insoluble in alcohol. Dose, gr. ij-v. 

Ferri et Ammonii Sulphas, Ammonio-ferric Alum, — pale, violet crystals, efflorescent, 
of styptic taste and slightly acid reaction, soluble in 3 of water at 59 F., insoluble in al- 
cohol. Is the least astringent of the sulphates of iron, but more so than any of the salts 
formed by vegetable acids. Dose, gr. iij-xv. 



FERRUM. 223 

Ferri et Ammonii Tartras, Ammonio-ferric Tartrate, — made from Liq. Ferri Tersul- 
phatis 90, Tartaric Acid 60, Aq. Ammoniae 72, Ammonium Carbonate, Water q. s. 
Transparent, reddish-brown scales, slightly deliquescent, of sweetish and slightly ferru- 
ginous taste, very soluble in water, insoluble in alcohol. Contains an equivalent of about 
25 per cent, of Ferric Oxide, and has but slight irritant qualities. Dose, gr. v-xx. 

Ferri et Potassii Tartras, Potassio ferric Tartrate, — made from Liq. Ferri Tersulphatis 
12, Potassii Bitart. 4, Aq. Destil. 32, Aq. Ammoniae, et Aquae q. s. Transparent, garnet- 
red scales, slightly deliquescent, of sweetish and slightly ferruginous taste, very soluble in 
water, insoluble in alcohol. Is the least disagreeable in taste of all the iron preparations, 
and contains a little more ferric oxide than the preceding salt. Is but slightly astringent 
and is not constipating. Dose, gr. v-x. 

Ferri et Quinines Citras, — prepared from Ferri Citras 88, Quinine, dried, 12, Aq. 
Destil. q. s. ad 100, mixed and evaporated. Thin, transparent yellowish-brown scales, 
slowly deliquescent, of bitter taste, slowly soluble in water, slightly soluble in alcohol. 
Contains 12 per cent, of dry quinine. Action, — astringent and stimulant to the digestive 
tract. Dose, gr. iij-v. 

Liquor Ferri et Quinines Citratis, — made directly from Ferri et Ammonii Citras 65, 
Quinine, dried, 12, Ac. Citric. 28, Alcohol 30, Aq. Destil. q. s. ad 200. A greenish- 
brown liquid, of bitter taste and slightly acid reaction. Contains 6 per cent, of quinine. 
Is very slowly soluble and of doubtful value. Dose, Tt^v-xv. 

Vinum Ferri Amarum, Bitter Wine of Iron, — has of the preceding 8 parts, Tinct. 
Aurantii Dulcis 12, Syrup 36, Stronger White Wine 44. May replace the various 
"elixirs of iron and calisaya." Dose, 3 j— iv. 

Ferri et Strychnines Citras, — Ferri et Ammonii Citras 98, Strychninse I, Ac. Citric I, 
Aq. Destil. 120, mixed and evaporated. Transparent, garnet-red scales, deliquescent, 
readily soluble in water, slightly so in alcohol. Contains I per cent, of Strychnine. 
Action, — astringent and stimulating. Dose, gr. j-iij. 

Syrupus Ferri, Quinines et Strychnines Phosphatum, Syrup of the Phosphates of Iron, 
Quinine and Strychnine. [Described under Phosphorus.] 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron. [Described 
under Phosphorus^ 

Mistura Ferri et Ammonii Acetatis, Basham's Mixture, — is properly a Liquor, and is 
prepared from Tr. Ferri Chloridi 2, Ac. Acet. Dil. 3, Liquor Ammonii Acet. 20, Elixir 
Aurantii 10, Syrup 15, Water 50 parts. An elegant and agreeable preparation, having 
some power as a diuretic and a diaphoretic. Dose, gij-v, well diluted. 

Unofficial Prepeiraiions of Iron. 

Ferri Albuminas, Albuminate of Iron, — a cinnamon-brown powder, soluble in water 
acidulated slightly with HC1. Dose, gr. x-xxx, in simple aqueous solution, or in pill. 

Ferri Arsenias, Ferrous Arseniate, Fe 3 As 2 8 , — a green, tasteless powder, insoluble in 
water, soluble in HO acid. Its activity is due to the arsenic alone. Dose, gr. ^-\. 

Ferrum Dialysatum, Dialysed Iron, — composition varies from Fe 2 G 6 .i2Fe 2 3 to 
Fe 2 Cl 6 .95Fe 2 3 , and is a 10 per cent, solution of Ferric Oxychloride in water. Prepared 
by treating a solution of Chloride of Iron with Ammonia, ferric hydrate being precipitated, 
this being dissolved by agitation is placed in a dialyzer and suspended in water, which is 
renewed as long as it shows a trace of HC1 acid. It is a reddish-brown liquid, free from 
astringent, styptic taste, but is a very feeble chalybeate, incapable of absorption except by 
change into a hydrated sesquioxide in the alimentary canal. Is used as a chalybeate, and 
as an antidote to Arsenic, but is not considered an eligible preparation. Dose, rn^x-xxx. 

Syrupus Ferri et Manganesii Iodieii, Syrup of the Iodide of Iron and Manganese. — is 
a pale, straw colored liquid, containing a little sulphate of potassium, and in each fluid ^ 
has 50 grains of the mixed iodides in the proportion of Iodide of Iron 3 parts to I of 
Iodide of Manganese. Dose, rrLx-xxx-gj. 

Syrupus Ferri et Manganesii Phosphatis, Syrup of the Phosphate of Iron and Man- 
ganese, — as used by Dr. Simpson of Edinburgh, contains in each % of syrup 2 grains of 
the Phosphate of Iron and 1 grain of Phosphate of Manganese. Dose, gj. 

Mistura Ferri Aromatica, — Pale Bark 4, Calumba 2, Cloves I, Iron wire 2, Tr. Car- 
damomi Co. 12, Tr. Aurantii Cort. 2, Aq. Menth. Pip. 50, — Macerate the first 4 in the 
last one for 3 days, filter, add the tinctures and make up to 50. Dose, ^ j-ij. 

Mistura Ferri Laxans, — Ferri Sulph. gr. ij, Magnesii Sulph. gj, Ac. Sulphurici Dil. 
mTij, Spt. Chloroformi Tl\xx, Aq. Menth. Pip. ad- !§j. 

Mistura Ferro-salina, — Magnesii Sulph. 3J, Potassii Bitart. gj, Ferri Sulph. Exsic. 
gr. x, Aquae quart j. Dose, a wineglassful. 



224 FERRUM. 

Notes on the Preparations. 

Oxides and Carbonates, including Ferrum Reductum, Ferri Car- 
bonas Saccharatus, Mistura Ferri Composita, Pil. Ferri Comp., Massa 
Ferri Carb., Ferri Oxidum Hydratum, Ferri Oxidum Hyd. cum Mag- 
nesia, and Mist. Ferri Aromatica, — possess the haematinic action of iron 
with but little astringency, and are therefore selected to restore the blood 
in anaemia, chlorosis and amenorrhcea, with tendency to dyspepsia and 
constipation. The Hydrated Oxides are only used as antidotes in 
arsenical poisoning. Ferrum Reductum is one of the best forms for 
internal use, but gives rise to sulphuretted or phosphoretted eructations 
which are very disagreeable. The Subcarbonate is little more than the 
Red Oxide, but in the Massa Ferri Carb. the oxidation is prevented by 
the sugar. 

Mineral Acid Salts and their preparations comprise the Sulphate in 
its 3 forms, the solutions of the Subsulphate and Tersulphate, the Phos- 
phate, Pyrophosphate and Hypophosphite, the Chloride and its prepara- 
tions and the Liquor Ferri Nitratis. They are characterized by their 
astringent and corrugating action, and are used locally especially as 
hemostatics, the Solution of the Subsulphate being preferred for topical 
use as it is powerfully styptic but not corrosive. The Tincture of the 
Chloride is one of the best preparations for internal use, and is most 
agreeable in the form of Creuse's tasteless preparation, which is made as 
follows, — Liq. Ferri Chloridi gj, Acidi Citrici 544 grains, Sodii Carb. 
1000 grains or q. s., Aquae Destil. §j, Alcoholis q. s. Dissolve the citric 
acid in the distilled water and heat to the boiling point, gradually adding 
sodium carbonate until the acid is saturated ; mix this with the iron solu- 
tion and make up to ^iv with alcohol. Of the Phosphates the best is 
the Pyrophosphate, which is easily assimilated, readily soluble and entirely 
unirritating. 

Vegetable Acid Salts and their preparations comprise the Lactate, 
Citrate and its preparations, Oxalate, and the preparations of the Acetate 
and the Tartrate. They are the least irritating to the stomach but are 
also the least efficient as chalybeates. They may be administered in 
white wines, or with alkalies and vegetable acids in effervescing mix- 
tures. 

The Albuminate is considered by several authorities to be the most 
readily assimilated of al.1 the iron preparations. 

Other Compounds are those in which Iron is combined with bodies 
equally active, as the Syrup of the Bromide, the preparations of the 
Iodide, those with Quinine, Strychnine, etc. Generally these prepara- 
tions are used for a two-fold purpose, namely, to relieve anaemia and 
at the same time act upon the .specific ailment on which the anaemia 
depends. 



FERRUM. 225 

Physiological Action. 

Metallic Iron is not inert,, for in the stomach it acquires molecular 
activity through its oxidation, setting hydrogen free. It is a normal con- 
stituent of the blood (1 part to 230 of red corpuscles), existing probably 
as.an oxide in combination with hsematin, which is not formed without 
it. It is also found in the bile, lymph, chyle, gastric juice, in the pigment 
of the eye, in the milk and the urine. Given medicinally in small doses 
it promotes appetite and digestion, and improves the quality of the blood, 
increasing the number of the red corpuscles. In the stomach all the salts 
of iron are converted into the Chloride and in the duodenum into an 
alkaline albuminate, entering the blood along the whole length of the 
alimentary canal. Large doses, or small ones long-continued are directly 
unfavorable to digestion, nausea and vomiting are produced by the soluble 
preparations, the per-salts are actively irritant, the Iodide, Chloride, 
Nitrate and Sulphate being active poisons, highly astringent, and act 
injuriously on the teeth. Only a small portion of iron is absorbed, the 
rest being eliminated by the intestinal canal, blackening the faeces by 
conversion into a sulphide. Of the portion absorbed from the alimentary 
canal, only a small part reaches the systemic circulation and is eliminated 
by the kidneys, the greater part being excreted by the liver with the bile. 

Locally most of the iron salts are more or less constringing to the 
tissues and the mucous membranes, acting as hemostatics and astringents 
by virtue of their power to coagulate albumen, and acting injuriously on 
the teeth. The Tincture of the Chlorate is considered diuretic. 

Inco?npatibles. 

Alkalies and their carbonates, acids, acidulous salts and vegetable astringents are 
incompatible with most preparations of iron, the latter group being so by virtue of their 
tannic and gallic acids which form a deep blue-black precipitate (tannate of iron) with 
the per-salts. The Tincture of the Chloride is decomposed by alkalies, alkaline earths 
and their carbonates, astringent vegetable infusions, and by mucilage of acacia, which 
latter produces therewith a brown, semi-transparent jelly. 

Therapeutics. 
The chief indication for the internal administration of Iron is anaemia; 
when plethora exists it is contraindicated. It should always be given 
after meals, and occasionally suspended for a time, to avoid deranging 
the stomach. When appetite and digestion are promoted by Iron it will 
do the greatest amount of good, many authorities holding that the prin- 
cipal benefit derived from its use, even in anaemia, is due to its stimulating 
digestion and the primary assimilation. The Sulphate is here probably 
the most efficient salt and is well .used in combination with aloes when 
there exists any intestinal torpor, especially as it increases the cathartic 
power of the latter drug, economizing it, and conferring upon it a 
permanence of action, which alone it does not possess. In pseudo-leuco- 
15 



226 FICUS. 

cythaemia, chorea of anaemic girls at the age of puberty, epilepsy and 
neuralgia of the anaemic, amenorrhoea and other menstrual disorders of 
the same class of subjects, and in acute rheumatism of pale, cachectic 
persons, the chalybeates are generally very efficient remedies, especially 
the Tincture of the Chloride. The same preparation is extensively 
employed in erysipelas and diphtheria with good results. In albumi- 
nuria with chronic disease of the kidneys the Tinctures of the Chloride 
and of the Acetate are useful as chalybeate diuretics. In many cardiac 
diseases of the anaemic, fatty heart, weak heart, dilatation, mitral disease, 
etc., ferruginous preparations are often of signal advantage. In the 
syphilitic cachexia, chancroid, and sloughing phagedena, the Iodide 
gives good results, particularly when the subject is one of debilitated 
constitution. In the nocturnal incontinence of children the Syrup of the 
Iodide is one of the most efficient remedies. In all chronic affections of 
the respiratory organs, when hemorrhage is not existing or threatened, 
the Phosphate of Iron, Quinine and Strychnine is used with much benefit. 
In passive hemorrhages, especially when due to anaemia, the Tincture of 
the Chloride is very effective, and in all active bleeding the Solution of 
the Subsulphate locally used is a prompt and efficient hemostatic. A 
weak solution of this preparation (gj ad ^viij) used in the form of spray is 
the most serviceable astringent in obstinate epistaxis, and in hematemesis 
the same solution may be swallowed in small quantities at short intervals. 
In chronic diarrhoea and dysentery the Solution of the Nitrate is an 
efficient astringent, and a weak solution of the Chloride is used as a 
rectal injection against thread-worms. 

In arsenical poisoning the most effective antidote is the Hydrated 
Oxide, which forms with Arsenious Acid an almost insoluble compound. 
The solutions used in its preparation should be kept on hand and only 
mixed when wanted for use. 



FICUS, Fig,— is the fleshy receptacle of Ficus Carica, bearing fruit 
upon its inner surface. The fig-tree is a member of the nat. ord. Urtica- 
ceae and a native of the shores of the Levant, but is cultivated in Southern 
Europe and in other warm countries. Figs contain about 62 per cent, of 
grape sugar, also gum, fat, etc., and are a constituent of the official 
Confectio Sennae. 

Figs are demulcent, laxative and nutritious. They are used in their 
fresh state as an aliment, but if eaten in quantity may produce flatulence, 
enteralgia and diarrhoea. They are chiefly used as an article of diet in 
habitual constipation, but may be employed as an ingredient of demulcent 
decoctions, and locally as a poultice to gum-boils. 



FCENICULUM FRANGULA FUCHSIN. 227 

FCENICULUM, Fennel, — is the fruit of Fcenicidam vulgare, a 
European cultivated plant of the nat. ord. Umbelliferae. It is ^ to yi 
of an inch long, oblong, slightly curved, separable into 2 mericarps, and 
having 5 ribs, and several oil-tubes, odor and taste aromatic. It contains 
a volatile oil, united with a terpene, and is a constituent of Pulvis Glycyr- 
rhizse Compositus. 

Oleum Fceniculi, — the volatile oil, a light-yellow colored liquid, having the odor of 
fennel, a warm taste and neutral reaction, soluble in alcohol. It is an ingredient of Spiri- 
tus Juniperi Compositus. Dose, mjj-v. 

Aqua Funiculi, —contains 2 parts of the oil in 1000 of distilled water percolated through 
cotton. Dose, ^ss-^j. 

Fennel is an aromatic stomachic and a mild stimulant. It is chiefly 
used as an agreeable carminative in flatulence and colic, and as a corri- 
gent to Senna, Rhubarb, and other disagreeable medicines. An infusion 
is often used as an enema to expel flatus in infants. 



FRANGULA, Buckthorn,— the bark, collected at least one year 
before being used, of Rhamnus Frangula, or Alder Buckthorn, a Euro- 
pean shrub of the nat. ord. Rhamnacese. Occurs in quilled pieces ^ inch 
thick, outer surface of gray-brown color, with numerous small warts. It 
contains several principles, of which the only important one is Frangulin, 
or Rhamnoxanthin, a lemon-yellow, odorless and tasteless glucoside, in- 
soluble in water and but sparingly so in alcohol or ether, and thought to 
be identical with Cathartin, the active principle of Senna. Another 
species of the genus Rhamnus is described under the title Cascara 
Sagrada, see ante, p. 162. 

Extr actum Frangulce Fluidum, — Dose, gss-ij. 

Frangula-bark when fresh is a violent irritant to the gastro- intestinal 
tract, producing vomiting, purging, and much pain. The old dried bark 
is a safe purgative without irritant qualities, and is much used in the con- 
stipation of pregnancy, and other conditions requiring purgation. The 
fluid extract is the best form for administration. 



FUCHSIN, Roseine, Magenta, Anilin Red (Unofficial),— is 
the Hydrochlorate of Rosanilm, C 20 H 10 N 3 .HC1, occurring in brilliant, 
elongated crystals having a green lustre, readily soluble in water and 
therein making a bright red solution. Given internally it has produced 
salivation, vomiting, and diarrhoea ; and when injected intravenously it 
has caused trembling, staggering, albuminuria and fatty degeneration of 
the kidneys, symptoms which are thought to be possibly due to the. 



228 FUCUS VESICULOSUS GALBANUM. 

presence of Arsenic or Anilin as impurities. It imparts a magenta color 
to the urine, and is excreted by the kidneys, liver and salivary glands. It 
has been found to be very efficient in reducing albuminuria, in many 
instances having entirely arrested it. It is best administered in pill with 
a vegetable extract as Liquorice or Gentian, and in doses of gr. ^-iv, 
according to age. 



FUCUS VESICULOSUS, Bladder-wrack, Sea-wrack (Un- 
official),— is a perennial plant of the nat. ord. Algae, growing on the 
shores of the Atlantic and Pacific Oceans as a sea-weed. It has a flat leaf, 
with a midrib throughout its length, and small spherical vesicles, filled 
with air, in the leaf. It contains mucilage and much Soda in saline com- 
bination, also Iodine, but less of the latter than other algae growing in 
deeper water. A decoction of the fresh plant is the best form for admin- 
istration. 

Fucus Vesiculosus is one of a number of marine plants which are 
used in various parts of the world as food for man and cattle and as 
manure. The species under consideration is considered alterative and 
tonic, and has been employed in goitre, glandular and joint enlargements 
and psoriasis, but especially to produce absorption of adipose tissue in the 
obese. An extract is sold under the title "Anti-fat." 



GALBANUM, — is a gum-resin obtained from Ferula galbaniflua, 
an Asiatic plant of the nat. ord. Umbelliferae, and probably from other 
allied plants. It occurs in minute tears, agglutinated into a hard mass, 
of balsamic odor and acrid, bitter taste. It contains a Volatile Oil iso- 
meric with Turpentine, a Gum, and a mixture of Resins which yield by 
dry distillation a blue oil and Umbelliferon, a tasteless substance in satiny 
crystals. Dose, gr. x-xx, in pill or emulsion. 

Pilules Galbani Composite ', — each pill contains of Galbanum \]/ 2 grain, Myrrh \ l / z 
grain, Asafttida ^ grain, and Syrup. Dose, ij-iij. 

Emplastrum Galbani, — Galbanum 1 6, Turpentine 2, Burgundy Pitch 6, and Lead 
plaster 76 parts. 

Galbanum is also an ingredient of Emplastrum Asafoetidse. 

Galbanum is stimulant, expectorant and antispasmodic, acting much 
like Ammonia and Asafetida, and usually given with either of these sub- 
stances. It is used in chronic bronchitis and catarrh of mucous mem- 
branes generally, in amenorrhcea and chronic rheumatism. The plaster 
is used as a stimulant application to indolent swellings. 



GALLA GAULTHERIA GELSEMIUM. 229 

GALLA, Nutgall, — is an excrescence on Quercus lusitanica, the 
D)er's Oak, a shrub of the nat. ord. Cupuliferae, growing in Western 
Asia, and is caused by the puncture and deposited ova of the insect Cynips 
Gallce iinctorice. Galls are hard, globular bodies, from ^ to ^ inch in 
diameter, of blackish-gray color, tuberculated on the surface, having a 
central cavity, and an intensely astringent taste. They contain from 15 
to 75 per cent, of Tannic Acid, about 5 per cent, of Gallic Acid, and 
other unimportant constituents. Dose, gr. v-xv. 

Tincturce Gallce, — strength 20 per cent. Dose, ^ss-iij. 
Unguentum Gallce, — strength 10 per cent. 

The action of Nutgalls is powerfully astringent, due to the Tannic and 
Gallic Acids contained in them. Having no special action or use of 
their own, their qualities may be learned by consulting the articles 
Acidum Tannicum and Acidum Gallicum, ante, pages 75 and 64. 



GAULTHERIA, Wintergreen,— is the leaf of Gaultheria pro- 
cumbens, an American evergreen plant of the nat. ord. Ericaceae, having 
a peculiar flavor, a fragrant odor, and an aromatic and astringent taste. 
Its active principle is the Volatile Oil, which is official. It also contains 
Tannic Acid, Arbutin, Urson, Ericolin, etc. 

Oleum Gaultheria, Oil of Wintergreen, — is the volatile oil, a liquid of peculiar and 
aromatic odor, sweetish, warm taste, and a slightly acid reaction. It is readily soluble in 
alcohol, and consists of Methyl Salicylate 90 per cent., and Gaultherilene, a hydrocarbon, 
10 per cent. Dose, TTLiij-x. 

Spiritus Gaultheria, — has of the oil 3 per cent., dissolved in 97 of alcohol. Used for 
flavoring. Dose, 5[ss-ij. 

Gaultheria is stimulant and slightly astringent. Its chief value is as 
one of the sources of the oil named after it, which is also found in the 
sweet birch and many other plants, and, containing so large a proportion 
of Methyl Salicylate or Methylsalicylic Acid, is powerfully antiseptic and 
antipyretic. In large doses it is irritant to the stomach, in one case ^j 
having caused death by violent gastritis. 

Oil of Gaultheria is used successfully as a substitute for Salicylic Acid 
in many conditions, especially in rheumatic and gouty disorders. The 
plant has been used as an emmenagogue and a galactagogue, but its prin- 
cipal employment is in the form of the spirit as an agreeable flavoring 
agent. 



GELSEMIUM, Yellow Jasmine, — is the rhizome and rootlets of 
Gelsemium sempervirens, a climbing plant of the nat. ord. Loganiaceae, 
with showy yellow flowers, which grows in the forests of the southern 
U. S. forming festoons from one tree to another. The rhizome is cylin- 



23O GELSEMIUM. 

drical, long, about an inch thick, of a light yellowish-brown color, an 
aromatic, heavy odor and a bitter taste. It contains a volatile oil, a resin 
and an alkaloid Gelsemine in combination with Gelsemic Acid. Dose, 
gr. ij-xx. 

Preparations. 

Extrachim Gelsemii Fluidum, — alcoholic. Dose, rujj-xx. 

Tinciura Ge/semii, — strength 15 per cent. Dose, TT^x- % j. 

Ge/semina, Gelsemine, C u H 19 N0 2 (Unofficial), — an amorphous, colorless, inodorous, 
nearly insoluble solid, of intensely bitter taste, and strong basic properties, neutralizing 
the strongest acids and with them forming soluble salts. Dose, gr. ^-^V 

Physiological Action. 

Gelsemium is a powerful motor-depressant, causing paralysis of motility 
and depression of sensibility by central action on the spinal cord. It is 
also antispasmodic and diaphoretic. In moderate doses it produces 
languor, slowing of the cardiac rate, enfeebled muscular action, impaired 
sensibility, drooped eyelids and dilated pupils, with some diaphoresis. 
In toxic dose, as a teaspoonful of the fluid extract, it produces vertigo, 
diplopia, drooped eyelids and dilated pupils (paralysis of 3d nerve), 
labored respiration, slow and feeble heart, dropped jaw, staggering gait, 
extreme muscular weakness and almost complete anaesthesia, profuse 
diaphoresis, loss of artitulation, and death by asphyxia from paralysis of 
the muscles of respiration, consciousness being preserved until C0 2 nar- 
cosis sets in. Convulsions occur in animals with backward movements, 
but not in man. Motion is affected before sensibility in warm-blooded 
animals, sensibility before motion in frogs. 

Gelsemium is not an arterial depressant, although it lowers the heart- 
rate, and is not irritant to the gastro-intestinal tract, but it produces a 
decided lowering of the body temperature. The effects of a moderate 
dose pass off in about three hours. 

Antagonists and Incompatibles. 

Morphine is the most complete antagonist, so are also Digitalis, Ammonia, Alcohol, 
and to some extent the tincture of Xanthoxylum fraxineum. Emetics, heat, faradization 
of the respiratory muscles and artificial respiration are measures of prime importance. 
The caustic alkalies and tannic acid are chemically incompatible. 

Therapeutics. 
Gelsemium is indicated in all conditions of exalted nerve function, and 
contraindicated whenever there is a weak heart. It is best used in 
cerebro-spinal meningitis, mania with great motor excitement and persist- 
ent insomnia, delirium tremens, many forms of sleeplessness, pneumonia 
and pleurisy if the heart be strong, coughs of convulsive and spasmodic 
character, neuralgia of the fifth nerve, remittent fever, after-pains, ovarian 
neuralgia, dysmenorrhcea, irritable bladder of women, and incontinence 
of urine from spasm of the vesical muscular fibres. In most of these 



GENTIANA. 23 1 

affections the remedy must be pushed to the inducing of some physio- 
logical symptoms, but its action should not be carried beyond the produc- 
tion of drooped eyelids, diplopia and muscular debility. It has also been 
used with varying success in intercostal neuralgia, myalgia, sciatica, 
spasmodic asthma, sick headache, eczema, pruritus and tetanus. Its espe- 
cial field, however, is in remittent and typho-malarial fevers and cerebro- 
spinal meningitis. It is not suitable to low fevers and has not sufficient 
power as a cardiac depressant to be of much use in sthenic forms. 

There is much evidence for the claim made for the drug Gelsemine, 
of singular efficiency in antagonizing the mental condition occasionally 
manifested by an unusual degree of dread, in regard to some approach- 
ing ordeal, or ordinary trial of life ; as, for example, that of a woman 
concerning her impending confinement, or of a student in reference to 
his examinations. In very many such cases, the use of Gelsemine, in 
small doses frequently repeated (gr. T ^ ter die), has seemed to remove 
the state of abnormal fear entirely. 

GENTIANA, Gentian, — is the root of Gentiana lutea, the Yellow 
Gentian, one of a numerous family of plants (nat. ord. Gentianaceae), 
which inhabit the mountainous districts of Europe. An American species, 
G. Catesbcei, Blue Gentian, is considered nearly equal in value»to the 
official species. Gentian occurs in cylindrical pieces or longitudinal 
slices of the root, which is ^ to 1 inch thick and several inches long, 
brown externally, yellowish-brown within, of faint, peculiar odor, and 
taste at first sweetish, afterwards persistently bitter. It contains an active, 
bitter glucoside, Gentopicrin or Geniianin, C2oH 30 12 , which is crystalline 
and soluble in water, also an inert, amorphous body, Gentianic or Gentesic 
Acid, gum, considerable sugar, and a trace of volatile oil, but no tannin. 

. Preparations. 
Extractum Gentiance, — aqueous. Dose, gr. j-v. 
Extractum Gentiance Fluidum, — Dose^ss-j. 

Tinctura Gentiance Composita, — Gentian 8, Bitter Orange Peel 4, Cardamom, 2, Di- 
luted Alcohol to 100. Dose, 3 ss— ij . 

Unofficial Preparations. 

Infusum Gentiance Composition, — contains Gentian 10, Bitter Orange Peel 2*4, Cori- 
ander 2^, Alcohol 40, Water to 320. Dose, gj- 5jj. 

Mistura Gentiana Alkalina, — Ac. Hydrocyan. Dil. VC[ii], Sodii Bicarb.gr. xv, Infusum 
Gentianse Co. to !|j. One dose. 

Mistura Gentiance et Sennce, — Infusum Sennae ^iij, Tr. Cardamomi Co. gj, Infusum 
Gentianae Co. 3 vj. One dose. 

Physiological Action and Therapeutics. 
Gentian is a simple bitter without astringency or aroma, its action 
corresponding to that of Calumba (see ante, page 149), but it is more 
apt to disagree with the stomach. In addition, like Cornus, a member 






232 GERANIUM GLYCERINUM. 

of the same class, it has considerable repute as an antiperiodic and 
febrifuge. 

Gentian has been considered a valuable tonic throughout all Europe 
from the earliest historical times. It is highly esteemed as a stomachic 
tonic in dyspepsia connected with a gouty diathesis, in hysteria, jaundice, 
and in convalescence from acute diseases and from malarial fever. The 
compound tincture is an excellent vehicle for cod-liver oil, and the now 
unofficial infusion is a good vehicle for the administration of chalybeates, 
mineral acids and neutral salts. The discoloration which iron salts make 
with gentian preparations is probably due to Gentesic Acid and not to 
tannin, as it contains none of the latter. 



GERANIUM, Cranesbill-root, — is the rhizome of the indigenous 
perennial Geranium tnaculatum (nat. ord. Geraniaceae). It is 2 or 3 
inches long, horizontal, contorted and tuberculated, with thin, fragile 
rootlets, inodorous, taste astringent. Its active constituents are tannic 
and gallic acids. 

Preparation. 

Extractum Geranii Fluidum, — Dose, rr^v-^j. 

Physiological Action and Therapeutics. 
Geranium is an efficient astringent, and its action corresponds with that 
of Tannic Acid (see ante, page 75). Having no unpleasant taste it is a 
useful agent for infants and others having delicate stomachs, and is a very 
popular domestic remedy in many parts of the country. It is especially 
used in diarrhoeas, dysentery,* cholera infantum, hemorrhages, relaxed 
conditions of mucous membranes, gleet and leucorrhcea. 



GLYCERINUM, Glycerin,— is a liquid obtained by the decom- 
position of fats or fixed oils, containing not less than 95 per cent, of 
absolute Glycerin, C 3 H 5 (HO) 3 , which exists in fats and fixed oils in com- 
bination with the fatty acids. 

Glycerin is clear and colorless, of syrupy consistence, hygroscopic, non-drying, odorless, 
of warm and very sweet taste, neutral reaction, sp. gr. 1.250, soluble in water and alcohol, 
but insoluble in ether, chloroform and fixed oils. It dissolves tannin, gallic acid, carbolic 
acid, salicylic acid, bromine, iodine, etc , and with the aid of heat metallic salts and 
oxides, alkaloids, etc. With strong Nitric Acid it forms Nitro-glycerin, and it reduces 
potassium permanganate, chromic acid and chlorinated lime with great violence. An 
impurity frequently present in it is Acrolein, formed by the use of too high a heat in its 
manufacture, and which is very acrid and poisonous. Glycerin is a constituent of Glyce- 
ritum Amyli, Glyceritum Vitelli, Pilulse Phosphori, Mucilago Tragacanthse, Massa Hy- 
drargyri, and several extracts and fluid extracts. Dose, £ j-ij, diluted. 



glycyrrhiza. 233 

Physiological Action. 

Glycerin is highly antiseptic, abstracts water from tissues with which it 
comes in contact, and unless pure is often very irritating to the skin. It 
is freely absorbed by all surfaces, cutaneous and mucous, and is decom- 
posed in the system, passing out as formic and other acids. On the 
stomach it has no particular action, but in large quantities it is laxative 
and is said to cause the solution of the red blood corpuscles and hemo- 
globinuria. The urine of persons using glycerin contains a body which 
acts like sugar in the copper and fermentation tests, but is not sugar. 
Glycerin is a good emollient and is considered nutritive by many 
authorities. 

Therapeutics. 

Glycerin has been used as a substitute for Cod-liver Oil in wasting dis- 
eases, but with little benefit. It has also been tried as a remedy in 
diabetes, but with unsatisfactory results so far as reported, except as a 
sweetening substitute for sugar in the dietary of those afflicted with that 
disease. It is said to be fatal to intestinal trichinae, and to be an efficient 
internal remedy in acne and flatulence. In chronic constipation, most 
excellent results are obtained from rectal enemata of Glycerin, or from 
suppositories thereof made with soap or gelatin (y^) to give them consis- 
tency. As a vehicle it is used for many drugs, and is a good ingredient 
of solutions for hypodermic use, promoting the solubility of many alka- 
loids and acting as an antiseptic. It is also employed to preserve and 
aid the action of the digestive ferments, Pepsin and Pancreatin, as well as 
to prevent the decomposition of vaccine lymph. 

Locally it is valuable in many cutaneous affections as an emollient and 
-softening agent. In acute coryza it gives great relief if applied by a 
brush or as a spray to the nasal mucous membrane. It is used on cotton 
to the cervix uteri as a depleting agent, and mixed with an infusion of 
flaxseed as an enema to relieve tenesmus in acute dysentery. With tinc- 
ture of Benzoin it is an excellent application to chapped hands or lips 
and fissured nipples. In the external auditory canal it is usefully 
employed to soften cerumen, diminish the 'secretion of pus, deplete the 
tissues, and keep the surface moist. [For other uses of Glycerin in com- 
bination see Glyceritum Vitelli, Glyceritum Amyli, and Glyceritum Acidi 
Tannici, under the titles of their respective bases.] 

GLYCYRRHIZA, Liquorice Root,— is the root of Glycyrrhiza 
glabra, a plant of the nat. ord. Leguminosae, native in southern Europe 
and Asia, but largely cultivated in many other parts. It occurs in long 
pieces, i to i inch thick, longitudinally wrinkled, of a grayish-brown 
color externally, tawny-yellow internally, pliable and tough, and of a 
somewhat acrid, sweet taste. It contains a yellow, amorphous glucoside, 



234 GOSSYPIUM. 

Glycyrrhizin, C 2 4H 36 9 , also Glycyrrhizic Acid, Asparagin, sugar, resin, 
gum, etc. Glycyrrhizin when boiled with dilute acids yields glucose and 
a very bitter substance named Glycyrretin. 

Preparations. 

Extraction Glycyrrhizce, — is the commercial extract of the root, occurring in glossy- 
black rolls, of sweet, peculiar taste. Not less than 60 per cent, of it should be soluble in 
cold water. 

Extr actum Glycyrrhizce Purum, — made with Aqua Ammonia and Water, by percola- 
tion and evaporation to a pilular consistence. Dose, indefinite. 

Extractum Glycyrrhizce Fluidum, — made with Aqua Ammonia and diluted Alcohol. 
Dose, indefinite. 

Mistura Glycyrrhizce Composiia, Brown Mixture, — has of the Pure Extract 3 parts, 
Sugar 3, Acacia 3, Tr. Opii Camph. 12, Vinum Antimonii 6, Spt. yEtheris Nitrosi 3, and 
Water 70. Dose, 3J-J§ss. 

Pulvis Glycyrrhizce Compositus, — Senna 18, Glycyrrhiza 16, Fennel 8, Washed Sul- 
phur 8, Sugar 50 parts. Dose, a teaspoonful. 

Trochisci Glycyrrhizce et Opii, — each has of Extract of Glycyrrhiza gr. ij, Extract of 
Opium gr. ^, Acacia, Sugar and Oil of Anise. Dose, j-ij every hour. 

Glycyrrhizinum Ammoniaium, Ammoniated Glycyrrhizin, — the sweet principle of 
Liquorice rendered soluble and therefore tasteable by Ammonia, believed to be the form 
in which Glycyrrhizin exists in the root. Occurs in brownish-red scales, very sweet, and 
soluble in water or in alcohol. Dose, gr. v-xv. Is a constituent of Velouline, for which 
see page 187. 

Physiological Action and Therapeutics. 
Liquorice is demulcent and mildly laxative. It has an agreeable taste, 
and increases the flow of saliva and mucus when slowly chewed or sucked, 
the increased secretions acting as emollients to the throat. It is used in 
many pharmaceutical preparations, covering the taste of Senna, Senega, 
Hyoscyamus, Turpentine, Chloride of Ammonium, bitter Sulphates, and 
to some degree the bitterness of Quinine. The powdered extract or root 
is used as an excipient in pills and troches. The Compound Mixture is 
an efficient expectorant, much employed in acute bronchitis and catarrhal 
laryngitis, but owing its power over cough mainly to the Opium contained 
in it. The Compound Powder is a gentle laxative", of which Senna is the 
most active ingredient. The Troches are used for cough, but must be 
carefully prescribed to children, as they contain gr. -^ of Extract of 
Opium in each. 



GOSSYPIUM, Cotton, — is the hair of the seed of Gossypium her- 
baceum, and of other species of Gossypium (nat. ord. Malvaceae), freed 
from adhering impurities and deprived of fatty matter. In this form it is 
known as Purified or Absorbent Cotton, is insoluble in water, alcohol or 
ether, but is soluble in an ammoniacal solution of Cupric Sulphate. Cot- 
ton-fibre is familiar in appearance to every one, but when examined 
microscopically, it shows as flattened, hollow and twisted bands, spirally 
striate, and slightly thickened at the edges. It is a modification of Cel- 
lulose, C 12 H 10 O 10 , and corresponds therewith in all its ordinary chemical 
properties. 



GOSSYPIUM. 235 

Preparations of the Cotton Plant. 

Gossypii Radicis Cortex, Cotton Root Bark, — thin bands or quilled pieces, brownish 
yellow exteriorly, white interiorly, of slightly acrid and astringent taste. Dose, gr. 

XXX— gj. 

Extractum Gossypii Radicis Fluidum, — made with Glycerin and Alcohol, by macera- 
tion and percolation. Dose, nrxxx-^j. 

Oleum Gossypii Se?ninis, Cotton seed Oil, — the fixed oil expressed from the seeds and 
purified. Is yellow, odorless, of bland taste and neutral reaction, soluble in ether, but 
slightly soluble in alcohol. Is introduced into the pharmacopoeia for the reason that it 
constitutes most of the "Olive Oil" sold in foreign-shaped bottles and under foreign- 
appearing labels. It is directed to be used in the official Liniments of Ammonia, Lime, 
Camphor, and Sub-acetate of Lead. 

Pyroxylinum, Pyroxylin, Soluble Gun-cotton, — is official for the purpose of making 
Collodium. It is prepared by macerating Cotton in a mixture of Sulphuric and Nitric 
Acids, washing, draining and drying. 

Collodium, Collodion, — made by dissolving Pyroxylin 4, in Ether 70 and Alcohol 26 
parts. 

Collodium Flexile, Flexible Collodion, — Collodion 92, Canada Turpentine 5, Castor 
Oil 3 parts. 

Collodium Stypticum, Styptic Collodion, — Collodion 55, Ether 20, Alcohol 5, Tannic 
Acid 20 parts. 

Collodium cum Cantharide, Cantharidal Collodion, — Cantharides 60, Flexible Collo- 
dion 85, Chloroform q. s. 

Physiological Action. 
Cotton-root is believed to be an efficient emmenagogue and oxytocic 
by Southern practitioners, also somewhat of a galactagogue, but experi- 
ments on pregnant animals have not confirmed this view of its action. 
The Oil of the seed is very bland and may be applied to all the purposes 
for which Olive Oil is used. Cotton itself, when freed from oily matter, 
is remarkably absorbent of water, and is a good agent for excluding air 
from injured surfaces. Pyroxylin is highly inflammable, and explosive 
at 300 F. Collodion is also inflammable, and rapidly dries on exposure 
to the atmosphere by evaporation of its ether, leaving a transparent film 
of Pyroxylin on the surface to which it has been applied ; which film, if 
the flexible collodion be used, does not contract on drying or readily- 
crack, making it an excellent protective application. Styptic Collodion 
is a solution of Tannin, and is an excellent hemostatic. Canthakidal 
Collodion is a convenient blistering agent, suitable for cases where the 
patient is inclined to remove a blister if applied in the ordinary way. 

Therapeutics. 

Absorbent Cotton is a valuable agent in surgical practice, being em- 
ployed as an application in burns and scalds, erysipelas, articular rheuma- 
tism, etc., to exclude the atmosphere, allay pain, and when covered with 
oiled-silk or rubber cloth to keep up local perspiration. It may be car- 
bolated, borated or salicylated by soaking in the respective solutions, and 
then used as an antiseptic dressing for wounds, ulcers, etc. It is employed 
by the pharmacist in funnels to filter oils, and for the preparation of the 
official waters. 

Cotton-root Bark is much employed by the negroes of the Southern 



236 GRANATUM. 

States in decoction as a supposed abortifacient, oxytocic and emmena- 
gogue. It is used in the South for intensifying uterine action in normal 
labor, in dysmenorrhcea and amenorrhcea. A decoction of giv in a 
quart of water boiled to a pint is the favorite preparation, administered 
in wineglassful doses. 

Collodion is used as a protective covering for superficial burns, ulcers 
and wounds, slight cuts, cracked nipples, anal fissures, and erysipelas. 
For these affections the flexible collodion should be used, but where it is 
desirable to produce pressure on the part the ordinary form is best, as it 
contracts in drying with considerable force. This property makes it 
highly useful in drawing the edges of wounds together, bringing pressure 
on buboes, incipient boils, carbuncles, etc. 

Styptic Collodion has many uses as a hemostatic and protective which 
will suggest themselves, and the Cantharidal form is a convenient epi- 
spastic for uneven surfaces, the therapeutics of which are detailed under 
Cantharis. (See ante, page 156.) 



GRANATUM, Pomegranate, — is the bark of the root of Punka 
Granatum, a small tree of the nat. ord. Granataceae, cultivated in sub- 
tropical countries. It occurs in thin quills of yellowish-gray color, warty 
or ridged on the external surface, inodorous, of astringent and slightly 
bitter taste. It contains Tannic and Punico-tannic Acids, Mannite and 
an active liquid alkaloid Pelletierine, C 8 H 13 NO, which is soluble in water, 
alcohol, ether, chloroform, etc., and has strong basic properties. There 
are no official preparations. 

Unofficial Preparations. 

Extr actum Granati Fluidum, — Dose, gss-jss. 

Decoctutn Granati, — gxvij of bark from the fresh root in 2j xvij of boiling water, 
boiled down to ^xij and strained. Dose, ,^iv-vj every hour, preceded and followed in 
a few hours by a brisk cathartic. The decoction of the Br. Phar. is of I to 8 strength 
and is given in doses of ^ ij— iv. 

Pelletierince Tannas, Tannate of Pelletierine, — Dose, gr. v-xx, taken fasting and fol- 
lowed in 15 minutes by a sharp purgative. 

Physiological Action and Therapeutics. 
Granatum and its alkaloid are taeniafuge, and very efficiently so, rarely 
failing to bring away the whole worm. The decoction is usually em- 
ployed, but lately Pelletierine has been coming into fashion, a proprietary 
form being sold as " Tanret's Pelletierine " in bottles containing one 
adult dose at three dollars each. The decoction, in full doses, causes 
nausea and vomiting, flatulence, purging, and sometimes cramps in the 
legs, giddiness, dimness of vision, general numbness of the limbs and in- 
crease of the quantity of urine. 






GRINDELIA. 237 

For the expulsion of tape-worm a mixed treatment by Pomegranate- 
root bark, Pumpkin seeds and Oleoresin and Male-fern is preferred by 
many practitioners. The following formula has proved very efficient. 
R. Granati gij, Aquae Ojss, boiled to gvij ; Pepinis g, deprived of 
outer coats and beaten to a paste with fine-powdered sugar ; Oleoresinae 
Aspidii, gr. xxx, made into emulsion with Acacia and the above decoction 
of Granatum, then added to the paste of Pepo, and flavored with Syrups 
up to %'\x, one-third of this to be taken in the morning after a light diet 
and a laxative on the previous day. If not successful the second and 
third portions may be taken at intervals of 3 hours. The worm should 
be passed sitting in a tepid sitz-bath to prevent the expelled portion 
tearing off, the head by its weight. 



GRINDELIA, — the leaves and flowering tops of Grindelia robusta, 
an herbaceous Californiari plant, of the nat. ord. Compositae, having a 
branched stem, lower leaves spatulate and tapering at the base, upper 
leaves oblong, pointed and have broad bases, flowers yellow, odor bal- 
samic, taste pungently aromatic and bitter. It contains a resin, a volatile 
oil, and an alkaloid with basic properties. 

Preparation. 
Extractum Grindelice Fluidum, — Dose, tt\,x-gj. 

Physiological Action. 
Grindelia is antispasmodic and a motor-depressant, inducing paralysis 
in small animals beginning in the hind extremities. It slightly slows the 
heart and respiration, and produces mydriasis and hypnotic effects if 
given in sufficient quantity, with reduced cutaneous sensibility and slug- 
gish reflexes. It has a pungent taste, creates a sense of warmth in the 
stomach, and in small doses promotes appetite and digestion. It is elimi- 
nated by the pulmonary mucous membrane and the kidneys, and is 
markedly diuretic. 

Therapeutics. 

Grindelia has been used chiefly in spasmodic asthma, bronchitis and 
whooping-cough, which it greatly relieves. It is a useful remedy in spas- 
modic coughs, dyspnoea of various pulmonary and cardiac affections, 
hay-fever, and chronic cystitis. Locally it is highly efficient as a sedative 
lotion (1 part of the fluid extract to 10 of water) in poisoning by Rhus 
toxicodendron, and in skin diseases attended with itching and burning 
sensations. 



238 GUAIACUM. 

GUAIACUM, Lignum Vitae, — is official in two forms, Guaiaci 
Lignum, the heart-wood, and Guaiaci Resina, Guaiac, the resin of the 
wood of Guaiacum officinale, a large West Indian tree of the nat. ord. 
Zygophyllaceae. The Resin is the important constituent, and itself con- 
sists of three resins, namely, — Guaiaconic Acid, C^H.^C^, 70 per cent., 
Guaiac Acid, C 6 H 8 3 , resembling Benzoic Acid, and Guaiarec Acid, 
C 2 oH 26 4 ; also an indifferent resin. The wood also contains a yellow 
coloring matter, gum, etc. 

Guaiaci Lignum, Guaiacum Wood, — generally used in the form of 
raspings of greenish- brown color containing whitish particles, of resinous 
odor, taste slightly acrid. Is a constituent of Decoctum Sarsaparillae 
Compositum. 

Guaiaci Resina, Guaiac, — occurs in large masses of a greenish-brown 
or reddish-brown color, feebly aromatic, taste somewhat acrid, fracture 
having a glassy lustre, insoluble in water, soluble in alcohol, ether, chlo- 
roform and alkaline fluids. Dose, gr. v-xxx, in wafer. 

Preparations. 

Tinctura Gtiaiaci, — Guaiac 20 percent. Dose, rr\v- 3 j, in mucilage or syrups, as 
the resin is precipitated by water. 

Tinctura Guaiaci Ammoniata, — Guaiac 20, Aromatic Spirit of Ammonia 80 parts. 
Dose, TT\,v- 3 ss. 

Physiological Action. 
Guaiac is diaphoretic, expectorant and alterative. Its taste is acrid and 
very disagreeable. Internally it is a local stimulant, producing salivation, 
an acrid sensation in the throat, warmth in the epigastrium, increase of 
the gastric and intestinal secretions and the flow of bile, and reflex stimu- 
lation of the heart. Its continued use causes gastric catarrh, and in large 
doses it is a gastro-intestinal irritant, causing vomiting, purging and 
severe congestive headache. Though a colloidal body it enters the blood, 
stimulates the liver and other excretory glands and the production of 
bronchial mucus, and causes increased circulation and diaphoresis. 
Sometimes it fails to act on the skin and then is markedly diuretic. 

Incompatibles. 
Mineral Acids and Spirit of Nitrous Ether are chemically incompatible with Guaiac 
preparations. 

Therapeutics. 
Guaiacum was first used as an antisyphilitic, being used in decoction 
and in large quantity, with a spare diet and external warmth. It acquired 
a great reputation in this disease during the 16th century, but it is now 
abandoned for this purpose except as an ingredient of the Compound 
Decoction of Sarsaparilla. It is a very efficient remedy in tonsillitis, 
given in gss doses of the tincture in emulsion with mucilage or yolk of 
egg, to abate the inflammation and abort the disease. It has considerable 



GUARANA GURJUN BALSAM. 239 

reputation in neuralgic dysmenorrhea, amenorrhoea, chronic rheumatism, 
gout, lumbago and sciatica. The ammoniated tincture in water makes a 
cleanly and not very disagreeable gargle. 



GUARANA, — is a dried paste prepared from the crushed or ground 
seeds of Paullinia sorbilis, a climbing plant of the nat. ord. Sapindaceae, 
growing in Brazil. It occurs in brown cakes or sticks, having an odor of 
chocolate and a bitter, astringent taste, partly soluble in water and in 
alcohol. It contains 25 per cent, of tannic acid, gum, albumen, starch, 
and a greenish fixed oil, also an alkaloid Gnaranine (5 per cent.), which 
is identical with Caffeine. The specimens of Guarana in the market are 
very untrustworthy, unequal in quality and expensive, it being a secret 
mixture prepared in Brazil. Hence it has been omitted from the list of 
Squibb's preparations, and a fluid extract of green coffee substituted in 
its place. 

Preparation. 
Exlractu?)i Guarance Fluidum, — Dose, rr^x-^ij. 

Physiological Action and Therapeutics. 
Guarana has similar actions to those of Coffee, the active principles of 
both plants being identical, both chemically and physiologically. It is 
chiefly employed in the treatment of nervous sick-headache (migraine) 
administered in half-drachm doses of the fluid extract when the attack is 
developing. It has been used in the diarrhoea of phthisis, convalescence 
from acute diseases, and generally in conditions requiring tonic treatment. 



GURJUN BALSAM, Wood Oil, Balsamum Dipterocarpi 

(Un official), — is an oleoresin obtained from incisions in various trees of 
the genus Dipterocarpus, growing in India. It is thick, opaque and 
grayish-brown by reflected light, soluble in chloroform and partly so in 
alcohol, ether and volatile oils, odor balsamic, taste bitter. It contains 
from 40 to 70 per cent, of a Volatile Oil, a Resin and Gurjunic Acid. 
Dose, TTLx-^ij, in emulsion, or in capsules. 

Physiological Action and Therapeutics. 
The properties of this balsam are similar to those of Copaiba, but it is 
less disagreeable and less apt to upset the stomach, also less actively diu- 
retic. It has been used with good success in leprosy, given internally in 
full doses and used locally at the same time. Mixed with 4 parts of Lime- 
water it is well applied in chronic eczema, lupus and psoriasis. 



24O GUTTA PERCHA H^SMATOXYLON. 

GUTTA-PERCHA, — is the concrete exudation of Isonandra Gutta, 
a large tree of the nat. ord. Sapotaceae, growing in the Malay peninsula 
and adjoining islands. Occurs in tough but somewhat flexible pieces, of 
grayish or yellowish color, plastic above 140 F., soft at 212 F., insol- 
uble in water or alcohol, soluble in chloroform, oil of turpentine, carbon 
bisulphide, benzin and benzol. It contains a hydrocarbon, Gutta, C 10 H 16 
(80 per cent.)? two Resins named Fluavil zxid Albau, also a volatile oil, 
salts, fat and coloring matter. 

Preparations. 

Liquor Gutta- Per chee, a solution of Gutta- Percha 9, Carbonate of Lead 10, in Chlo- 
roformum Venale 91 parts. Used as a protective application to eruptions and slight 
wounds, the evaporation of the menstruum leaving behind a thin adhesive and non-irrita- 
ting pellicle. 

Traumaticine (Unofficial), — is the name given to a 10 per cent, solution of Gutta-percha 
in Chloroform, which forms on drying a permanent, unirritating, adhesive, flexible and 
non-contractile skin for the treatment of skin affections and slight wounds. It forms an 
excellent basis for the application of Chrysarobin to psoriasis. 

Uses. 
Gutta-Percha has neither physiological action nor therapeutics, being 
used for its physical qualities alone. In surgical practice it has several 
applications, making a good material for splints, as it can be softened in 
hot water and adapted to any surface while pliable. From it are manu- 
factured pessaries, specula, stethoscopes and other instruments. The 
solution may be used as a protective covering for excoriations and slight 
wounds, to prevent pitting in small-pox, and to paint over the line of 
suture after post-mortem examinations. 



HiEMATOXYLON, Log-wood,— is the heart-wood of Hama- 
toxylon campechianum, a tree of the nat. ord. Leguminosse, native of 
tropical America, but naturalized in the West Indies. It occurs in chips 
or powder of a dark brown-red color, often with a greenish lustre, of 
feeble and agreeable odor, taste sweet and astringent, and colors the saliva 
a dark pink when chewed. It contains tannic acid, and a sweet, crystal- 
line coloring principle named Hmnaioxylin, C 10 H u O 6 , which is colorless 
when pure, but turns red on exposure to light. 

Preparations. 

Extractum Hce?natoxyli, — Dose, gr. v-xx. 

Decoctum Hccmatoxyli (Unofficial), — strength 1 in 17. Dose, ,^j-ij. 

Physiological Action and Therapeutics. 
Logwood is mildly astringent, its properties depending on the tannin 
contained in it. As it is devoid of irritating qualities it is well adapted 
to the diarrhoeas and hemorrhages of young children. It does not pro- 



HAMAMELIS HEDEOMA. 24 1 

duce constipation nor disorder the bowels, but colors the urine and stools 
blood-red, and has caused phlebitis. It has been used as an hemostatic 
in bleeding of the lungs, and hemorrhages from the uterus and intestines, 
and as an astringent in leucorrhcea. 



HAMAMELIS, Witch-hazel, — the leaves, collected in autumn, 

of Hamamelis virginica, a shrub of the nat. ord. Hamamelacese, growing 

in the United States, having yellow flowers and oval-shaped leaves about 

4 inches long, which are inodorous, but of a bitter and astringent taste. 

They contain about 8 per cent, of tannic acid, a bitter principle and 

probably some volatile matters, but the chemistry of the plant has not 

been fully studied. 

Preparations. 

Ext factum Hamamelidis Fluidum, — Dose, rnj-gj, is the only official preparation, 
and is prepared from the leaves. 

Hamamelin (Unofficial), — is an uncertain extract of very indefinite composition. Dose, 

Distilled Extracts, so-called, but really Waters distilled from the bark, are sold by 
various manufacturers, and are said by the vendors to contain the volatile principles of 
the plant. Ponds Extract is such a preparation, said to be made by distilling the bark 
with a very dilute alcohol, and is a proprietary medicine of uncertain composition. 

Physiological Action and Therapeutics. 
No trustworthy experimentation has yet been made with this drug. It 
is tonic, astringent, styptic and sedative, owing most of its properties to 
its tannin, but appears to possess some special influence over the venous 
circulation similar to that of Aconite on the arterial system. In full 
doses it may produce severe throbbing pain in the head. It is used both 
internally and locally with great benefit in hemorrhoids, particularly those 
of the bleeding variety, varicose veins and ulcers, varicocele, venous con- 
gestions and threatening local inflammations. It is highly recommended 
in hemorrhages from the nose, stomach, lungs, rectum and kidneys, 
threatened abortion, and externally for sprains and bruises, foul ulcers, 
the pruritus of eczema, leucorrhoea and gonorrhoea. An Ointment of 
Witch-hazel is found in the shops, and suppositories may be prepared 
extemporaneously by evaporating the fluid extract and incorporating the 
residue with cocoa-butter. 



HEDEOMA, Pennyroyal, — the leaves and tops of Hedeoma pule- 
gioides, a plant of the nat. ord. Labiatae, common to all parts of the U. S., 
having a four-sided, hairy stem, pale blue flowers, leaves }i inch long, 
glandular on the under surface, odor strong and mint-like, taste pungent. 
Its only important constituent is the Volatile Oil, which is official. 
16 



242 HELLEBORUS. 

Preparations. 

Oleum Hedeomtz, Oil of Pennyroyal, — is the volatile oil, readily soluble in alcohol. 
Dose, rnjj-x. 

Spiritus Hedeomiz (Unofficial), — contains I part of the oil in 9 of alcohol. Used ex- 
ternally or as spray. 

Physiological Action and Therapeutics. 
Hedeoma is a stimulant aromatic, also somewhat carminative and 
emmenagogue. Its odor is extremely repulsive to insects, especially fleas 
and mosquitoes. In warm infusion it is a popular remedy for amenorrhoea 
and flatulent colic. It may be used as a corrective with other medicines, 
and the spirit is well employed on the hands and face to keep away mos- 
quitoes. The writer has known death by narcosis to result from an over- 
dose of the oil taken to produce an abortion. 



HELLEBORUS, Hellebore (Unofficial),— the rhizome and root- 
lets of Helleborus niger (Black Hellebore) and Helleborus viridis (Green 
Hellebore), plants of the nat. ord. Ranunculaceae, natives of Europe. A 
third variety, Helleborus occidentalism growing in Greece, is probably the 
true Hellebore of the ancients. The rhizome is 1 to 3 inches long, 
knotty, with transverse rings, of, rancid odor when freshly bruised, and 
bitter, acrid taste. Its most important constituents are two glucosides, 
Helleborin and Helleborein, both crystalline and very poisonous. 

Preparations. 

Extractum Hellebori "Nigri (Unofficial), — Dose, gr. j-x, cautiously. 
Extractum Hellebori Nigri Fluidum (Unofficial), — Dose, mjj-xv. 
Helleborin, C 36 H 4? 6 (Unofficial), — crystalline, insoluble in water, soluble in alcohol 
and chloroform. 

Helleborein, C 26 H 44 15 (Unofficial), — crystalline, very soluble in water, slightly so in 



Physiological Action. 

Black Hellebore is a drastic, hydragogue cathartic, and an emmen- 
agogue. In overdoses it is a violent gastro-intestinal irritant, producing 
vomiting, hypercatharsis, vertigo, cramps and convulsions, which may 
result fatally. Locally applied, the fresh root is violently irritant to the 
skin, producing inflammation and vesication. 

Helleborin is an active poison, acting on the tongue like Aconite, 
and on the nervous system as a narcotic, producing in animals paresis of 
motion and sensation, cerebral and spinal congestion, dilated pupils and 
death. It is less irritant than Helleborein to the mucous membranes. 

Helleborein is less actively toxic to animals, but is very irritant, 
producing conjunctivitis, sneezing, salivation, nausea, vomiting and 
purging. It affects the heart like Digitalis, small doses frequently re- 



HOANG-NAN. 243 

peated slowing its action, but large ones quicken it and then suddenly 
paralyze it through the pneumogastric nerve. Respiration is at first 
accelerated, then slowed and rendered laborious. Diuresis is a constant 
result, the kidneys and uterus are congested, gradual paralysis and severe 
convulsions follow, and death occurs by paralysis of the heart. 

Therapeutics. 
Black Hellebore is an old remedy, having been highly esteemed by 
the early physicians in insanity, dropsies, worms, cutaneous affections and 
amenorrhcea. It has at present gone out of fashion, but might be use- 
fully employed in dropsies and as a revulsant in acute cerebral affections. 
Recently Helleborein has come into notice as a substitute for Digitalis in 
cardiac affections, as being of less bulk and more definite composition. 
Its action on the heart is obtained by doses much smaller than 
those necessary for its irritant effects on the gastro-intestinal canal. 
Its solubility in water and the freedom with which it can be used hypo- 
dermically are important qualities to recommend it. 



HO^NG-NAN, or Hwang-Nao, — is the bark of Strychnos Gaul- 
theriana, or Tropical Bind-weed, a creeping vine of the nat. order 
Loganiacese, found in the mountains of Tonquin. It contains the alka- 
loids t Strychnine and Brucine, thus resembling in composition its con- 
geners Nux-Vomica and Ignatia, but differing from them, as they do from 
each other, in the proportional quantities in which the alkaloids are 
contained, — Brucine predominating in this plant, as Strychnine does 
in the other two. 

Physiological Action and Therapeutics. 

Like the other members of the Strychnos family, Hoang-Nan is an active 
tetanizer, its action generally corresponding with that of Nux-Vomica. 
It was first brought into notice by the missionary fathers stationed in the 
French colonies in Asia, they having found its employment general 
among the natives for leprosy and hydrophobia. Along the coast of 
Tonquin and Cochin-China, and in Pondicherry, Trinidad, Venezuela, 
etc., it has an established reputation in the two terrible diseases men- 
tioned, also as a remedy for the bites of venomous serpents and other 
reptiles, scrofulous and syphilitic ulcers, indolent sores, etc. It has been 
used successfully for malarial fevers, in lieu of quinine, and is highly 
spoken of by Father Brosse, as a stimulant to the intellect, without pro- 
ducing any subsequent depression. 

The Dose of the powdered drug is about gr. iij-v ; — of the aceto- 
alcoholic Extract, gr. ^-^ ; — and of the concentrated Tincture, fflj-v. 



244 HUMULUS — HYDRANGEA. 

HUMULUS, Hops, — the strobiles (fruit-cones) of Hamulus Lupu- 
lus, a cultivated creeping plant of the nat. ord. Urticaceae. They are 
ovate, i to ij^ inch long, and consist of a hairy, undulating axis and 
several membranous, greenish scales, odor aromatic, taste bitter, aromatic 
and slightly astringent. Its constituents are wax, resins (50 per cent.), 
tannin (5 per cent.), a liquid volatile alkaloid, Lupuline, a Volatile Oil 
(2 per cent.) which consists in part of Valerol and Trime thy famine, and 
a crystalline, bitter principle Lupulinic Acid (n per cent.). These, 
except tannin, are more abundant in the glandular powder of the strobiles, 
which is named Lupulin. 

Prep a rations. 

Tinctura Humuli, — strength 20 per cent. Dose, gj-ij. 

Lnfusum Humuli (Unofficial), — !|ss to the pint. Dose, ^j-iv. 

Lupidinum, Lupulin, — is the glandular powder separated from the strobiles, of bright 
brownish-yellqw color, aromatic and bitter taste. The Volatile Oil resides in the Lupulin 
grains, and contains Valerol, which is changed into Valerianic Acid by long exposure, 
giving a disagreeable odor to old hops. Dose, gr. v-xv. 

Extractum Lupulini Fluidum, - alcoholic. Dose, Tr^x- gj. 

Oleoresina Lupulini, — an ethereal extract. Dose, gr. ij-v. 

Tinctura Lupulini (Unofficial), — strength y%. Dose, gss-ij. 

Mineral acids and metallic salts are chemically incompatible with preparations of 
Hops. 

Humulus is a bitter tonic, a feeble hypnotic, and somewhat diapho- 
retic, astringent and anaphrodisiac. It increases the cardiac action and 
the cutaneous circulation. After slight cerebral excitement it pro- 
duces calm and a soporific disposition, especially if the solution admin- 
istered be strongly alcoholic. The stomachic and tonic effects are due to 
the bitter principle, lupulinic acid, and are found in bitter ale. The 
primary stimulant and secondary sedative effects are due to the volatile 
oil and are also possessed by ales and beer. 

Hops are used as a tonic and calmative in delirium tremens, in which a combination of 
the tincture with Tr. Capsici is very efficient and is an excellent substitute for alcohol. In 
dyspepsia of atonic form Humulus is an excellent stomachic tonic, and in nervous 
irritability the fluid extract of Lupulin may be used as a calmative and hypnotic, or the 
hop-pillow, which certainly exercises considerable influence, imaginary or otherwise. A 
poultice of hops is a favorite domestic application in inflammations and pain. Lupulin 
has been used with benefit in irritable bladder, alcoholism, and as an anaphrodisiac in 
the treatment of chordee, gonorrhoea, spermatorrhoea and other affections of the genito- 
urinary organs, 



HYDRANGEA (Unofficial), — is the root of Hydrangea arborescens, 
a plant of the nat. ord. Saxifragacese, growing in the southeastern U. S. 
It is a white, tough root, having a thin brown bark which peels off in 
spots, inodorous, taste insipid, afterwards pungent. It contains gum, 
albumen, starch, resin, and a ferrous salt, with other salts. Dose, 
3ss— ^ij, best in fluid extract. A decoction of the root may be used 
in doses of ]§j-ij. 



HYDRARGYRUM. 245 

Hydrangea has been long used by the Cherokee Indians in calculous affections, and 
reports of cases by competent observers show that it is of unquestionable utility in this 
class of disorders, promoting the removal of gravel from the bladder, and relieving pain 
during the passage of renal concretions through the ureters. Large doses produce vertigo, 
oppression of the chest, and considerable cerebral disturbance. 



HYDRARGYRUM, Mercury, Quicksilver, Hg,—is a shining, 
silver-white metal, fluid and slowly volatile at ordinary temperatures, 
solidifies at — 40 F., boils at 662 F., volatilizes without residue, 
insoluble in ordinary solvents, wholly soluble in nitric acid, of sp. gr. 
13.5, odorless and tasteless. 

Preparations of Mercury. 

Hydrargyrum cum Creta, Mercury with Chalk, Gray Powder, — has of Mercury 38, 
Sugar of Milk 12, Prepared Chalk 50, Ether and Alcohol, triturated together to a uniform 
gray powder. Dose, gr. ss-x. 

Massa Hydra?'gyri, Blue Mass, Blue Pill, — contains of Mercury 33 parts, Liquorice 5, 
Althaea 25, Glycerin 3, Honey of Rose 34. Each grain contains gr. y£ of Mercury. 
Dose, gr. ss— xx. 

Unguentum Hydrargyria Mercurial Ointment, Blue Ointment, — Mercury 450, Lard 
225, Suet 225, Compound Tincture of Benzoin 40, Old Mercurial Ointment 100 parts, 
triturated until globules of Mercury cease to be visible under a magnifying power of 10 
diameters. 

Emplastnun Hydrargyri, Mercurial Plaster, — Mercury 30, Olive Oil 10, Resin io, 
Lead Plaster 50 parts. 

Emplastrum Ammoniaci cum Hydrargyro, — see ante, page 94. 



Chlorides and their Preparations. 

Hydrargyri Chloridum Corrosivum, Corrosive Chloride of Mercury, Bichloride, Mercuric 
Chloride, Corrosive Sublimate, HgCl 2 , — heavy colorless crystals, of acrid, metallic taste, 
acid reaction, soluble in 16 of water and 3 of alcohol at 59 F., in 2 of boiling water, 
1.2 of boiling alcohol and in 4 of ether. Dose, gr. ^j— tV 

Hydrargyri Chloridum Mite, Mild Chloride of Mercury, Subchloride, Mercurous 
Chloride, Calomel, Hg 2 Cl 2 , — a heavy, white, impalpable powder, insoluble in water, 
alcohol or ether, odorless and tasteless. Is an ingredient of Pil. Antimonii Co. and Pil. 
Catharticae Co. Dose, gr. 2V _X - 

Hydrargyrum Ammoniatum, Ammoniated Mercury, White Precipitate, Mercur- 
ammonium Chloride, NH 2 HgCl, — is a white, insoluble powder, odorless and tasteless. 
Only used externally. 

Unguentum Hydrargyri Afnmoniati, White Precipitate Ointment, — Ammoniated 
Mercury 10, Benzoinated Lard 90 parts. 



Oxides and their Preparations. 

Hydrargyri Oxidum Flavum, Yellow Oxide of Mercury, Precipitated Oxide, HgO, — 
an orange-yellow, heavy, impalpable powder, odorless and tasteless, insoluble in water or 
alcohol, but wholly soluble in nitric or hydrochloric acid. Used to prepare : 

Unguentum Hydrargyri Oxidi Flavi, — strength I to 9 of Ointment. 

Oleatum Hydrargyri, — Yellow Oxide 10, Oleic Acid 90. 

Hydrargyri Oxidum Rubrum, Red Oxide of Mercury, HgO, — a heavy, orange red 
crystalline powder, having the same properties as the yellow oxide, from which it differs 
only in being crystalline and not in such a minute state of subdivision. Dose, gr. ^-"tV 

Unguentwn Hydrargyri Oxidi Rubri, — strength I to 9 of Ointment. 



246 HYDRARGYRUM. 

Iodides and their Preparations. / 

Hydrargyri Iodidum Rubrum, Red Iodide of Mercury, Biniodide, Mercuric Iodide, 
Hgl 2 , — a scarlet-red, crystalline powder, almost insoluble in water, soluble in 130 ot 
alcohol, in solution of iodide of potassium or of mercuric chloride. Prepared by double 
decomposition between Iodide of Potassium n parts and Mercuric Chloride 9 parts. 
Dose, gr. ^tV 

Liquor Arsenii et Hydrargyri Iodidi, Solution of Iodide of Arsenic and Mercury, 
Donovan's Solution, — see ante, page 1 19. 

Hydrargyri Iodidum Viride, Green Iodide of Mercury, Protiodide, Mercurous Iodide, 
Hg 2 I 2 , — a dull green or greenish-yellow powder, insoluble in alcohol or ether and almost 
so in water. Dose, gr. T \j-^. 

Acid Combinations and their Preparations. 

Liquor Hydrargyri Nitratis, Solution of Mercuric Nitrate, — a liquid containing in 
solution .about 50 per cent, of Mercuric Nitrate, Hg(N0 3 ) 2 , with some free Nitric Acid. 
Prepared from the Red Oxide of Mercury 40, by Nitric Acid 45, and Distilled Water 15 
parts. Used as a caustic. 

Unguentum Hydrargyri Nitratis, Citrine Ointment, — prepared by dissolving Mercury 
7, in Nitric Acid 17, and adding Lard Oil 76. 

Hydrargyri Subsulphas Flavus, Yellow Subsulphate of Mercury, Basic Mercuric 
Sulphate, Turpeth Mineral, Hg(HgO) 2 S0 4 , — a heavy, lemon-yellow powder, insoluble in 
water or alcohol, soluble in nitric acid and in 20 parts of hydrochloric acid without residue. 
Dose, as an emetic, gr. ij-v. 

Sulphide and Cyanide. 

Hydrargyri Sulphidum Rubru?n, Red Mercuric Sulphide, Cinnabar, HgS, — Red, 
crystalline masses, or a fine, scarlet powder, insoluble in ordinary solvents, but soluble in 
nitro-hydrochloric acid with separation of sulphur. Used only for mercurial fumigation. 

Hydrargyri Cyanidum, Mercuric Cyanide, Hg(CN) 2 , — colorless, prismatic crystals, of 
bitter, metallic taste, soluble in 12.8 of water and in 15 of alcohol at 59 F. Dose, gr. 
Ttro'To- 

Triturations. 

These may be prepared according to the general formula under " Triturationes " in 
the Pharmacopoeia, 10 parts of the substance to 90 of Sugar of Milk. Mercury itself 
or any of its salts may be so treated with excellent results, the particles being much 
finer and therefore more easily absorbed than if rubbed up with another agent. 

Unofficial Preparations. 

Lotto Hydrargyri Flava, Yellow Wash, — prepared by adding Corrosive Sublimate gr. 
xviij to Lime water ^ x, producing the yellow oxide, a favorite application for syphilitic 
sores. 

Lotio Hydrargyri Nigra, Black Wash, — prepared by adding Calomel gr. xxx, to Lime- 
water ^ x, producing the black oxide, and used as an application to syphilitic sores. 

Unguentum Hydrargyri Nitratis Rubrum, — Red Ointment of Mercuric Nitrate, Brown 
Citrine Ointment, — differs from the official ointment only in being made with Cod-liver 
Oil, which gives it a brown color, and a more agreeable odor. 



Physiological Action. 
Mercury is tonic, purgative, alterative, antiphlogistic and sorbefacient, 
but not directly cholagogue. Some of its salts are corrosive poisons, 
others are local caustics, all produce by long-continued administration the 
peculiar cachexia termed Hydrargyrism. The metal itself is inert, but by 
combination with the acids and fluids of the body becomes active, and is 
easily absorbed in any form, passing into the blood from the skin, mucous 



HYDRARGYRUM. 247 

membranes, lungs and stomach, in each case probably as an Oxyalbuminate 
of Mercury. Entering the stomach in any form it is first converted into a 
double Chloride of Sodium and Mercury, then uniting with the albuminous 
juices to form a complex molecule of Mercury, Sodium, Chlorine and 
Albumen, which being soluble in an excess of sodium chloride or albumen, 
exists in solution, and is easily absorbed, being decomposed in the blood 
and changed to the oxyalbuminate. Entering the intestines a purgative 
action is soon set up, of more or less severity according to the preparation 
used, a small portion only is absorbed, the rest being converted into a 
Sulphide and excreted with the faeces, unless combined with opium, which 
delays its progress through the intestines and permits of its greater ab- 
sorption. In the blood its effects are tonic in small doses, but in quantity 
it indirectly produces impoverishment thereof, impairs the ozonizing 
function, diminishes the red corpuscles, and consequently disorders nutri- 
tion and deranges digestion. From the blood it enters the tissues, where 
it remains for an indefinite period, exerting a peculiar influence, termed 
" alterative " on all processes characterized by growth of young cells, but 
not producing any definite anatomical changes either in the viscera or the 
nervous tissue, though in the latter a low form of inflammation arises, 
resulting in loss of coordination-power. It stimulates most of the glands 
of the body, especially the salivary glands and the pancreas, to the pro- 
duction of pathological secretions, and is excreted with comparative 
slowness by all the secretory organs, being found in the saliva, sweat, milk, 
urine and bile. It tends to accumulate in the liver, while stimulating its 
cells, and is not a cholagogue, though stimulating the flow of bile already 
secreted by reflex action on the bile-ducts due to its direct purgation of 
the duodenum. Its excretion is hastened and completed by the use of the 
iodide of potassium. 

In small doses administered for a short time the mercurial preparations 
are blood-tonics, improving its general condition, increasing the number 
of red corpuscles and the body weight. They soon begin to promote 
waste by stimulating the lymphatic system, and if the small doses are long 
continued or the quantity is increased, symptoms of mercurial poisoning 
begin to manifest themselves. 

The first symptoms of Hydrargyrism are fetid breath, swollen and 
spongy gums having a bluish line along their margins, stomatitis, sore and 
loosened teeth, inflamed and tender salivary glands pouring out a peculiar, 
thin saliva of foul odor iniarge quantity, and a metallic taste in the mouth. 
Anorexia, diarrhoea and fever follow, also ulceration and in some cases even 
gangrene of the lips and tongue. If the use of the drug be continued 
nutrition will be greatly impaired through the extreme promotion of ret- 
rograde metamorphosis, and various nervous disturbances will follow, the 
effects being emaciation, pallor, oedema, ulcerated skin, erythematous, 



248 HYDRARGYRUM. 

vesicular or pustular eruptions, headache, insomnia, neuralgia, tremor 
through paresis of the muscles of the head and extremities, epilepsy, coma 
and convulsions. In pregnant women abortion will occur by reason of 
the impoverishment of the blood. Indeed, as Dr. Ringer said in the 
earlier editions of his Handbook of Therapeutics, the phenomena produced 
by mercury are singularly similar to those which will result from syphilis, 
and the serious symptoms known as secondary and tertiary syphilis can be 
produced both by syphilis and by mercury. The drug is probably a true 
vital antidote against the syphilitic virus, and is capable of bringing about 
a radical cure of the disease, if introduced into the system in considerable 
quantity and its use protracted over a very long time, the action of the 
drug in all cases being kept short of ptyalism or any pronounced physio- 
logical effects. 

Salivation is most readily produced by Blue Mass, next by Calomel, 
and less easily by Gray Powder. Individuals differ greatly in their sus- 
ceptibility to the action of mercury, some persons having been affected 
after a single moderate dose. Children are not easily salivated. Inhala- 
tion of mercurial vapors is apt to affect the nervous system most ; its 
internal administration and that by inunction are more likely to produce 
salivation. 

The observations on the antiphlogistic and sorbefacient actions of 
Mercury are clinical rather than physiological, but it is generally agreed 
that exhibited in inflammation mercurials antagonize the increase of the 
haemic fibrin which is so constant an effect of the inflammatory process, 
and that in chronic diseases attended by the formation of semi-organized 
deposits, a mild mercurial course will almost insensibly remove the new- 
formed material. 

A not uncommon result of full doses of Blue Pill is an acute coryza of 
very severe character, which the writer has frequently observed to follow 
on neglect of the old-fashioned precaution to " work off" the mercurial 
by a saline cathartic. The symptoms produced are those of a severe 
attack of influenza, epistaxis, conjunctivitis and obstinate muco-purulent 
discharge from the nasal passages being especially marked. Similar 
effects have been observed during physiological experiments with mercury 
on animals by Overbeck and Bennett. 

Notes on The Action of the Preparations. 
Metallic Mercury is not used internally except in the finely-divided 
form obtained in Blue Pill and Gray Powder, which are capable of pro- 
ducing all the effects above described. Mercurial Ointment is the pre- 
paration generally used for inunction, apiece the size of a small nut being 
daily rubbed into the soft skin at the flexures of joints. The Oleate 
painted over the surface is a more cleanly method of making the same 
application. Both these preparations are efficient parasiticides. 



HYDRARGYRUM. 249 

The Bichloride is the most actively toxic of the mercurial salts. It is 
probably the most active zymoticide and parasiticide, a solution of 1 part 
in 2000 being efficiently antiseptic for use as injections or dressings, and 
one of 1 to 250 being the usual strength for use against epizoa and parasitic 
skin affections. It is a very active gastro-intestinal irritant, in toxic dose 
producing nausea, retching and vomiting, a metallic taste, constriction of 
the fauces, burning pain in the stomach, suppression of urine, bloody 
dianhoea, collapse and death often preceded by convulsions. It affects 
specifically the lower bowel [Calomel preferring the upper intestine], and 
produces inflammation and ulceration of the rectum. It is, however, 
one of the most manageable and efficient of the mercurials when used in 
proper doses. 

The Subchloride (Calomel) is very insoluble and unirritating, taste- 
less, laxative in grain doses, decomposed by the alkaline contents of the 
intestines, the Oxide of Mercury being formed, and acts especially on 
the excrementitious glandular appendages of the upper intestine, stimu- 
lating the liver by indirect reflex action as a duodenal purgative. In the 
presence of alkaline chlorides it is converted into the Bichloride, but not 
in sufficient quantity to render it dangerous in the gastro-intestinal canal. 
Externally applied it is very sedative to the mucous membranes and the 
skin. Calomel is a very efficient diuretic. 

Ammoniated Mercury is an Ammonio-Chloride, and a useful stimu- 
lant and parasiticide when used locally in the form of ointment. 

The Iodides are actively poisonous, the Red being much the most 
irritant, in overdoses producing symptoms and results very similar to 
those caused by the Bichloride. The Cyanide is also actively poisonous. 
The Yellow Subsulphate is a prompt and usually harmless emetic, but 
has occasionally produced fatal results by local irritant action. The 
Oxides are irritant, the Red being the most so, and are rarely used inter- 
nally. The Acid Nitrate is a good escharotic, the pain caused by it 
being transient though severe, and its caustic action being comparatively 
superficial. The Ointment of the Nitrate (Citrine Ointment) is more 
irritant than that of the Ammoniated Mercury, and generally needs dilu- 
tion. All these preparations may produce the constitutional effects of 
mercury, and their administration should be carefully watched for the first 
symptoms of mercurialization. 

Antidotes and Incompatibles. 

Albiwien in some form, the white of one egg to gr. iv of the bichloride, forms the 
albuminate, which must be at once evacuated by emesis or the stomach pump, as it is 
soluble in excess of albumen or in the alkaline contents of the intestines. 

The Chlorides are incompatible with very many agents, and the Bichloride should be 
administered in distilled water or pill by itself, being easily decomposed. Calomel is 
decomposed by alkaline Iodides or Bromides. The combination of Calomel with Hydro- 
chloric Acid or Chlorides is apt to produce Corrosive Sublimate. In the " mixed treat- 
ment ; ' of syphilis, a mercurial is combined in solution with Iodide of Potassium, and the 



25O HYDRARGYRUM. 

Red Iodide is the preparation usually selected, as the Bichloride is decomposed by the 
Potassic Iodide, Red Iodide of Mercury being precipitated. All trouble regarding incom- 
patibility can be avoided by using sugar of milk triturations according to the general 
official formula. In this form, says Piffard, " a larger proportion of the drug is utilized for 
specific purposes, while but a small amount remains to give rise to local irritation." 



Therapeutics. 

Mercury is undoubtedly a specific in syphilis, "but is not applicable to 
the tertiary form of that disease. It is best administered in very small 
doses carefully watched and stopped just short of ptyalism, but renewed 
and so continued for a long time. Fumigation by Calomel volatilized by 
heat, or inunction by the Oleate or by Mercurial Ointment may be used 
when the stomach will not bear any mercurial. The hypodermic method 
is also used, employing a solution of the Bichloride gr. j to ^j each of 
glycerin and distilled water, of which the dose is rt^x once daily ; or the 
Albuminate in solution with Sodium Chloride. The Green Iodide in 
doses of gr. T x 7 to }& thrice daily with Opium is the best preparation for 
internal use. Accuracy of diagnosis is an absolutely necessary prelimi- 
nary to the administration of Mercury, for where there is no syphilitic 
virus to be antagonized the constitutional effects of mercurials will become 
manifest sooner and may do great harm in feeble subjects, besides the risk 
of mistaking them for the results of the disease supposed to be present. 

Tonsillitis, parotitis and other acute glandular inflammations of the 
throat and neck may often be rapidly cured by Calomel gr. -^ or Gray 
Powder gr. \ every two hours. In irritable stomach with obstinate vom- 
iting the same small doses of Calomel every half hour are very efficient. 
The dysentery of adults with slimy and bloody stools is best treated by 
small doses (gr. y^) of the Bichloride, and in the diarrhoea and dysen- 
tery (ileo-colitis) of infants Gray Powder gr. \ or Calomel gr. -^ will be 
found very effective. In gastric ulcer and in the first stage of hepatic 
cirrhosis, the Bichloride in doses of gr. -fa to -^ thrice daily is a good 
remedy. Typhoid fever is treated in Germany by daily doses of Calomel, 
gr. x, for three days as an antipyretic. Diphtheria is by many practition- 
ers, considered to be best antagonized by Calomel in large doses, and in 
this affection the Cyanide has many advocates given in doses of gr. ywo~ 
Jg- every hour, a weak solution being at the same time used as a gargle. 
Asiatic cholera is frequently treated by small, repeated doses of Calomel 
with Opium from the start. Inflammations of sthenic character in the 
stage of exudation, especially when affecting serous membranes, are con- 
sidered by many authorities to be best met by the free use of mercurials, 
but this treatment is fast going out of favor, excepting in cases of iritis, 
which, however, is very often of syphilitic causation, and pneumonia, 
which is frequently treated, according to the best American authorities, 
with sedative doses (gr. xv-xx) of Calomel. 



HYDRASTIS. 25 1 

In the general condition known as "biliousness," manifested by 
whitish or clay-colored stools, constipation, nausea, anorexia, coated 
tongue, slight jaundice, etc., mercurial purgatives have long been a rou- 
tine remedy, but mild saline purgatives are by many authorities considered 
equally efficient. As an antiseptic to the gastro-enteric tract in many 
forms of stomach and intestinal disorders (dyspepsia septica), the admin- 
istration of minute doses of the Yellow Oxide of Mercury will be found 
remarkably efficient. It is best used in trituration, with sugar of milk, 1 
to 1000, and in daily doses of gr. -g^—sV By the use of these small 
doses failing digestion and nutrition may almost certainly be improved. 

In membranous laryngitis or true croup the Subsulphate as an emetic 
is by many considered to have some specially beneficial influence. 

Locally, an ointment of Calomel 3J to §j of Lard is an excellent 
antipruritic, and ointments of the Chlorides and Iodides are much used 
in skin diseases, particularly psoriasis, herpes, acne, and pityriasis. In 
parasitic affections a lotion of the Bichloride, gr. ij to ^j of distilled 
water, or a 5 per cent. Oleate with j^jth part of Ether, are very efficient. 
The Oleate is a serviceable application to syphilitic indurations, but is not 
deemed advisable when ulceration exists. In conjunctivitis Calomel may 
be used as a sedative application, or still better an Ointment of the Yellow 
Oxide, gr. x to §j of Vaseline, triturated to the utmost fineness before 
mixing. Goitre and enlarged spleen are often speedily reduced by rubbing 
into the skin covering them the Ointment of the Red Iodide somewhat 
diluted and applied before a hot fire or in the direct sunlight. The Acid 
Nitrate Solution is one of the best caustics for destroying chancroid and 
syphilitic warts and vegetations. Black and Yellow Wash are used as 
applications to syphilitic erosions and ulcerated indurations. 

As an antiseptic injection or application to dressings a solution of the 
Bichloride, gr. vijss in a quart of hot water ( 20 1 00 ), is probably the most 
efficient that can be used, and still weaker solutions ( 5 q 00 ) are sufficiently 
antiseptic for most purposes. 



HYDRASTIS, Golden Seal, — the rhizome and rootlets of Hydrastis 
canadensis, a small plant of the nat. ord. Ranunculaceae growing in most 
parts of the U. S. The rhizome is 1 ^ inch long, rough, bent and branched, 
externally of a yellowish-gray color, internally a bright reddish -yellow, 
having numerous thin, brittle rootlets, a slight odor and a bitter taste. 
It contains an unnamed Resin and 3 alkaloids, Hydrastine, C 22 H 23 N0 6 , 
white and crystalline, soluble in alcohol, ether, etc., Berberine, C 20 H 17 NO 4 , 
yellow crystals soluble in hot water and alcohol, but not in ether (see page 
133), and Xanthopuccine, also yellow and crystalline. All these alkaloids 
unite with acids to form salts. 



252 HYDRASTIS. 

Preparations. 

Exlractum Hydrastis Fluidum, — Dose, TT^v-xxx. 
Tinctura Hydrastis, — strength 20 per cent. Dose, gss-ij. 

Hydrastin (Unofficial), — an impure extract precipitated by Hydrochloric Acid from the 
alcoholic solution, chiefly consisting of Muriate of Berberine. Dose, gr. ij-v. 

Physiological Action. 
Hydrastis is a simple bitter and a stomachic tonic. It promotes 
appetite and digestion* and increases the secretions of the gastro-intestinal 
tract and the flow of bile, but if long used it will derange digestion and 
produce constipation. It is possessed of antiperiodic powers, and is a 
protoplasmic poison, arresting the movements of the white blood-corpus- 
cles. By many observers it is also considered alterative to the mucous 
membranes, deobstruent to the glandular system, cholagogue, diuretic 
and antiseptic. The alkaloid Hydrastine produces effects on the 
nervous system somewhat similar to those caused by Quinine, but seems 
to be devoid of toxic power, large doses only producing a sense of warmth 
in the epigastric region, and noises of a rushing character in the ears. 

Incompatibles. 

Tannic Acid, Hydrochloric Acid and the Alkalies are chemically incompatible with 
preparations of Hydrastis. 

Therapeutics. 
Hydrastis is chiefly used as a stomachic tonic, an antiperiodic, a mild 
laxative and an antiseptic. Its alkaloid (Hydrastine) and extract 
(Hydrastin) are ranked high in the treatment of intermittents and chronic 
malaria, though much less efficient than Quinine. It is an excellent 
remedy locally and internally in all forms of catarrh, especially that of 
the stomach, duodenum, gall-ducts, bladder, uterus and vagina. Internally 
it is efficient in many glandular swellings, in chronic constipation due to 
a sluggish state of the liver or deficiency of the other intestinal secre- 
tions, in chronic dyspepsia, and as a substitute for alcohol in dipsomaniacs 
when a catarrhal state of the stomach has been induced. In gonorrhoea, 
gleet, and chronic nasal catarrh it is locally employed with much benefit, 
also in syphilitic affections of the mouth, throat and nares. As a local 
alterative and antiseptic application it is highly recommended for unhealthy 
ulcers and sores, cancerous ulcerations, mercurial and aphthous stomatitis, 
rectal fissure, fistula and prolapse, internal and external hemorrhoids, 
cracks, fissures and abrasions of the nipples, erosion and ulceration of the 
cervix uteri, and in conjunctivitis with muco-purulent discharge. In 
gonorrhoea a very efficient injection is an infusion of Hydrastis, 3J of the 
powdered root to gviij of boiling water, or the fluid extract diluted 
in the proportion of gss or 3J to the pint of water, but it should not be 
used until the acute stage has subsided. 



HYDROCOTYLE HYOSCYAMUS. 253 

HYDROCOTYLE, Pennywort (Unofficial;,— is the leaf of 
Hydrocotyle asiatica, a small plant of the nat. ord. Umbelliferae, a native 
of southern Africa and India. It contains a peculiar, oleaginous sub- 
stance, Vellarine, which has a bitter, persistent taste, and is thought to be 
the active principle. It has long been used in its native countries as an 
alterative to purify the blood, and has lately been found of great service 
in eczema, lupus, psoriasis, syphilitic and scrofulous sores, and in leprosy. 
An ounce of the dried plant or leaves is given daily in infusion. It causes 
great itching over the whole body, ovarian pain in females, and urinary 
irritation. In one case in which the drug was being given for lupus of 
the hand a severe orchitis was set up without any other apparent cause. 
It certainly exerts a markedly special influence on the genito-urinary tract. 

HYOSCYAMUS, Henbane,— the leaves, collected from plants of 
the second year's growth, of Hyoscyamus niger, a biennial plant of the 
order Solanaceae, growing in Europe and the northern U. S. The 
leaves are ovate, often 10 inches long and 4 broad, of grayish-green color, 
glandular-hairy, midrib prominent, odor heavy and narcotic, taste bitter 
and acrid. It contains an alkaloid Hyoscyamine, C n H 23 N0 3 , which is 
isomeric with Atropine and identical with Daturine and Duboisine, occur- 
ring as an oily liquid or in tufted crystals of silky lustre and yellow color, 
soluble in hot water, alcohol or ether. Another substance, Hyoscine, is 
by some authorities considered a derivative of Hyoscyamine, by others a 
second alkaloid. It is' semi-liquid, isomeric with Atropine, and yields 
Tropic Acid and Pseudotr opine. Hyoscyamus leaves also contain a fatty 
Oil and much Potassic Nitrate, while from their destructive distillation 
an empyreumatic Oil is obtained which is a powerful narcotic. 

Preparations, 

Abslractum Hyoscyami, — Dose, gr. iij-v. 

Extr actum Hyoscyami Alcoholicum, — Dose, gr. j, when active. 

Extractum Hyoscyami Fluidum, — Dose, TT^v-xx. 

Tinciura Hyoscyami, — Strength 15 per cent. Dose.^j-iv; as a hypnotic ^ ss-j is 
necessary. 

All the preparations of Hyoscyamus are uncertain in strength and in activity, so much 
so that the effective dose of the extract (no longer official) ranged from 2 to 250 grains. 

Hyoscyamina Sulphas, — Sulphate of Hyoscyamine (C 17 H 23 N0 3 ) 2 .H 2 S0 4 , — occurs 
in small, yellow scales or crystals, which are deliquescent, of bitter taste, and very soluble 
in water and in alcohol. It varies much in purity of the base and consequently in 
activity. A grain of the commercial article, which was formerly very impure, has been 
given with impunity, but gr. ^L- of the pure alkaloid has produced violent poisoning. 
Dose, hypodermically, should not exceed gr. -g 1 - ; by the mouth gr. %.-] may be given in 
urgent cases. 

Hyoscyamine of good quality is difficult to procure and is very expensive, while 
Duboisine is easily obtained in any quantity, so that if these alkaloids prove to be physio- 
logically as well as chemically identical, as is now claimed, the latter will be used to the 
exclusion of the former. 

Hyoscince Hydrobromas, Hydrobromate of Hyoscine (Unofficial). — Merck's is the only 
reliable preparation on the market. Dose, hypodermically, gr. jfo ; by the mouth gr. 



254 HYOSCYAMUS. 

Physiological Action. 

Hyoscyamus has similar action to that of Belladonna, Duboisia and 
Stramonium, except that it is the least powerful and irritant of the group, 
but the most calmative and hypnotic. The delirium produced by it is 
never furious and is without hypersemia, but is accompanied by insomnia. 
It is more stimulant to the vaso-motor system and to the cardiac accele- 
rator apparatus than is Stramonium, but is less active on the pneumo- 
gastric. It has decidedly laxative and carminative effects on the intes- 
tines and a very marked sedative influence on the urinary passages. 

Hyoscyamine corresponds in action to the plant and its congeners, 
being considered by many authorities as almost identical with Atropine, 
but less powerful. No death has directly resulted from it. Except in 
very large doses it is more an anodyne or anaesthetic than a narcotic 
or soporific. It is a mydriatic, excites the cerebral functions and 
depresses the spinal. Many observers deny that it has any soporific 
influence. 

Hyoscine is a powerful hypnotic, lowers the pulse-rate and lessens the 
frequency of the respirations. It especially affects the motor tract of the 
spinal cord and the cerebral cortex, slightly depresses the heart, but para- 
lyzes respiration. It is free from irritant qualities and may be used 
hypodermically. Its habitual use brings on muscular paralysis and 
delirium of violent character. It is coming into use as a hypnotic by 
alcoholics and nervous subjects, and will probably ere long be responsible 
for many deaths. As a mydriatic its reputation is doubtful, some observ- 
ers claiming greater power for it in this respect than that of Atropine, 
while others say that mydriasis may follow its use but is not always pro- 
duced by even large doses. 

Antagonists and Incompatibles. 

These are the same as for Belladonna (see ante, page 130). Liquor Potassae though 
incompatible is frequently prescribed in combination with Hyoscyamus. All the fixed 
caustic alkalies decompose its alkaloid, as also those of the allied plants. 

Therapeutics. 
Hyoscyamus is a valuable narcotic and is chiefly used as a hypnotic and 
anodyne when Opium is contraindicated, and for children. It is by far 
the best agent to use in acute mania with high motor excitement, obsti- 
nate insomnia and varied hallucinations. Chronic mania has been more 
benefited by it than by any other drug, and it is very efficient in insanity 
characterized by frequent delusions. In delirium tremens and the delir- 
ium of fevers it is an excellent hypnotic, and the monomania of hypo- 
chondriacs is alleviated and often cured by it. Whooping-cough, nervous 
coughs, and especially a dry, tickling night-cough, are greatly alleviated 
by full doses of Hyoscyamus. It is also efficient in colic of various forms, 



ICTHYOCOLLA JGNATIA. 255 

to palliate the trembling of paralysis agitans and mercurial tremor, and 
to relieve the pains and disordered coordination of locomotor ataxia. In 
constipation it is a good remedy, the extract being much employed in 
combination with other purgatives to render them more efficient and less 
drastic, but the quantity used is generally too small to be of any par- 
ticular benefit. The tincture is an efficient remedy in irritability of the 
bladder from any cause. 

Hyoscyamine may be used for the same purposes as Atropine, but 
being liable to considerable variation in purity and activity, it is not a 
popular agent with the profession. 

Hyoscine has been used in neuralgia, whooping-cough, insomnia from 
cerebral excitement, delirium tremens, asthma and enteralgia, also in oph- 
thalmic practice as a mydriatic. Doses of gr. -fe are given by the stomach, 
gr. yi-g- hypodermically. 



ICHTHYOCOLLA, Isinglass, — is the swimming bladder of Aci- 
penser Huso, and of other species oi A ripens er (Sturgeon). It occurs in 
horny sheets, semi-transparent, iridescent, soluble in 24 parts of boiling 
water, forming on cooling a transparent jelly. It is the purest form of 

Gelatin known. 

Preparation. 
Emplastrum Ichthyocollte, Court Plaster, — consists of Isinglass 10, Glycerin 1, Alcohol 
40, Water and Tincture of Benzoin, spread on taffeta and allowed to dry. 

Physiological Action and Therapeutics. 
Isinglass is slightly nutritious, but has no advantage over any other form 
of gelatin. It is used for clarifying liquids, and in solution as a test for 
tannin. The plaster is a common protective application. 



IGNATIA, St. Ignatius' Bean, — is the seed of Strychnos Ignatii, 
a small tree of the nat. ord. Loganiacese, native in the Philippine Islands, 
and also called Ignatia Amara. The seed is about an inch long, ovate, 
irregularly angular, hard and horny, enclosing an irregular cavity con- 
taining an oblong embryo, inodorous, taste very bitter. It contains the 
alkaloids Strychnine and Brucine, abou.t 1 per cent, of each, for a descrip- 
tion of which see the title Nux Vomica. 

Preparations, - 
Abstraction Ignatice, — Dose, gr. ss-j. 
Tinctnra Ignatia, — strength 10 per cent. Dose, TTLij-x. 

Physiological Action. 
Ignatia closely resembles Nux Vomica in action, a poisonous dose pro- 
ducing the same exaltation of the spinal functions, muscular writhing, te- 






256 ILLICIUM INULA. 

tanic spasms, and death by asphyxia through tetanic fixation of the respi- 
ratory muscles, but containing a greater quantity of Strychnine than the 
latter it is more powerful in the same dose. It especially exalts the sus- 
ceptibility of the sensory nerves, and of the nerves of special sense, for a 
time, but an opposite condition soon succeeds, manifested by numbness 
and torpor with great mental depression. It causes a feeling of constric- 
tion about the throat and a sensation of intense anguish at the pit of the 
stomach. Its antagonists and incompatibles are the same as for Nux 
Vomica. 

Therapeutics. 
Ignatia is recommended for hysteria, to control the general hypersesthe- 
sia, insomnia, clavus hystericus, mental excitement or depression, aphonia, 
diseased appetite, convulsive crying or laughing, etc. It will often re- 
move the intercostal neuralgia of hysterical subjects and the sensation as 
of a ball rising to the throat (globus hystericus). Cerebro-spinal irrita- 
bility is diminished by small doses though excited by large ones, Ignatia 
being probably the most efficient controller of functional phenomena of 
the cerebro-spinal axis. In the convulsions of children from intestinal 
irritation without cerebral congestion, and in insomnia from nervous 
erethism, small doses of Ignatia are used with the happiest results. It is 
by many practitioners preferred to Nux Vomica as a stomachic tonic, and 
is useful in the treatment of dyspepsia, hypochondriasis and various ner- 
vous affections. 



ILLICIUM, Star Anise, — is the fruit of Illicium anisatum, an 
Asiatic shrub of the nat. ord. Magnoliacese, and is formed by 8 boat- 
shaped carpels arranged in a star-shaped whorl around a central axis which 
is the top of the stalk. Each carpel contains a single seed, flat, oval, 
glossy, and of a brownish-yellow color. It contains a Volatile Oil which 
is chemically and practically identical with the Oil of Anise. Another 
species, Illicium religiosum, is very poisonous, causing vomiting, epilepti- 
form convulsions, dilated pupils and cyanosed countenance. Its carpels 
are more woody, shrivelled and wrinkled, and end in a curved beak. Illi- 
cium is recognized officially as a source of the Oil of Anise, and has simi- 
lar actions and uses to those of Anisum (see ante, page 102). 



INULA, Elecampane, — is the root of Inula Helenium, a plant of 
the nat. ord. Compositae, growing in Europe and N. America. It occurs 
in slices or sections, externally grayish-brown, internally white, fleshy and 
full of resin cells, of peculiar, aromatic odor, pungent and bitter taste. It 
contains a volatile oil, a resin, a crystalline substance named Helenin, 



IODUM. 257 

C 6 H 8 0, and a peculiar principle resembling starch, Inultn, C 6 H 10 O 5 , which 
is found in Arnica, Taraxacum and other plants. Having the same chem- 
ical composition as starch, Inulin differs from the latter in being colored 
yellow by iodine, and depositing from its solution in hot water as the solu- 
tion cools. It is contained in Elecampane in large quantity, from 19 to 
44 per cent., the latter in autumn. There are no official preparations, but 
a decoction (^ss to Oj) may be given in doses of ^j-ij. Dose of the pow- 
dered root, gr. xx-gj. 

Physiological Action and Therapeutics. 
Inula is a gentle stimulant to the secretory organs, and is said to be ex- 
pectorant, diaphoretic and diuretic. In large doses it causes nausea and 
vomiting. It was formerly supposed to be emmenagogue and was much 
used in amenorrhoea. It is now chiefly employed as a domestic remedy in 
chronic bronchitis and dyspepsia, and to promote the eruption in exanthe- 
matous fevers. 



IODUM, Iodine, I, — is a non-metallic element, existing in sea-weed, 
sea-water, some fresh waters and fresh-water plants, also in sponge, oysters, 
eggs, cod-liver oil, rock salt and several ores. It occurs in bluish-black 
rhombic plates, of metallic lustre, peculiar odor, acrid taste and neutral 
reaction, sparingly soluble in water (1 in 7000), readily so in ether, and 
in 11 of alcohol at 59 F., also in a solution of potassic iodide or sodic 
chloride. It volatilizes slowly at ordinary temperatures, and produces 
a dark-blue color with gelatinized starch in a cold solution. Internally 
it is generally administered in the form of an Iodide or as the Compound 
Solution of Iodine. Dose, gr. ss-j. 

Preparations of Iodine. 

Tinctiira Todi, — strength 8 per cent. Dose, ruj-v, but it is generally used as a local 
application or for injection into cavities. 

Liquor Iodi Compositus, Lugol's Solution, — is a solution of Iodine 5 and Iodide of 
Potassium 10 in Distilled Water 85 parts. Dose, TT\j-x, well diluted. 

Unguentum Iodi, — has of Iodine 4, Iodide of Potassium 1, Water 2, Benzoinated* Lard 
93 P ar ts. 

Amylum lodatum, Iodized Starch, — contains of Starch 95, Iodine 5, Distilled Water 
q. s. ad 100 parts, triturated together, dried, and rubbed to a fine powder. Intended to 
enable Iodine to be given without irritating the stomach. Dose, ^j-,^j. 

Iodized Phenol, Carbolate of Iodine (Unofficial), — a mixture of Iodine and crystallized 
Carbolic Acid in varying proportions, generally 1 of the former to 4 of the latter, for local 
use. 

Iodides and their Preparations. 

Ammonii Iodidum, NHJ, — a deliquescent, granular, white salt, soluble in I of water 
and in 9 of alcohol at 59° F. Dose, gr. ij-x. 

Potassii Iodidum, KI, — a colorless, deliquescent, crystalline salt, of saline and bitter 
taste, soluble in 0.8 of water and in 18 of alcohol at 59 F. Dose, gr. v-gj. 

Unguentum Potassii lodidi, — has of the Iodide 12, Hyposulphite of Sodium 1, Boiling 
Water 6, Benzoinated Lard 81 parts. 

17 



258 IODUM. 

Sodii lodidum, Nal, — deliquescent, minute crystals, soluble in 0.6 of water and in 1.8 
of alcohol. Dose, gr. v-3 ij. 

Jodoformiun, Iodoform, Iodide of Formyl. — small lemon-yellow crystals, of saffron- 
like and penetrating odor, unpleasant and iodine-like taste, sp. gr. 2000, soluble in 80 of 
alcohol at 59 F., and in chloroform, ether, benzol, benzin, carbon bisulphide, fixed and 
volatile oils, not perceptibly soluble in water. Its solutions have a neutral reaction. To 
remove its odor without forming a compound the best agents are Thymol (gtt. ij ad £}), 
Oil of Mirbane (gtt. vj ad gr. xv), Oil of Bitter Almonds, or Oil of Rose (gtt. j ad 3 j). 
Dose, gr. j-v. 

Unguentum Iodoform, — Iodoform, finely pulverized, 10, Benzoinated Lard 90 parts, 
thoroughly mixed by trituration. 

lodol, Tetra-iodo-pyrol (Unofficial), — is a grayish -yellow powder, insoluble in water, 
tasteless and odorless, and contains 85 to 90 per cent, of Iodine in combination with 
Pyrol, a constituent of mineral oil. Dose, gr. ss-v, in tablet. 

Other Iodides and preparations thereof are — Argenti lodidum, Arsenii lodidum, Liquor 
Arsenii ec Hydrargyri lodidum, Hydrargyri lodidum Rubrum, Hydrargyri lodidum Vi- 
ride, Syrupus Ferri Iodidi, Pilulae Fern Iodidi, Plumbi lodidum, Sulphuris lodidum 
and Zinci lodidum. As these preparations are allied in action and uses less to Iodine 
than to the other elements in their composition, they are described under other titles. 
(See Argentum, Hydrargyrum, etc.) The Iodide of Ethyl or Hydriodic Ether is 
described under ^ther (see ante, page 82.) 

Preparation of Hydriodic Acid. 

Syrupus Acidi Hydriodici, — contains 1 per cent, of absolute Hydriodic Acid, HI. 
Dose, 3J-iv, well diluted. 

Physiological Action. 

Iodine is irritant to the mucous membranes and to the skin. Applied 
to the latter it stains a deep yellowish-brown color and combines with the 
albumen of the tissue, causing considerable pain and subsequent exfolia- 
tion of the epidermis. Vesication may be quickly produced if the quan- 
tity used be large. Inhaled its vapor irritates the respiratory mucous 
membrane, producing sneezing, cough, dyspnoea, also pain in the chest 
and over the frontal sinuses. In the gastro-intestinal canal it is equally 
irritant, but is gradually converted into the iodide or iodate of sodium, 
in which form or as an albuminate it is absorbed into the blood. Iodine 
decomposes organic molecules, and in the presence of phosphoretted or 
sulphuretted gases it acts like chlorine but more feebly, uniting with their 
hydrogen and thus breaking up those noxious compounds it is disinfectant 
and deodorant. 

The Iodides of Sodium, Potassium, etc., are very diffusible and are as 
rapidly excreted ; setting free nascent oxygen (Ozone) and Iodine at the 
points of elimination, they are remotely irritant to the mucous mem- 
branes, setting up violent coryza, with soreness of the throat, acute con- 
junctivitis, profuse mucous discharges, headache and irritation of the 
kidneys and the skin. If used for any length of time they induce great 
waste and rapid elimination of waste products, causing anaemia, emacia- 
tion and mental depression. They combine with certain poisons in the 
system, particularly Lead, Mercury, and the products of the syphilitic 
disease, hastening their elimination. Iodism is the term applied to the 
general condition produced by these agents, and comprises the symptoms 



IODUM. 259 

above noted together with frontal headache, ptyalism, a saline taste in 
the mouth, dysphagia, temporary impotence, and an acneform eruption 
on the face and limbs. Sometimes the eruption is furuncular or even 
purpuric. Copiously diluting these salts with water promotes their excre- 
tion and to a great extent prevents the development of these results. 

Iodoform contains from 94 to 97 per cent, of Iodine and naturally 
resembles the latter in action. Locally its action is anaesthetic and pow- 
erfully antiseptic. It is one of the best agents to prevent decomposition 
and to destroy the germs of putrefaction and of disease, but must be 
carefully employed, as when used in quantity on an extensive raw surface 
it has often "produced fatal results with symptoms of narcotic poisoning. 
The first sign of its dangerous absorption is increase of temperature, which 
may reach 104 or more, then headache, quick and feeble pulse, marked 
anxiety and restlessness, and suddenly collapse and death may supervene. 
The quantities which have produced fatal results from local absorption 
have varied from 525 to 4500 grains. In small doses internally it is con- 
sidered to be a tonic and alterative, wasting does not occur, but the body 
weight increases and the general condition improves. In these respects 
its action markedly differs from that of Iodine or the Iodides. 

Iodol has the same action as Iodoform, but is odorless and is said to 
be devoid of toxic power. Though insoluble in water it dissolves readily 
in the gastric juices, and is rapidly absorbed and as quickly diffused 
through the system. 

Ethyl Iodide (see ante, pages 80 and 82) is used by inhalation to bring 
the system rapidly under the influence of Iodine. It is a good antispas- 
modic and general stimulant and a very slow anaesthetic. 

Antagonists and Incompatibles. 

Restorative agents and vasomotor tonics, Quinine, Digitalis, etc., are therapeutically 
antagonistic. Starch is the antidote to free Iodine, but the stomach must be evacuated, as 
the Iodide of Starch is not inactive. The mineral acids, metallic salts, ammonia and 
vegetable alkaloids are incompatible with Iodine, and if the Potassium salt be prescribed 
with Potassium Chlorate a poisonous compound will result. In chronic poisoning by the 
iodides a free salivary flow induced by chewing Pyrethrum root will hasten the elimina- 
tion of the drug. 

Therapeutics of Iodine. 
The tincture or the compound solution are much employed locally as 
counterirritants and by injection into cavities as alterative applications, 
instances of which are their use in glandular tumors, hypertrophied ton- 
sils, cervical and ovarian cysts, empyema, hydrocele, etc. In various 
skin diseases, as chloasma, lentigo, lupus, etc., the tincture or a glycerite 
is well applied, and in many splenic and hepatic disorders of chronic type 
the ointment or tincture is a favorite counterirritant application. In sores, 
ulcers, fissures, etc., the Iodide of Starch or a mixture of Iodoform and 
Tannin, are strongly recommended, and the tincture is much used locally 



260 IODUM. 

to promote absorption of the products of acute inflammations. In acute 
catarrh and hay-fever inhalations of iodine-vapor, or that from Iodized 
Phenol are very serviceable, and in the vomiting of pregnancy i to 5 
drop-doses of the tincture every hour are often efficient. The compound 
solution well diluted is given thrice daily in typhoid fever with good 
results in many cases, and in malarial fevers the same preparation com- 
bined with Carbolic Acid has remarkably curative power. In strumous 
conditions Iodine internally is much more efficient than any of the 
Iodides. 

Therapeutics of the Iodides. 

The Iodide of Potassium is the most frequently used, and is the form 
in which Iodine is generally administered internally. It is usually admin- 
istered in simple solution or in the compound infusion or syrup of Sarsa- 
parilla. Though its mode of action has never been explained satisfactorily, 
it is known by clinical experience to counteract many pathological condi- 
tions, to promote the absorption of morbid products, and the elimination 
of several metallic poisons. It is almost of specific rank in tertiary 
syphilis and its results, as neuralgias, paralyses from gummata, ulcerations, 
syphiloma of the internal viscera, lupus, chronic rheumatism and sciatica, 
in all of which when of syphilitic origin this iodide in large doses (50 to 
150 grains daily) to saturation of the system will speedily cause improve- 
ment. So in mercurial poisoning and other chronic metallic toxsemise, 
the best treatment is by rapid saturation with Potassic Iodide. The pro- 
ducts left behind by pneumonia, pleurisy and pericarditis often yield to 
moderate doses (5 grains), which if used for a prolonged period seem to 
retard the changes of chronic nephritis. It is the best remedy for the 
early stage of hepatic cirrhosis, and acts as a most efficient expectorant in 
chronic bronchitis. Aneurisms are often cured by large doses (20' to 30 
grains) of Potassic Iodide, the sac becoming perfectly solid by fibrinous 
deposit. In acute catarrh and hay-fever, it is useful with Arsenic, the 
Iodized Phenol being at the same time used locally in weak solution. In 
tonsillitis and simple sore throat a weak solution (gr. ij-v ad 3) is a good 
gargle, and in large doses it is often very efficient in spasmodic asthma 
when induced by bronchial catarrh. 

The Iodide of Ammonium in grain dose repeated frequently is an ex- 
cellent remedy in acute catarrh, hay-fever, duodenal catarrh and its 
accompanying jaundice, in chronic and capillary bronchitis, and in 
catarrhal pneumonia to prevent caseation of the products. In the first 
stage of hepatic cirrhosis and in chronic malarial poisoning it is equally 
efficient administered in conjunction with Arsenic. Being somewhat 
more irritating than the other iodides it is usually given in smaller quan- 
tity, but being less stable it is more energetic in action. 

The Iodide of Sodium may be used instead of the potassium salt, 



IODUM. 26l 

and the same may be said of the Syrup of Hydriodic Acid if freshly 
prepared. 

Hydriodic Acid is used as a substitute for Iodine and the Iodides. As 
an alterative it is believed by some to possess all the powers of Iodine 
while it is much less offensive to the taste and the stomach. It has been 
used with benefit in asthma and bronchitis. The acid itself is not now 
official, as it is liable to change by the development of free Iodine. 

Therapeutics of Iodoform and Iodol. 

Iodoform is chiefly employed in local diseases as an antiseptic, anaes- 
thetic and alterative agent. It may be dusted in fine powder over a wound 
or sore, or used in ethereal solution to saturate gauze qr absorbent cotton. 
It is particularly useful as an application to sloughing and phagedenic 
ulcers, gunshot wounds, chancroids, fistulae, sinuses and painful affections 
of the rectum or uterus. Internally it may be used as a general tonic and 
alterative in syphilis and other cachexias, also for neuralgia, and is fre- 
quently prescribed with Iron. Triturated with Tannin it forms a useful 
application to the cervix uteri in erosions and ulcerations thereof, or an 
Iodo-tannin may be prepared by saturating the Tincture of Iodine with 
Tannic Acid, and applied on a cotton tent to the uterine mucous mem- 
brane in many chronic affections of that organ. 

Iodol, if equally efficient, as is claimed, will doubtless replace Iodoform 
largely as a topical application. Internally they are both highly esteemed 
as remedies in chronic gastric catarrh, and intestinal catarrh, ulceration 
of the gastro-intestinal mucous membrane, etc. Iodol may be given 
midway between meals. In bronchitis, bronchial catarrh, and various 
respiratory neuroses, Iodol has been found highly useful. Tuberculosis 
is successfully treated by Iodoform, which certainly does check the 
activity of the bacillus of that disease, also by Iodol in many cases. 

Diabetes has been apparently cured by Iodoform. 

Syphilis will be combated successfully by Iodoform or Iodol, in lieu of 
the Iodide of Potassium. 

Hydriodic Acid is used as a substitute for Iodine and the Iodides, 
being less offensive to the taste and stomach. It is official only as the 
Syrup, the Acid itself not being a stable preparation. 

Aristol, Dithymoi- Iodide (Unofficial), — is a combination of Iodine (45.8) and Thymol, 
prepared by adding an alkaline solution of the latter to a solution of the former in 
Potassium Iodide. It is an amorphous, unstable, odorless, non-toxic powder, of a brown- 
red color, insoluble in water or glycerine, sparingly soluble in alcohol, but freely so in 
ether, chloroform, and fatty oils. As the Iodine leaves it readily no heat should be used 
in dispensing it, and it should not be mixed with alkalies, metallic oxides, or starch. 

As a substitute for Iodoform in the local treatment of wounds, ulcers, etc., Aristol is 
highly praised, being considered as nearly if not quite as efficient, with the great advantage 
of being odorless. Excellent results have b en obtained with it in the treatment of indo- 
lent soft ulcers,lupus, psoriasis, syphilitic ulcerative processes, eczema* severe burns, affec- 



262 IPECACUANHA. 

tions of the ear, nose, and pharynx, as well as in the various cases in gynaecological and 
dermatological practice in which Iodoform has hitherto stood supreme. Its prolonged 
employment may give rise to chronic iodine poisoning. 

Aiistol is best applied in powder, in solutions in oil or ether (5 to 10 per cent.), or as 
ointments with lanolin or vaseline (5 to 10 per cent.). A useful application is a liniment, 
prepared by dissolving 5 grains of Aristol in % ij of a mixture of equal parts of ether and 
alcohol, then incorporating ^j of soft soap therewith. 



IPECACUANHA, Ipecac,— is the root of Cephaelis Ipecacuanha, 
a small shrubby plant of the nat. ord. Rubiaceae, growing in Brazil. The 
root is of the thickness of a small quill and about 4 inches long, of dull 
gray-brown color, contorted and finely wrinkled, internally white, tough 
and ligneous ; odor slight but nauseous, taste acrid, bitter and nauseating. 
It contains starch, gum, a trace of volatile oil, a crystalline alkaloid, 
Emetine, C 2 oH 30 N05, and a glucoside named Ipecacuanhic Acid. Dose of 
the powdered root, as an expectorant gr. ss-ij, as an emetic gr. xv-xxx. 

Preparations. 

Extractum Ipecacuanha Fluidum, — Dose, TT\j-v. 

Syrupus Ipecacuanha, — strength 5 per cent. Dose, S»j-^ss. 

Vinum Ipecacuanha, — strength 7 per cent. Dose, mj-gj. 

Trochisci Ipecacuanha, — each contains gr. % of Ipecac. 

Trochisci Morphines et Ipecacuanha, — each contains of Morphine Sulphate gr. -^, of 
Ipecac gr. y 1 ^, with oil of Gaultheria, Sugar, etc. 

Pulvis Ipecacuanha et Opii, Dover's Powder, — consists of Ipecac 10, Pulvis Opii 10, 
Sugar of Milk, 80 pans Dose, gr. ij-xv. 

Tindura Ipecacuanha et Opii, — Deodorized Tincture of Opium loo parts evaporated 
to 85, Fluid Extract of Ipecac 10, Alcohol q. s. ad 100. Dose, rn^v-xxx. 

Emetina, Emetine (Unofficial), a crystalline alkaloid, white, becoming yellow, odor- 
less, bitter, nearly insoluble in water, but forming with acid salts which are readily 
soluble. Is powerfully poisonous in large doses. Dose as an expectorant, gr. T ^—^ s ; 
as an emetic, gr. yi-%.- 

Physiological Action. 
Ipecac is nauseant, emetic, expectorant, cholagogue, diaphoretic, hemo- 
static, sternutatory, and counterirritant. Applied to the skin it produces 
pustulation, and used as snuff it excites violent sneezing and reflex 
mucous secretion, in some persons the smallest inhalation of the dust ex- 
citing an asthmatic paroxysm. Internally small doses (gr. }&-%) act as 
a stomachic tonic and increase the gastric secretions ; larger doses 
(gr. v-xx) are nauseant and emetic in from 20 minutes to half an hour, 
but the emesis produced is not violent nor is it followed by much depres- 
sion. If these doses are repeated a tolerance of the stomach to the drug 
becomes established and a cathartic action is produced, the stools having 
a peculiar bilious character. The circulation is only slightly affected by 
Ipecac, but it relaxes the skin and increases the broncho-pulmonary 
mucus, being diaphoretic and expectorant. In large doses it is decidedly 
irritant to the intestinal canal, but here also it is capable of the same tol- 
erance as in the stomach. In poisonous doses it has frequently produced 
hemoptysis and other hemorrhages. 






IRIS. 263 

Emetine, the active principle, causes death in animals by cardiac 
paralysis, and the autopsies show evidences of gastro-intestinal irritation 
and hyperaemic lungs with patches of hepatization. 

Antagonists and Incompatibles. 
Narcotics generally antagonize the emetic action, so also do Bismuth, Carbolic and 
Hydrocyanic Acids. The salts of Lead and Mercury, Vegetable Acids and astringent 
infusions are incompatible with Ipecac. 

Therapeutics. 

Ipecac is much used as an emetic, being safe, efficient and non-depres- 
sant, though slow of action. It is the best agent of the kind to relieve 
the stomach in acute indigestion and bilious sick-headache, and an ipecac- 
vomit is frequently very serviceable at the commencement of eruptive, 
continued and periodical fevers. The syrup is a favorite domestic emetic 
to cut short an attack of spasmodic laryngitis, and it may be used bene- 
ficially in membranous croup and capillary bronchitis. 

Dysentery is a disease in which large doses of Ipecac (gr. xx every 4 
hours) are used with great success, especially in the epidemic form, and 
in the summer dysentery of teething children. Tolerance must be estab- 
lished to produce its curative action. In small doses (nij of the wine) 
frequently repeated, it will relieve many kinds of vomiting, especially 
those of nervous origin, perhaps through a sedative action on the pneu- 
mogastric. As an antihemorrhagic it has been efficiently employed in 
post-partum hemorrhage, menorrhagia, epistaxis, hemoptysis, etc., and it 
is considered very useful in night coughs, acute catarrh and bronchitis, 
spasmodic asthma and hay fever. In most of these affections slightly 
nauseating doses must be used. 



IRIS, Blue Flag, — is the rhizome and rootlets of Iris versicolor, an 
indigenous plant of the nat. ord. Iridacese, growing in moist meadows 
and on the borders of swamps, having large blue flowers and a horizontal 
rhizome, 2 to 4 inches long, with long rootlets, slight odor, but an acrid, 
nauseous taste. It contains tannin, sugar, starch, gum, an acrid resin, 
fixed oils and traces of an alkaloid. Dose of the powdered root, gr. v-xx. 

Preparations. 

Extractum Iridis, — Dose, gr. j-v. 

Extractum Iridis Fluidum, — Dose, ITLv-gj. 

Iridin or Irisin (Unofficial), — is a so-called resinoid found in the shops, of undeter- 
mined composition, but probably an oleoresin precipitated by water from an alcoholic 
preparation. Dose, gr. j-v. 

Physiological Action. 
Iris when fresh is actively purgative, emetic and diuretic, producing 
severe nausea and prostration. Iridin has been the subject of experimen- 



264 JALAPA. 

tation upon dogs, and is shown to be a powerful hepatic stimulant with 
considerable influence on the intestinal glands, being more purgative than 
Euonymin and less irritant than Podophyllin. In very small doses it 
causes obstinate constipation by producing rectal inactivity. 

Therapeutics. 
Iris is very serviceable in duodenal catarrh with obstruction of the bile- 
ducts and consequent jaundice, also in malarial poisoning, bilious remit- 
tents, and jaundice of malarial origin. It is used in many hepatic and 
intestinal disorders as a cholagogue and purgative of mild but efficient 
action, also as a diuretic in dropsies. In small doses (try of a tincture) it 
is strongly recommended in a peculiar blinding headache in the right supra- 
orbital region with nausea or vomiting, supposed to be of hepatic origin. 



JALAPA, Jalap, — is the tuberous root of Exogonium purga, a Mexi- 
can plant of the nat. ord. Convolvulaceae. It is large, turnip-shaped, 
externally dark-brown and wrinkled, internally grayish-brown with num- 
erous concentric circles composed of small resin-cells, odor slight, taste 
sweetish and acrid. It contains 15 to 20 per cent, of the official Resin, 
which is composed of two resins, Jalapin, soft, soluble in ether, and 
Convolvulin, C 31 H 50 O 16 , which is hard, insoluble in ether, and the most 
active of the two. 

Preparations. 

Abstractum Jalapce, — is an ingredient of Pil. Cathartics Composite, gr. j in each. 
(See ante, page 190.) Dose, gr. j-v. 

Resina Jalapce, — prepared by precipitation by water from a tincture. Insoluble in 
water, soluble in alcohol. Dose, gr. ij-v. 

Pulvis Jalaptz Compositus, — jalap 35, Potassium Bitartrate 65 parts, triturated together. 
Dose, gr. x-gj. 

Physiological Action. 

Jalap is an active cathartic, producing copious and watery stools, with 
considerable tormina and tenesmus, also sometimes nausea. It does not 
produce hemorrhoids, but does increase the secretions of the intestinal 
canal and the flow of bile. Its action is not due to any one of the con- 
tained principles, but all the active constituents are found in the resin. 
Compared with other agents of the same class its action most resembles 
that of Scammony. It is more drastic than Senna and less irritant than 
Gamboge, but in overdoses may produce dangerous hypercatharsis. 

Convolvulin in sufficient dose is an active irritant poison, producing 
gastro-enteritis and narcotism. Its action as a purgative seems to be 
wholly local, as from its intravenous injection no catharsis results, yet it 
exerts little if any irritant action on the conjunctiva, nasal mucous mem- 
brane or skin. It is not eliminated in the urine or the faeces, and is there- 
fore probably destroyed in the system by oxidation. 



JUGLANS JUNIPERUS. 265 

Therapeutics. 
In olden bowel-moving times Jalap and Calomel were used together in 
doses of gr. x each (" ten and ten "), as a routine purgative prescription. 
Less ponderous doses are now considered equally efficient, and one grain 
of each agent with the same quantity of Extract of Hyoscyamus as a cor- 
rective may be used with advantage at the onset of fevers and inflamma- 
tions. As the compound powder it is much employed to produce free 
watery evacuations in ascites and anasarca. Being nearly tasteless it is a 
useful cathartic for children, and may be administered in Syrup of Rhu- 
barb (gr. ij-v in ^ss). As a vermifuge it is efficient as an adjunct to more 
powerful agents, and is employed with Calomel and Santonin for the ex- 
pulsion of lumbrici. Jalap is contraindicated in all inflammatory condi- 
tions of the intestinal mucous membrane, but in proper doses it is one of the 
most manageable and efficient cathartics. 



JUGLANS, Butternut, — is the inner bark of the root, collected 
in autumn, of Juglans cinerea, the Butternut or White Walnut, an indige- 
nous forest tree of the nat. ord. Juglandaceae. It occurs in flat or curved 
pieces, the outer surface smooth, dark-brown, mottled and nearly free 
from corky remnants of the outer bark, odor feeble, taste bitter and acrid. 
It contains an orange-yellow, crystalline and acrid substance named Ju- 
glandic Acid or JVucin, resembling Chrysophanic Acid, also some resin, 
volatile acid, etc., but neither tannin nor any alkaloid. 

Preparation. 
Extractum Juglandis, — Dose, gr. v-xx or more. 

Physiological Action and Therapeutics. 
Juglans is a mild cathartic operating without the production of pain or 
irritant symptoms. It is never used in substance, but the extract is a 
good laxative in doses of gr. v-x, and a purgative in larger doses. It has 
considerable reputation in dysentery and chronic constipation. 



JUNIPERUS, Juniper, — is the fruit of Juniperus communis, an 
evergreen shrub of the nat. ord. Coniferae, growing in Europe and N. 
America. The fruit or berry is dark-purple with a bluish-gray bloom, 
having a three-rayed furrow at the apex, internally pulpy, containing 3 
triangular, bony seeds. It contains a Volatile Oil which is official and 
consists of terpenes and camphors in complex combination, also a non- 
crvstallizable principle named Juniperin, and grape sugar, resin, formic, 
acetic and malic acids, etc. 



266 KAMALA. 

Preparations. 

Oleum Juniperi, — the volatile oil, a colorless or faintly greenish-yellow liquid, of sp. 
gr. about 0.870, of terebinthinate and sweetish taste, and the odor of juniper, soluble in 
12 of alcohol. Dose, tr^v-xx. 

Spiritus Juniperi, — has of the oil 3 parts in 97 of alcohol. Dose, 3J-,^j. 

Spiritus Juniperi Compositus, — approximates closely to the best grade of " Gin " (see 
ante, page 87). It contains Oil of Juniper 10, Oil of Caraway I, Oil of Fennel I, Alco- 
hol 3000, and Water sufficient to make 5000 parts. Dose, ,^ss-j. 

Infusum Juniperi (Unofficial), — Juniper Berries %} in Oj of boiling water. Dose, 
gss-ij. 

Oleum Cadini, Oil of Cade (Unofficial), — is a tar obtained by the destructive distilla- 
tion of Juniper wood, but is of uncertain purity. The official Oleum Picis Liquids (Oil 
of Tar) is just as efficient for all purposes to which the Oil of Cade has been applied. 



Physiological Action. 

Juniper is a stomachic tonic, diaphoretic, diuretic and aphrodisiac. 
The oil is the active principle, and is readily diffused, exciting increased 
cardiac action, stimulating the renal functions and the action of the skin, 
and causing a subjective sense of heat throughout the system. It is elimi- 
nated chiefly by the kidneys, and may set up renal irritation, in large 
doses producing strangury, priapism, hematuria, suppression of the urine, 
and uraemic convulsions. It imparts a violet odor to the urine, and will 
produce diuresis when inhaled. 

Therapeutics. 

The Oil of Juniper is used to flavor gin and to impart the diuretic power 
popularly ascribed to that liquor. The medicinal use of the juniper 
preparations (spirit and compound spirit) is restricted to their employ- 
ment as vehicles for less irritant diuretics. The oil acts therapeutically 
like the Oil of Turpentine, and may be used in chronic pyelitis and cys- 
titis, prostatorrhcea, gleet, etc., but it is contraindicated in all cases where 
acute inflammation of the kidneys exists. 

Oil of Cade is used locally in chronic skin diseases as a stimulant 
application. It is too active for acute eruptions, but has been used with 
benefit in chronic eczema and psoriasis. The official Oil of Tar (see Pix) 
is equally efficient. 



KAMALA, Rottlera, — the glands and hairs from the capsules of 
Mallo'tus philippinensis, or Rottlera tinctoria, a small tree of the nat. ord. 
Euphorbiaceae, growing in Abyssinia, Arabia, India, China, etc. It 
occurs as a granular, mobile, brick-red powder, inodorous and nearly 
tasteless, partly soluble in alcohol and ether. It contains several resins, 
one of which is named Rottlerin, C n H 10 O 3 , also tannin, starch, gum, red 
coloring matter, etc. There are no official preparations. Dose, gss-iij. 



KINO. 267 

Physiological Action and Therapeutics. 
Kamala is anthelmintic and purgative, sometimes causing nausea and 
colic, seldom vomiting. It is used as a tseniafuge and to expel lumbrici 
and ascarides vermiculares. One or two drachms are given suspended in 
water, mucilage or syrup, and repeated in 4 hours if necessary. A tinc- 
ture (gvj in xvj of alcohol) may be used in doses of 3J-^ss. In India 
it is used locally in scabies and other skin affections, and has been found 
of especial service in herpetic ringworm. As a remedy against tapeworm 
it is perhaps next after Male-fern in efficiency, and requires no preparatory 
treatment. 



KAVA-KAVA, Ava-Kava (Unofficial),— the root of Piper methys- 
ticwn, a shrub of the nat. ord. Piperacese growing in South America and 
the South Sea Islands. The root is large, weighing from 2 to 20 pounds, 
fibrous, light and spongy, and contains a crystalline principle, Kavahi?i 
or Methysticin, which is analogous to Piperin, an acrid, greenish-yellow 
resin, Kawin, which is probably the active principle, also a Volatile Oil. 
Dose, ^ss-j, macerated in water, or the same quantity of a fluid extract. 

Physiological Action and Therapeutics. 
Kava is intoxicant, diuretic and motor-depressant. A beverage is pre- 
pared in the Sandwich Islands by chewing the root and then infusing it in 
water or cocoanut milk, which produces a drowsy intoxication with 
pleasant dreams often of erotic character, and followed by severe head- 
ache. A moderate dose is tonic and stimulant, lessening the sense of 
fatigue and sharpening the mental facilities. It is highly recommended 
in gonorrhoea and gout, also in chronic gleet and obstinate cystitis. 

KINO, — is the inspissated juice of Pterocarpus Marsupiwn, a tall tree 
of the nat. ord. Leguminosse, growing in India. It occurs in angular, 
brown-red pieces, shining and brittle, inodorous, taste astringent and 
sweetish, soluble in alcohol. It contains 75 per cent, of a variety of tan- 
nin named Kino-ta7inic Acid, C 18 H 18 8 , which gives a greenish precipitate 
with persalts of iron, also a crystalline, neutral substance, Kinoin, C 14 H 12 6 , 
and Kino-red, formed from Kino-tannic Acid by oxidation, besides gum, 
pectin, etc. There are several other varieties of Kino in the market, 
brought from S. America, Africa, Australia, etc., which are products of 
other trees than the official one. 

Preparations. 

Tinctura Kino, — strength 10 per cent. Dose, rr\,x-gij. 

Pulvis Kino Compositus (Unofficial). — Kino 15, Opium 1, Cinnamon 4 (has of Opium 
I in 20). Dose, gr. v-xx. 



268 krameria kumyss. 

Physiological Action and Therapeutics. 
The action of Kino is the same as that of Tannic Acid, though less 
powerful (see ante, page 75), and maybe used for the same purposes, both 
internally and locally. It is chiefly employed as an astringent gargle and 
as a constituent of diarrhoea-mixtures. 

KRAMERIA, Rhatany, is the root of Krameria triandra and 
Krameria tomentosa, shrubs of the nat. ord. Polygalacese, growing in S. 
America, the first-named in Peru and the latter in New Granada. It i s 
about an inch thick, branched below, more or less knotty, covered with 
a brownish bark which is very astringent ; and contains 20 to 45 percent, 
of Rhatania-tannic Acid, C 54 H 34 2 i, and Rhatanine, C 10 Hi 3 NO 3 , an alka- 
loid, — also wax, gum, etc. 

Preparations. 

Extractum Kramerice, — aqueous. Dose, gr. v-x. 

Extractum Krameria Eluidum, — Dose, TT\,v- 5 ss. 

Tinctura Kramerice, — 20 per cent. Dose, HLv-^j. 

Syrupus Kramerice, — Fluid Extract 35, Syrup 65. Dose, ^ss-^ss. 

Trochisci Krameria, — each troche contains gr. j of the extract, with Tragacanth, Sugar 
and Orange- Flower Water. 

Physiological Action and Therapeutics. 
Krameria possesses the same astringent qualities as Tannic Acid (see 
ante, page 75), and may be employed for the same purposes except as an 
antidote to Antimony. It has long had a high reputation as an injection 
for fissure of the anus, as a local application to spongy gums, and as a 
tonic for debilitated subjects. 

KUMYSS, Kopmiss (Unofficial), — is an effervescing fermented 
liquor originally prepared by the Tartars from mare's milk, but now 
imitated with cow's milk by adding sugar of milk, fermenting in open 
tanks, skimming off the casein and butter, then bottling during active 
fermentation. Wolff's formula for its preparation in small quantity is as 
follows : — • 

Dissolve ^ ss (a tablespoonful) of grape sugar in ^iv of water. Dissolve gr. xx (a 
teaspoonful) of Fleischmann's compressed yeast or well washed and pressed-out brewer's 
yeast in ^ij of cow's milk. Mix the two solutions in a quart champagne bottle, and fill 
to within two inches of the top with good cow's milk. Cork well, secure the cork with 
wire, keep it in a cellar or ice chest, maintaining a temperature of 50 F. or less, and 
agitate twice daily. In three or four days it is ready for use, but should not be kept 
longer than four or five days. Draw it with a champagne tap. 

The following table of analysis shows the average composition of milk, 
koumiss and kefir: — 

Cow's milk. Koumiss. Kefir. 

Albumen, 48 11.2 38 

Butter, , 38 20.5 20 

Sugar of milk, 41 22. 20 

Lactic acid, — 1 1.5 9 

Alcohol, — 16.5 8 

Water and salts 873 918.3 905 






LACTUCARIUM. 269 

Physiological Action and Therapeutics. 

The taste of Kumyss is acidulous and peculiar. In large quantity it 
takes the place of food, each quart equalling four ounces of solids. It is 
said to be a powerful diuretic, especially in cold weather, and in warm 
weather to produce free diaphoresis. It is stimulating and tonic, increases 
the body nutrition and produces considerable somnolence. The stomach 
is very tolerant of it, and retains it when any other food will be rejected. 
It is easily assimilated and very nutritious. 

Kumyss is an invaluable article of diet in many wasting diseases, espe- 
cially phthisis. It is also of great benefit in dyspepsia, the diarrhoea of 
children, convalescence from acute maladies, chronic affections of the 
kidneys, chronic bronchitis, and other cachexias. In cases of feeble 
digestive power % every hour is sufficient, but as its digestion and assimi- 
lation increase it may be given almost ad libitum, and when used with 
other food a half-pint may be taken after each meal. 

Kefir is the name of a fermented drink prepared from the milk of a 
cow or mare by the addition of a mushroom-like ferment found near the 
snow-line in the Caucasian mountains. It is used by the natives of the 
Asiatic plains as a remedy for struma, anaemia, lung and stomach diseases. 
Kefir is richer in albumen than Kumyss, is less alcoholic and less acid. 



LACTUCARIUM, Lettuce, — is the concrete milk-juice of Lactuca 
virosa, or Acrid Lettuce, a biennial European plant, of the nat. ord. 
Compositae. It occurs in sections of cakes or irregular pieces showing the 
form of the vessel in which it hardened, externally reddish-brown, inter- 
nally white or yellowish and of waxy lustre, odor heavy and narcotic, taste 
bitter, partly soluble in alcohol and in ether, and yielding a turbid mix- 
ture when triturated with water. Lactucarium is a mixture of several sub- 
stances, the most important being Lactucerin, 42 per cent., a crystalline, 
tasteless body, resembling caoutchouc, insoluble in water and probably 
inert; Lactucin, 0.3 per cent., a neutral principle, crystallizing in pearly- 
scales, insoluble in cold water, persistently bitter; Lactucic Acid, bitter, 
amorphous, but crystallizes after long standing. 

Preparations. 

Extractum Lactucarii Fluidum, — Dose, for a child TT\J — ii j , for an adult nrx-^j, 
according to the activity of the drug. 

Syrupus Lactucarii, — 5 per cent. Dose, gj-3j. 

Physiological Action and Therapeutics. 
Lactucarium is feebly hypnotic, somewhat sedative and diuretic. It is 
supposed to act similarly to Opium, but very feebly and without depressing 
after-symptoms. Its preparations are very uncertain in activity, and are 



2/0 LANOLINUM LAPPA. 

chiefly used as placebos, to allay cough and quiet nervous irritability. The 
syrup is a good vehicle for expectorants and antispasmodics. 



LANOLINUM, Lanolin, — is a cholesterin fat obtained from the 
suds from the washing of sheep's wool, by a process patented in the United 
States by Prof. Liebreich, the discoverer of Chloral ; and though a very old 
medicament, being mentioned by Ovid, Herodotus, Pliny and Aristo- 
phanes, it is now being introduced to the medical world as the best basis 
for ointments. It contains 25 to 30 per cent, of water, and readily unites 
with no per cent, of its own weight of water ; differing from all other fatty 
substances, chiefly in resisting saponification and the action of water, 
having no tendency to become rancid. It readily passes through the in- 
tegument, carrying with it any medicament with which it is charged. It 
is a perfectly neutral base, and hence is not liable to decompose any 
ordinary substance. The difficulty about its use has been its very disa- 
greeable sheepy smell, but recent samples, exhibited to the British Medical 
Association, seem to have been devoid of this objectionable quality. It is 
particularly useful in chronic skin diseases where there is infiltration, and 
a penetrative action is desired for medicaments. In a few cases of acute 
and subacute eczema it has proved irritating, but as a rule it is perfectly 
bland. Where a simple protective action is desired it is inferior to Lard, 
Vaseline or Cold Cream. 



LAPPA, Burdock, — is the root of Lappa officinalis, the common 
Burdock, a coarse-looking biennial weed of the nat. ord. Compositae, 
found in waste places and along roadsides in Europe, Asia and N. America. 
Three varieties are recognized, — Lappa major, L. tomentosa, and L. minor, 
of which the first-named is most frequently met with in this country. The 
root, about a foot long, an inch thick, has a feeble odor and a mucilagin- 
ous, bitterish taste, and contains a bitter principle, traces of a volatile 
oil, also inulin, resin, tannin, mucilage, sugar, etc. There are no official 
preparations. Dose, 3j-ij, in infusion, decoction or tincture. Dr. Squibb 
recommends a tincture of the seed, lb j of ground seed to gall, j of whiskey, 
allowed to stand for two weeks before decanting, and used in doses of 
^ij-iij before meals. 

Physiological Action and Therapeutics. 
Lappa promotes all the secretions and is considered aperient, diuretic 
and diaphoretic, without irritating qualities. In decoction it has been a 
popular domestic remedy for many morbid conditions, especially rheuma- 
tism, gout, pulmonary catarrhs, and chronic cutaneous affections. By 
several practitioners it is praised as an alterative in constitutional diseases, 



LAVANDULA LEPTANDRA. 271 






as syphilis and scrofula, also as an external application to swellings, 
hemorrhoids and chronic sores. A tincture of the seed has proved re- 
markably efficient as a stomachic tonic and has cured several cases of 
psoriasis inveterata. (See Squibb's Ephemeris, vol. i, page 116.) 



LAVANDULA, Lavender, — the flowers of Lavandula vera, a 
small European shrub of the nat. ord. Labiatae, largely cultivated in 
England. They have a bluish-gray tubular calyx, a violet- blue corolla, a 
fragrant odor, and an aromatic, camphoraceous taste, and contain resin 
and tannin, also a Volatile Oil which is official. Lavender is a constitu- 
ent of Vinum Aromaticum. 

Preparations. 

Oleum Lavandulce, — is a volatile oil dialled from the flowering tops or the whole herb. 
It is much coarser than the oil of lavender flowers and more stimulant. Dose, Try-v. 

Oleum Lavandulce Florum, — is a volatile oil distilled from fresh Lavender, and having 
the fragrant odor of the flowers. Sp. gr. 0.890, soluble in alcohol and in acetic acid of 
90 per cent. It is a constituent of Spiritus Odoratus. (See ante, page 87.) Dose, HI j-v. 

Spiritus Lavandulce — has of the Oil of Lavender Flowers 3 parts in 97 of Alcohol. 
A perfume and flavoring. Dose, ^ss-j. 

Tinctura Lavandula Composita, — an aromatic stimulant composed of Oil of Lavender 
8, Oil of Rosemary 2, Cinnamon 18, Cloves 4, Nutmeg 10, Red Saunders 8, Alcohol 680, 
Water 270, Diluted Alcohol q. s. add 1000 parts. Dose, gss-ij. Is a constituent of 
Liquor Potassii Arsenitis. 

Physiological Action and Therapeutics. 
Lavender is aromatic, stimulant and carminative, but is rarely used 
alone as a medicine. It is an agreeable flavoring and perfume, in the 
form of the official spirit, which is sold under the name of "Lavender- 
water," after the addition of Oil of Bergamot and Essence of Ambergris. 
The compound tincture, formerly called the compound Spirit of Lavender, 
is a very agreeable compound of spices, and is much used as a remedy for 
gastralgia, nausea, flatulence, etc., and as an adjuvant or corrigent of 
other medicines. 



LEPTANDRA, Culver's Root, — is the rhizome and rootlets of 
Leptandra virginica, an indigenous perennial plant of the nat. ord. Scrofu- 
lariacese. The rhizome is horizontal, about 5 inches long and ^ inch 
thick, bent and branched, with thin, wrinkled rootlets, inodorous, taste 
bitter and feel acrid. It contains a glucoside named Leptandrin, which 
is probably the active principle, also Saponin, resin, tannin, etc. The 
Leptandrin of the shops is an impure alcoholic extract. 

Preparations. 

Extr actum Leptandrce, — Dose, gr. j-iij. 
Extractum L.eptandrce Fluidum, — Dose, ir^xx- 3jj. 



272 LICOPERDON GIGANTEUM LIMON. 

Physiological Action and Therapeutics. 

Leptandra is tonic, laxative, and like other resin-bearing purgatives is 
decidedly cholagogue. The recent root is a violent cathartic, but in the 
dried state it is less active. It is indicated in duodenal indigestion and 
chronic constipation with insufficiency of the biliary and intestinal se- 
cretions. 



LICOPERDON GIGANTEUM, Puff-Bail,— is a common 
fungus of the nat. ord. Trichogastres, found in hilly and wooded districts. 
The dust, which consists of the capillitium and spores, is a valuable 
hemostatic, and dusted over bleeding surfaces acts promptly in arresting 
hemorrhage. It has been proposed as a surgical dressing, but while use- 
ful in emergencies where other agents are unattainable, the fetor which 
results from its application to wounds will prevent its use becoming general 
for this purpose. It may prove of value as an internal hemostatic in 
hematemesis and the hemorrhage of typhoid fever. 



LIMON, Lemon, — is the fruit of Citrus Limonum, a tree of the nat. 
ord. Aurantiacese, native in Asia, but cultivated in southern Europe and 
many other countries. It is official in the two forms described below. 
The Orange (Citrus Vulgaris and C. Aurantiuni), the Citron (Citrus 
medica), and the Lime (Citrus acris), all belong to the same genus as 
the Lemon (Citrus Limonum). 

Limonis Cortex, Lemon Peel, — is the rind of the recent fruit, and 
contains a Volatile Oil, C 10 H 16 , which is official, and a bitter crystalline 
glucoside, Hesperidin, C 22 H 26 12 , chiefly contained in the white portion 
of the rind. 

Limonis Succus, Lemon Juice, — is the freshly expressed juice of the 
ripe fruit, each lemon yielding from ^ to 1 fluid ounce. It contains 
about 7 per cent, of free Citric Acid, besides Phosphoric and Malic 
Acids, Citrates of Potassium and of other bases, etc. Dose, gss-iv. 

Acidum Citricum, Citric Acid, H 3 C 6 H 5 7 .H 2 0, — is obtained from the 
juice of the Lemon or the Lime by adding chalk to form the Citrate of 
Calcium, which is then decomposed by dilute Sulphuric Acid. It occurs 
in colorless, rhombic crystals which are very soluble in water. A solution 
of gr. xvij in ^ss of water corresponds to ^ss of fresh lemon-juice, and 
this quantity of either will neutralize of Potassium Bicarbonate gr. xxv, 
of Sodium Bicarbonate gr. xx, and of Ammonium Carbonate gr. xivss. 
Dose, gr. x-xxx. 

Citrates of Bismuth, Bismuth and Ammonium, Iron, Iron and Ammo- 
nium, Iron and Quinine, Iron and Strychnine, Lithium, Potassium, eight 



LIMON. 273 

in all, are official. They are described under their respective bases, to 
which rather than to the acid their medicinal qualities are due. 

Preparations. 

Oleum Limonis, Oil of Lemon, C 10 H 16 , — is the volatile oil, isomeric with oil of tur- 
pentine, and extracted from fresh lemon peel by mechanical means. It is used for flavor- 
ing and is an ingredient of Spiritus Limonis, Spiritus Odoratus, and Spiritus Ammoniee 
Aromaticus. Dose, tt\j-v. 

Spiritus Limonis, Essence of Lemon, — prepared by macerating 6 parts of the oil and 
4 of the peel in 90 of alcohol. Used for flavoring. Dose, according to the alcohol 
required to be given. 

Syrupus Limonis, — Lemon-juice 40, Lemon-peel 2, Sugar 60, Water q. s. ad 100 
parts. Dose, indefinite. 

Syrupus Acidi Citrici, — Citric Acid 8, Water 8, Spirit of Lemon 4, Syrup 980 parts. 
Dose, indefinite. 

Physiological Action. 

Lemon-Peel is bitter and probably tonic to the stomach, but is only 
used for flavoring purposes. Lemon-Juice, on the other hand, is refrig- 
erant and antiscorbutic, entering the blood as alkaline citrates, potassium 
salts and phosphoric acid, the citrates being therein partly oxidized into 
C0 2 and H 2 0, while the potassium salts and phosphoric acid probably act 
upon the red corpuscles. 

Citric Acid has the same general action as Acetic and the other vege- 
table acids (see Acidum Aceticum, ante, page 59). It is wholly decom- 
posed in the blood, and appears to be non-toxic in man, but used inter- 
nally it may precipitate uric acid and thus promote the formation of 
calculi. 

Therapeutics. 

Lemon-juice is employed largely in the treatment and prevention of 
scurvy, in which disease it possesses powers of specific rank, but whether 
its action therein is due to the citric acid, the phosphoric acid or the salts 
of potassium is not known. Lime-juice is equally efficient but Citric 
Acid itself is not so. 

As refrigerants and diuretic mixtures in fevers, Lemon-juice and Citric 
Acid are much used, entering into the composition of lemonades, efferves- 
cing draughts, etc., to allay thirst and subdue restlessness, and to pro- 
mote the action of the skin and the kidneys. For acidity of the stomach 
they are efficient if given in small doses before meals, but the mineral 
acids are usually preferred for this purpose. Long-continued they will 
impair digestion and impoverish the blood. Atheromatous degeneration 
of the vessels is said to be retarded by the daily use of lemon-juice, which 
is supposed to dissolve the excess of organic matter and to aid its excre- 
tion. Obesity may be reduced by using the juice of limes or lemons in 
large quantity, but it will be done at the expense of the digestion. Lemon- 
juice has been found of service in acute rheumatism, probably through the 
alkalies which it conveys into the blood. As a local application it has. 



274 LINUM LITHIUM. 

been found efficient in pruritus scroti, sunburn, post-partum hemor- 
rhage, and as a gargle in diphtheritic sore throat. 



LINUM, Flaxseed, Linseed, — is the seed of Linutn usitatissimum 
(flax), a cultivated annual plant of the nat. ord. Linacese. The seeds are 
small, flattened, oblong-ovate bodies, brown and glossy, inodorous, taste 
mucilaginous and bitter; and contain 15 per cent, of Mucilage in the 
epithelium, also 30 to 40 per cent, of Fixed Oil in the embryo. Ground 
Flaxseed should yield not less than 25 per cent, of the fixed oil. 

Preparations. 

Oleum, Lint, Linseed Oil, — the fixed oil expressed from flaxseed without the use of 
heat. A yellow, oily liquid, of slight odor, bland taste, and neutral reaction, soluble in 
5 of absolute alcohol and in 1*4 of ether. Consists chiefly of the Glyceride of Linoleic 
Acid C 16 H 28 4 , which having a powerful affinity for oxygen becomes resinoid on expo- 
sure to the air, making it a " drying oil." Dose, ^ss-ij. 

Infusum Lini, Linseed Tea (Unofficial), — Flaxseed 3 iij, Liquorice-root gj, Boiling 
Water ^ x, infused for four hours and strained. Dose, indefinite. 

Carron Oil (Unofficial), — is made by emulsifying equal parts of Linseed Oil and Lime- 
water. The official Linimentum Calcis is intended for the same purposes. 

Physiological Action and Therapeutics. 
Flaxseed is demulcent, emollient, expectorant and diuretic. The oil is 
laxative in a dose of gj, and in smaller doses is oxidized in the system 
and excreted as a resinoid body by the kidneys, which it stimulates 
slightly. The infusion contains the mucilaginous principle and a small 
portion of the oil, and is advantageously used in inflammations of the 
mucous membrane of the throat, the gastro-intestinal tract and the urin- 
ary passages. It is an excellent demulcent in coughs of various kinds, 
and will be found very serviceable in cystitis, irritable bladder, renal 
colic, strangury, etc. The oil may be administered internally as a laxa- 
tive but is usually given as an enema, and has considerable reputation as 
a remedy^ for hemorrhoids in doses of gij twice daily. Externally it is a 
favorite application to burns when made into an emulsion with lime- 
water. The ground seed (flaxseed meal) is one of the best agents for use 
in poultices, and is universally employed for that purpose. 

LITHIUM, Li, — is represented in the Pharmacopoeia by five of its 

salts, of which the Carbonate is but slightly soluble while the others are 

readily so. The low atomic weight of this metal (7) makes its saturating 

power greater than that of other alkaline metals, hence the value of its 

salts in medicine. 

Salts of Lithium. 

Lithii Benzoas, Benzoate of Lithium, LiC 7 H 5 2 , — is classed with the Benzoates and 
described under Benzoic Acid. (See ante, page 132.) 

Lithii Bromidum, Bromide of Lithium, LiBr, — is classed with the Bromides and 
described under Bromine. (See ante, page 136.) 



LOBELIA. 275 

Lithii Carbonas, Carbonate of Lithium, Li 2 C0 3 , — a light, white powder, permanent 
in the air, odorless, of alkaline taste and reaction, soluble in 130 of water, insoluble in 
alcohol. Dose, gr. ij-xv. 

Lithii Citras, Citrate of Lithium, Li 3 C 6 H 5 7 , — a white, deliquescent powder, odor- 
less, of faintly alkaline taste and neutral reaction, soluble in 5^ of water, slightly in 
alcohol. Dose, gr. v-xxx. 

Lithii Salicy/as, Salicylate of Lithium, 2LiC 7 H 5 3 .H 2 0, — is classed with the Salicy- 
lates and described under Salix. 



Physiological Action. 
The Lithium salts have strong alkaline qualities and act on the system 
in the same manner as other alkalies (see under Potassium). The high 
saturating power of this metal makes its salts more alkaline than those of 
Potassium, Sodium or Calcium, hence more efficient in alkalinizing the 
urine. The Urate of Lithium is the most soluble of the urates, hence the 
value of lithium salts in the uric acid diathesis. The Carbonate and 
Citrate are the salts referred to in this connection, the others partaking 
more of the qualities of their acid factors. Both these salts are antacid 
and strongly diuretic, the Carbonate being but slightly soluble is given in 
wafer or in carbonic acid water, and the Citrate in solution. The latter 
may be extemporaneously prepared by adding Citric Acid to an aqueous 
solution of the Carbonate, and in the organism is decomposed, the citric 
acid being oxidized and the carbonate formed. Many mineral waters 
contain small quantities of the carbonate, varying from a mere trace to 
0.01 grain to a pint, an amount so minute as to be practically inert in 
comparison with the much greater quantities of potassium and sodium 
salts in the same waters. 

Therapeutics. 
The Carbonate and Citrate of Lithium are extensively used in gout 
and the lithsemic diathesis, for the purpose of holding the uric acid in 
solution as urate of lithium, and preventing its deposit in the tissues as 
urate of sodium which is less soluble. Their prolonged administration is 
so efficient in this affection that they have been credited with the power 
of dissolving uric acid calculi and called lithontriptics. They are also 
highly useful in the indigestion and rheumatism of obese subjects, and in 
irritable bladder from excess of acid in the urine. Lithiated Arsenical 
Water has been lately praised as a remedy in diabetes. 



LOBELIA, Indian Tobacco, — the leaves and tops of Lobelia 
inflata (nat. ord. Lobeliaceae), collected after a portion of the capsules 
have become inflated. The plant is a common annual weed growing 
on roadsides throughout the United States, having pale-green, alternate 
leaves, a single, erect and very hairy stem, with hairy branches and small, 
pale-blue flowers, odor slight but irritating, taste at first mild, afterwards 



276 LOBELIA. 

burning and acrid. It contains gum, resin, fixed oil, wax, lignin, salts of 
lime, potassium and iron, a liquid alkaloid, Lobeline, which is the narcotic 
principle of the plant, also Lobelic Acid, and an acrid substance named 

Lobelacrin. 

Preparations. 
Extractum Lobelice Fluidum, — Dose, TnJ-x. 
Tinctura Lobelice, — 20 per cent. Dose, rr^v-xxx. 
Acetum Lobelice, — 10 per cent. Dose, VC\y-^). 
Infusum Lobelia (Unofficial), — ^j to a pint. Dose, 2[j-^j. 
Lobelin (Unofficial), — an impure resinoid. Dose, gr. ss-j. 

Physiological Action. 
Lobelia has an acrid, nauseous taste, and a heavy, unpleasant odor. It 
is expectorant, diaphoretic, emetic, purgative, antispasmodic, motor-de- 
pressant and narcotic. It excites an abundant flow of saliva, much gastric 
mucus, profuse urination and sweating, with nausea, vomiting and great 
depression. The heart's action is enfeebled, and the blood-pressure, at 
first increased, soon falls ; muscular debility, reduced temperature and 
coma follow, and death occurs by paralysis of the respiratory apparatus. 
The drug produces paralysis of the motor nerve-trunks, the peripheral 
vagi, and probably the respiratory and vaso-motor centres also. It 
strongly resembles tobacco in its action, and is highly dangerous in full 
medicinal doses, having caused many deaths when administered thera- 
peutically, the most important instance of its fatal results being the 
case of Ezra Lovett, Jr., who in 1809 was poisoned by Lobelia admin- 
istered by the founder of the Thomsonian sect of medical practitioners. 
The responsible party escaped conviction on the plea that he gave the 
drug in ignorance of its qualities. 

Antidotes and Lncompatibles. 
Tannic Acid to form the insoluble tannate. Strychnine, Picrotoxine and Thebaine 
antagonize its action on the nervous system ; — the vaso-motor excitants, as Alcohol, 
Digitalis, Belladonna, Ergot, etc., antagonize its effects on the circulation. Caustic 
alkalies are incompatible, decomposing the alkaloid. 

Therapeutics. 
Lobelia was a favorite remedy with the Indians at the time of the first 
settlement of the United States, and was introduced into regular practice 
as an anti-asthmatic, after having served as the main stock-in-trade of the 
irregular practitioners for many years. Its principal therapeutic action is 
that of an antispasmodic, and in cautious hands it is extremely useful in 
paroxysmal spasmodic asthma, as well as in dry cough with constant tick- 
ling in the throat. As an enema in cases of strangulated hernia the infu- 
sion is much safer than Tobacco and fully as efficient, and may overcome 
the obstruction in intussusception, while the tincture in 2 -drop doses every 
hour will often relieve a case of impacted caecum. In constipation from 
atony and deficient secretion a 10-minim dose of the tincture at bed- 



LYCOPODIUM MAGNESIUM. 2JJ 

time acts excellently, and in the poison-oak eczema the infusion is a good 
local application. As an emetic it is entirely too depressant for chil- 
dren's use. 

LYCOPODIUM, — is a very mobile, pale-yellow, fine powder, con- 
sisting of the sporules or seeds of the Club-moss, Lycopodium ciavatum, 
and of other species of Lycopodium (nat. ord. Lycopodiacese). The 
plant is a native of Europe and the U. S., has a trailing stem several feet 
long, with smooth, deep-green, pointed leaves, flowers in terminal spikes, 
and yellow capsules which contain the seeds. Lycopodium is odorless, 
tasteless, floats on water, which does not wet it, and burns quickly when 
thrown on a flame. It should be free from pine-pollen, starch, sand and 
other impurities, which are detected by means of the microscope, the 
seeds being about -g-J^ of an inch in diameter, four-sided and reticulated, 
with short projections on the edges. They contain about 47 per cent, of 
a bland, fixed oil. 

Physiological Actions and Therapeutics. 

The plant was formerly considered to be diuretic and anti-spasmodic, 
and was used in rheumatism, epilepsy and pulmonary and renal disorders. 
The powder is now employed quite extensively in pharmacy to facilitate 
the rolling of a pill-mass and to prevent adhesion of pills to each other. 
It makes an excellent absorbent and protective powder when dusted over 
an excoriated surface, as seen between the thighs of infants. 

By the homoeopathic practitioners Lycopodium is elevated to the rank 
of an active drug when triturated with sugar of milk sufficiently long to 
break up the seeds and liberate their oily contents. In their first centesi- 
mal trituration (y-J-Q-) it is said to have produced symptoms of high excite- 
ment of the circulation and irritation of the urinary organs, and they 
profess to use it with benefit in many affections of the mucous tracts, dys- 
pepsia, pyrosis, flatulence, constipation, ileo-colitis of infants, hepatic 
congestion, aneurism, chronic affections of the lungs and bronchi, diph- 
theria, lithiasis, intertrigo, porrigo capitis, plica polonica and pruritus 
ani, in all of which as an internal remedy and in high attenuation. 

MAGNESIUM, Mg. — This metal is represented by its Oxide, 
Carbonate, Citrate, Sulphate and Sulphite, of which the Sulphate occurs 
native in sea-water, caves, etc., the others being prepared from it. The 
first two are almost insoluble in water or alcohol. Its salts are either 
white or colorless, and those which are official are as follows : — 

Official Salts of Magnesium. 
Magnesia, Light Magnesia, Oxide of Magnesium, MgO, — made by heating the light 
carbonate in a crucible to expel nearly all the carbonic acid. A white, light and very fine 
powder, almost insoluble in water, insoluble in alcohol, and gelatinizes with 1 5 of water 



278 MAGNESIUM. 

after standing y z hour, having become hydrated. Is a constituent of Pulvis Rhei Com- 
positus, Massa Copaibse and Ferri Oxidum Hydratum cum Magnesia. Dose, gr. x-^j. 

Magnesia Ponderosa, Heavy Magnesia, Oxide of Magnesium, MgO, — is a white, dense 
and very fine powder, corresponding in other properties and reactions with Magnesia, ex- 
cept that it does not gelatinize with water. It is made by calcining the heavier variety of 
the carbonate, and is much slower in action than the light magnesia. Dose, gr. x-^j. 

Magnesii Carbonas, Carbonate of Magnesium, (MgC0 3 ) 4 Mg(HO) 2 .5H 2 0, — light, 
friable masses, or powder, odorless and tasteless, insoluble in alcohol, almost insoluble in 
water. Dose, gr. x-^j. 

Magnesii Sulphas, Sulphate of Magnesium, Epsom Salt, MgS0 4 .7H 2 0, — colorless 
prisms or acicular needles, slowly efflorescent, odorless, of cooling, saline taste, and neu- 
tral reaction, very soluble in water, insoluble in alcohol. Is a constituent of lnfusum 
Sennse Compositum. Dose, gj-^j. 

Magnesii Sulphis, Sulphite of Magnesium, MgS0 3 .6H 2 0, — a white, crystalline pow- 
der, becoming oxidized on exposure to air, of sulphurous and slightly bitter taste, and 
neutral or slightly alkaline reaction, soluble in 20 of water, insoluble in alcohol. Dose, 
gr. x-xxx. 

Preparatiotis. 

Magnesii Citras Granulaius, Granulated Citrate of Magnesium, — prepared from the 
Carbonate with Citric Acid, Sugar, Bicarbonate of Sodium, Alcohol and Distilled Water. 
A coarsely granular, white salt, deliquescent, of acidulous taste and acid reaction, soluble 
with copious effervescence in 2 of water, insoluble in alcohol. Dose, gij-^j. 

Liquor Magnesii Cilratis y — prepared from the Carbonate gr. 200, Citric Acid gr. 400, 
.Syrup of Citric Acid gr. 1200, Potassium Bicarbonate gr. 30, Water q. s. ad Jxij. Dose, 
^iv-vj, repeated for catharsis. 

Trochisci Magnesii, — each troche contains of Magnesia gr. 3, Nutmeg gr. 0.15, with 
Sugar and Mucilage of Tragacanth. Dose, indefinite. 

Mistura Magnesice et Asafoetidce, Dewees' Carminative, — contains of the Carbonate 5 
per cent., Tincture of Asafoetida 7, Tincture of Opium 1, Su°far 10, and Distilled Water 77. 
Dose, gss-iv. Used for flatulent colic and diarrhoea in infants. 

Physiological Action. 

Magnesia and the Carbonate of Magnesium are mildly laxative and 
antacid, neutralizing free acids in the stomach and forming therewith lax- 
ative salts. If used in large quantity for any length of time it may 
become hydrated and produce intestinal concretions. The freshly-pre- 
cipitated hydrate (see above, Magnesia) is an antidote to Arsenic in 
solution, but less effective than the Hydrated Sesquioxide of Iron, with 
which it is combined in the official Ferri Ox. Hydratum cum Magnesia. 
(See ante, page 222.) Magnesia may also be used in acid or phosphorus- 
poisoning. 

The Citrate and Sulphate are saline cathartics, the latter being the 
most powerful, producing prompt and free watery discharges, with but 
little griping or irritation, but frequently a sense of coldness and depres- 
sion. The purgative action is chiefly due to increase of the intestinal 
fluids by an outward osmosis from the vessels, and not from increase of 
the secretions of the glandular appendages. If the purgative action 
should not take place a diuretic one will result, but to secure the desired 
catharsis the drug should be administered in a considerable quantity of 
water. Sulphate of Magnesium is the principal aperient constituent of 
many of the popular laxative mineral waters, as Friedrichshall, Piillna, 
Hunyadi, etc. 



MAGNOLIA MALTUM. 279 

The Sulphite shares the actions and uses of the other sulphites, and is 
more properly considered with them. (See ante, page 74.) 

Therapeutics. 

Magnesia and the Carbonate are used as antacids and laxatives, in acid- 
ity, sick headache, flatulent colic, etc., and as antidotes in poisoning by 
acids, arsenic, phosphorus, mercuric and cupric salts. The Citrate is an 
agreeable laxative, cooling and acceptable to the stomach. The Sulphate 
is the most efficient of the saline cathartics and has a wide field of appli- 
cation. In acute inflammatory conditions, renal and cardiac dropsy, 
ascites from obstruction of the portal circulation, increased blood-pressure 
within the cranium, intestinal obstruction without acute inflammation, the 
constipation of lead poisoning, and habitual constipation from deficiency 
of the intestinal secretions, this agent will be found to be exceedingly 
serviceable. Acute dysentery is well treated by Magnesium Sulphate 
combined with diluted Sulphuric Acid, and followed by Opium and starch 
enemata. Bleeding from hemorrhoids and uterine hemorrhage are often 
relieved by the same combination when other agents fail. The ferro- 
saline mixture (see ante, page 223) is a very useful laxative in the consti- 
pation of anaemic women. The bitter taste of Epsom Salt is best covered 
by coffee. 



MAGNOLIA,— is the bark of Magnolia glauca (Sweet Bay, Swamp 
Sassafras), M. acuminata (Cucumber-tree), and M. tripetala (Umbrella- 
tree), all of which belong to the nat. ord. Magnoliaceae, and are indi- 
genous to the eastern and southern States. It occurs in quilled or curved 
pieces, of orange-brown color externally, whitish or a pale-brown inter- 
nally, taste astringent, pungent and bitter. It contains a crystalline prin- 
ciple named Magnolin, which is insoluble in water, but soluble in alcohol, 
ether, etc. Dose of the powdered bark, gss-j. There are no official 
preparations. 

* 
Physiological Action and Therapeutics. 

Magnolia is an aromatic bitter tonic and diaphoretic, usefully employed 
in chronic rheumatism, remittent and intermittent fever. Jn the latter 
affection it will arrest the paroxysms if used freely. 

MALTUM, Malt, — is the seed of Hordeum distichum, Barley (nat. 
ord. Graminaceae), caused to enter the incipient stage of germination by 
artificial means and dried. The germination is allowed to go far enough 
to develop the maximum amount of Diastase, the peculiar ferment by 
which the starch of the grain is converted into Glucose. Malt is the 



280 MANACA MANGANUM. 

source of beer, ale and whiskey, and is composed of the germinated, dead 
grains with their acrospires and radicles. It should be fresh, not darker 
in color than a pale amber, and of agreeable odor and sweet taste. 

Preparations. 

Extractum Malti, — a liquid of the consistence of thick honey, containing all the solu- 
ble principles of malt in permanent form. It consists chiefly of diastase and glucose. 
Dose, 3J-iv. 

Horlick' 's Food (Unofficial), — is like Mellin's and many other foods for children, a 
granulated Extract of Malt. Hoff's Malt Extract is another such preparation, contain- 
ing alcohol, and corresponding to a concentrated beer. 

Physiological Action and Therapeutics. 
Malt Extract is directly nutritive, containing good food elements, and 
indirectly so from the presence of the ferment Diastase, which converts 
the starch of bread or other farinas into sugar. It is usefully employed 
in wasting diseases, and mixed with milk or oleaginous foods it aids their 
digestion and assimilation. It may be used to form a syrupy mixture 
with preparations of Iron or Cinchona. 



MANACA (Unofficial), — is the root of Franciscea uniflora, a shrub 
of the nat. ord. Scrophulariacese, indigenous to Brazil, where it is known 
as Mercurio- vegetal, or Vegetable Mercury, a name applied by charlatans 
to a number of widely differing plants. Very little is known about 
Manaca, but it is extensively advertised as an unfailing remedy for sub- 
acute and chronic rheumatism. It is also considered purgative, diuretic, 
emmenagogue and antisyphilitic, being official in the Brazilian Dispensa- 
tories, and noticed as follows in the Diet, de Botan. Brazileira. 

" This whole plant, but especially the root, excites powerfully the lymphatic system, 
eliminating morbid matter by the skin and kidneys. It is antisyphilitic ; the interior bark 
is nauseating and stimulates the throat. In small doses it is resolvent ; in larger purga- 
tive, diuretic and emmenagogue. In large doses it is an acrid poison." 

A fluid extract is on the market, the average dose of which is rr^x three 
or four times daily. 



MANGANUM, Manganese, Mn. — This metal is represented in 
the Pharmacopoeia by two of its salts, viz. — the native Black Oxide and 
the Sulphate, as follows : — 

Mangani Oxidum Nigrum, Black Oxide of Manganese, Dioxide of Manganese, — is 
native, crude Binoxide of Manganese, containing at least 66 per cent, of the pure Oxide, 
Mn0 2 . A heavy, grayish-black powder, odorless and tasteless, insoluble in water or alco- 
hol, giving off oxygen gas at a red heat, and if heated with hydrochloric acid it causes 
the evolution of chlorine gas. Is used in preparing Chlorine Water. Dose, gr. ij-x. 

Mangani Sulphas, Sulphate of Manganese, MnS0 4 4H 2 0. — colorless prisms, of 
slightly bitter and astringent taste, faintly acid reaction, very soluble in water, insoluble in 
alcohol. Dose, gr. ij-v. 



MANGANUM. 28 1 

Preparations. 

Potassii Permanganas, Permanganate of Potassium, K 2 Mn 2 8 , — deep, purple-violet 
prisms, of sweet and astringent taste, neutral reaction, soluble in 20 of water with a 
scanty, brown residue, decomposed by alcohol. It should be kept in well- stoppered 
bottles, and should not be triturated nor combined in solution with organic or readily 
oxidizable substances. Dose, gr. ss-ij, in distilled water. 

Syrupus Mangani Iodidi, Syrup of the Iodide of Manganese (Unofficial), — contains 
about J^j of the iodide in each 3 . Dose, TTLx-xxx. For formula see U. S. D., page 
1691. 

Syrupus Ferri et Mangani Iodidi, Syrup of the Iodide of Iron and Manganese (Un- 
official), — each ^ contains gr. 50 of the mixed iodides in the proportion of 3 of the 
Iodide of Iron to 1 of that of Manganese. Dose, TT^x-xxx. For formula see U S. D., 
page 1692. 

Ferri et Mangani Carbonas Saccharatus, — Saccharated Carbonate of Iron and Man- 
ganese (Unofficial), — is a tasteless, reddish-brown powder. Dose, gr. v-xx. For formula 
see U. S. D., page 1693. 

Physiological Action. 

The salts of Manganese in small doses improve the appetite and the 
digestion and stimulate the action of the heart. Used in larger doses and 
for considerable length of time they lower the heart's action, paralyze the 
muscular system, especially the muscular coat of the arteries, causing pro- 
gressive wasting, paraplegia, and acute fatty degeneration of the liver. 
They are gastro-intestinal irritants, and the Sulphate is emeto-cathartic 
and decidedly cholagogue. Manganese is closely associated with Iron in 
the blood, bile, etc., in the proportion of about i to 20. The Black 
Oxide is an efficient emmenagogue. 

Permanganate of Potassium is an active oxidizer, containing as it 
does a large proportion of oxygen which it yields very readily in the form 
of ozone, and then becomes the binoxide of manganese. This property 
gives it the qualities of an antiseptic, a disinfectant and a deodorant. It 
is considered by some authorities to be an efficient emmenagogue. Used 
internally it must be instantly decomposed in the stomach, and probably 
is not absorbed in its own state. 



Therapeutics. 

The salts of Manganese are used by those practitioners who affect to see 
a manganese-anaemia in cachectic subjects, and they are always combined 
with ferric preparations. In amenorrhcea, gastrodynia and pyrosis the 
purified oxide is a good remedy in doses of 10 to 15 grains, and the same 
preparation is used as an ointment in many skin diseases. In jaundice of 
malarial origin or catarrh of the biliary passages the sulphate gives good 
results. 

Permanganate of Potassium is used as an antiseptic and oxidizing agent 
in diphtheria, scarlatina, septicaemia, erysipelas, etc., given internally and 
used locally at the same time. It is given with apparent benefit in dys- 
pepsia, flatulence, lithaemia and obesity, and has often seemed to be of 
service in acute rheumatism. In amenorrhoea it is reported to be very 



282 MANGO MANNA. 

efficient, and has lately been used with success as a remedy for the bites 
of venomous serpents and for other animal poisons. Locally it is fre- 
quently employed (3 j to the pint) to correct fetor in cancer, ulcer, caries, 
abscesses, ozaena, and it will destroy the odor of a foul breath or that of 
the fetid perspirations of the feet. It is used both as a test and as a cor- 
rigent for organic impurities in drinking-water. 

Manganese is becoming more of an acknowledged remedy in derange- 
ments of the menstrual function, as irregular or scanty menstruation, amen- 
orrhcea, menorrhagia, and even metrorrhagia. By some authorities, the 
emmenagogue power of Potassium Permanganate is ascribed to its large 
proportion of Oxygen, which it is supposed to give up to the uterus ; as, 
until recently, Potassium Chlorate was supposed to do by the system at 
large. According to the views of others who have studied its action, 
Manganese should be classed with the excito-motors, increasing arterial 
tension, and specifically acting upon the uterus. The best preparation is 
the Binoxide, in freshly-made pills of two grains each, of which 1 to 3 or 
5 pills may be taken twice or thrice daily. The Permanganate of Potas- 
sium has generally been the preparation given when the effects of Man- 
ganese were desired ; but as it causes great gastric irritability, with ab- 
dominal pains and burning sensations, besides other decidedly unpleasant 
symptoms, it is a difficult matter to get patients to take it for any length 
of time. 



MANGO (Unofficial), — is the , bark of Mangifera indica, an Indian 
tree of the nat. ord. Guttiferse. It is supposed to be an astringent with 
special tonic action upon mucous membranes. It is highly recommended 
by its vendors for nasal catarrh, hemorrhages, and muco-purulent dis- 
charges from the intestines, uterus, vagina and bronchi. A fluid extract 
is sold, which may be used in doses of Tt^x-^j. 

Mango-Fruit or Mangosieen is the fruit of Garcinia mangostana, nat. ord. Guttiferse, 
also from India. It is a powerful astringent, and is used for nasal catarrh, diarrhoeas, 
dysentery, leucorrhoea, etc. 



MANNA, — is the concrete, saccharine exudation of Fraxinus Ornus, 
or Flowering Ash, a tree of the nat. ord. Oleacese, growing in Southern 
Europe. Manna is produced also by several other trees, and substances 
resembling it are exuded by many plants. The official Manna occurs in 
three-edged, flattish pieces, brownish-white and glutinous externally, white 
and crystalline internally, odor honey-like, taste sweet, slightly bitter and 
faintly acrid. It contains from 40 to 90 per cent, of Mannit, C 6 H u 6 , 
or Manna-sugar, which does not undergo vinous fermentation, and is 
chemically allied to the alcohols and to glycerin. Manna also contains 



MARRUBIUM MASTICHE. 283 

glucose, mucilage, some acrid resin, and a small quantity of the fluores- 
cent glucoside Fraxin, C 16 H 18 O 10 . There are no official preparations, but 
Manna itself may be given in doses of gj-ij. 

Physiological Action and Therapeutics. 
Manna is a mild laxative, with some tendency to produce flatulence 
and colic. It is usually combined with other purgatives, as Senna, Rhu- 
barb, Magnesia, etc., to disguise the taste and increase the effect. It is 
a constituent of the official Infusum Sennas Compositum. Manna may 
be eaten by children if of good quality, or may be readily dissolved in 
milk and so administered. 



MARRUBIUM, Horehound, — the leaves and top of Marrubium 
vulgare, a plant of the nat. ord. Labiatae, native in Europe, but natural- 
ized in America. It contains a bitter principle named Marrubiin, also a 
volatile oil, resin, tannin, lignin, etc. There are no official preparations. 
Dose, ^ss-j. 

Physiological Action and Therapeutics. 
Horehound in large doses is laxative, diuretic and diaphoretic, and in 
ordinary dosage it is a gentle tonic and stomachic. It is generally used 
in catarrhal states of the air-passages, over which it seems to have a sooth- 
ing effect, and is much employed in confectionery as an ingredient in 
" cough-drops." 



MASTICHE, Mastic, — is a concrete, resinous exudation from 
Pistacia Lentiscus, a tree of the nat. ord. Terebinthaceae, growing in the 
island of Scio. It occurs in globular tears, covered with a whitish dust, 
of weakly resinous odor and slightly tejebinthinate taste. Alcohol dis- 
solves about 90 per cent, including the resin Mastichic Acid, C2oH 32 3 , 
the remainder consisting of another resin Mastichin, which is soluble in 
ether and resembles copal. There are no official preparations, but Mastic 
is an ingredient of the official Pil. Aloes et Mastiches (see ante, page 91). 

Physiological Action and Therapeutics. 
Mastic was formerly used for supposed properties analogous to those of 
other oleoresins, but now its application is confined to dentistry, being 
employed as a temporary filling for carious teeth, a solution in ether being 
applied on cotton with moderate pressure, and remaining as a firm plug 
after evaporation of the solvent. 



284 MATICO — MATRICARIA MEL. 

MATICO, — the leaves of Artanthe elongata (Piper angustifolium), a 
Peruvian shrub of the nat. ord. Piperacese. They are 4 to 6 inches long, 
and prominently venated on the under surface, the veins forming deep, 
angular meshes. Matico contains a crystallizable acid named Artanthic 
Acid, also resin, tannin, and a volatile oil. Its odor is aromatic, and its 
taste astringent, spicy and somewhat bitter. 

Preparations. 
Extr actum Matico Fluidum, — Dose, Jss-ij. 
Tinctura Matico, — 10 per cent. Dose, ^ss-ij. 

Physiological Action and Therapeutics. 
Matico is an aromatic tonic and stimulant, also aphrodisiac, vulnerary 
and hemostatic. It acts, like cubebs, on the urinary passages, and is an 
excellent alterative stimulant to mucous membranes. It has been used 
with considerable success in mucous catarrhs, as gonorrhoea, leucorrhoea, 
chronic cystitis, etc., also in epistaxis, hemorrhoids, menorrhagia, hemop- 
tysis, hematemesis and other hemorrhages. The under surface of the leaf 
is so formed as to promote coagulation of blood if applied to a bleeding 
surface, and therefore it is a good local hemostatic for trivial cuts or 
wounds. 

MATRICARIA, German Chamomile,— the flower-heads of 
Matricaria Chamomilla, a European annual plant of the nat. ord. Com- 
positae. They are small, yellow flowers, with white ray-florets, the recep- 
tacle being hollow, naked and conical, of strongly aromatic odor and 
bitter taste ; and contain *^th per cent, of a blue Volatile Oil (the color 
of which is due to Azulen), also a bitter extractive, tannin, etc. There are 
no official preparations, but the flowers may be eaten or a decoction or 
infusion used almost ad libitwn. 

Physiological Action and Therapeutics. 
Matricaria is a mild tonic, in large doses emetic, anthelmintic and 
antispasmodic. It is much used in Germany, and in this country is a 
popular domestic remedy among German people, who use it in infusion as 
a diaphoretic, etc. This plant is the " Chamomilla " of the homoeopaths, 
who find in it remarkable power over morbid impressionability of the 
sensory and excito-motor nerves, and administer it in various pains, aggra- 
vated at night and by warmth, clonic spasms of pregnancy, irritability of 
teething-children, flatulent colic, etc. 

MEL, Honey, — is a saccharine secretion deposited in the honey- 
comb by Apis mellifica, the honey-bee; occurring as a pale-yellowish, 
syrupy liquid, gradually becoming crystalline and opaque, of peculiar and 
heavy odor, and a very sweet, faintly acrid taste. It is a strong aqueous 



MELISSA MENISPERMUM. 285 

solution of several sugars (cane and grape sugar, levulose), with wax- 
pollen, coloring and odorous matters, etc. The sugars, which may be 
resolved into Levulose and Dextrose, amount to 70 or 80 per cent. 
Honey is frequently adulterated with starch and artificial glucose, which 
may be detected by the official tests (see U. S. Phar.). Dose, indefinite. 

Preparations. 

Mel Despumatum, Clarified Honey, — is honey heated, skimmed and strained. It 
is an ingredient of Confectio Rosse, Mel Rosse, and Massa Ferri Carbonatis. Dose, 
indefinite. 

Mel Rosce, Honey of Rose, — Red Rose 8, Clarified Honey 93, Diluted Alcohol q. s. 
Dose, indefinite ; generally used as a local application to the throat for its astringency and 
flavor, in combination with more active agents. 

Physiological Action and Therapeutics. 
Honey is emollient, nutritive and laxative, in some persons giving rise 
to pyrosis, flatulence and colic, and in others to an eruption of urticaria, 
but generally constituting an agreeable article of diet. It is sometimes 
actually poisonous from the presence of toxic agents extracted by the bee 
from certain plants, in this country generally the Mountain Laurel 
(Kalmia Latifolia). Honey is chiefly used as an emollient in diseases of 
the throat, to relieve dryness, pain, cough and dysphagia. A mixture of 
Honey 8 parts to 1 each of Acetic Acid and Water is official in the Br. 
Phar. under the title Oxymel, and forms a pleasant addition to gargles or 
a vehicle for expectorant medicines. Honey of Rose is somewhat astrin- 
gent, and is used in gargles for the throat and in mouth washes. 



MELISSA, Balm, — the leaves and tops of Melissa officinalis, a 
European plant of the nat. ord. Labiatae, growing also in America. It 
has a perennial root, which annually gives forth several stems from 1 to 2 
feet high, with leaves about two inches long, deeply serrate, hairy and 
glandular, and white or yellowish flowers in axillary whorls of four or five 
around half the stem. It contains gum, tannin, bitter extractive, and a 
fragrant essential oil in very small quantity (^ to ^ per cent.). There 
are no official preparations. 

Balm has little or no action, except to flavor hot water for use as a 
beverage or a mild diaphoretic. 



MENISPERMUM, — is the rhizome and rootlets of Menispermum 
canadense, or Canadian Moonseed, a woody, climbing plant of the nat. 
ord. Menispermacese, native of the eastern U. S., having peltate three-to 
seven-lobed leaves, greenish-yellow flowers in small clusters, and a kidney- 
shaped fruit. The rhizome is several feet long, % inch thick, finely 
wrinkled, rootlets numerous, taste bitter. It contains starch, Berberine, 



286 MENTHA PIPERITA. 

and a white alkaloid which is soluble in alcohol and in ether. There are 
no official preparations. Dose, gr. v-xx, in infusion. 

Menispermum is reputed to have tonic properties, and is used in some 
of the Southern States in domestic practice as a substitute for Sarsa- 
parilla in scrofulous conditions. Little is known about it of a definite 
character. 



MENTHA PIPERITA, Peppermint,— the leaves and tops of 
Mentha piperita, a perennial herbaceous plant, of the nat. ord. Labiatae, 
native of Britain, but largely cultivated elsewhere. The leaves are about 
2 inches long, ovate-lanceolate, sharply serrate, of aromatic odor, and 
pungent, cooling taste. They contain i to i}( per cent, of a Volatile 
Oil which is official, and a little tannin. 

Preparations. 

Oleum Menthce Piperita, Oil of Peppermint, — is the volatile oil distilled from the fresh 
herb; a colorless or pale yellow fluid of sp. gr. about 0.900, having the odor of pepper- 
mint, a strongly aromatic taste followed by a cold sensation when air is drawn into the 
mouth. It consists of a liquid terpene, and a stearoptene named Menthol or Peppermint 
Camphor, C 10 H 20 O. Dose, mj-v. 

Aqua Menthce Piperita:, Peppermint Water, — has of the oil 2 parts in ioooof Distilled 
Water. Dose, indefinite. 

Spiritus Mentha; Piperita;, Essence of Peppermint, — is an alcoholic solution containing 
10 per cent, of the Oil and 1 per cent, of the powdered herb. Is an ingredient of Mistura 
Rhei et Sodae. Dose, TT\x-xxx. 

Trochisci Mentha: Piperita:, Peppermint Troches, — each troche contains gr. -J^ of the 
Oil, with Sugar and Mucilage of Tragacanth. Dose, indefinite. 

Menthol, Peppermint Camphor, (J 10 H 20 O (Unofficial), is a stearoptene deposited by 
Oil of Peppermint on exposure to cold. Used externally. 

Physiological Action. 

Peppermint is an aromatic stimulant, carminative and antispasmodic. 
The oil possesses these qualities in greater degree and is also a local ano- 
dyne and anaesthetic when applied locally, especially if its evaporation be 
prevented. The Chinese oil is particularly anodyne and contains a large 
Quantity of Menthol. The oil is best administered internally in its 
alcoholic solution, the spirit. Menthol is antiseptic and locally 
anaesthetic, but not corrosive, and acts also as a vascular stimulant when 
applied to the surface. 

Therapeutics. 

Peppermint is used internally for the relief of nausea and colic, and 
to expel flatus by its local stimulant and after sedative action on the 
bowels. It is an agreeable corrigent for combination with purgatives to 
prevent griping, and efficiently covers the taste of many nauseous sub- 
stances. The spirit is the best form for internal use. The oil is used 
locally to relieve the pain of superficial neuralgia, a cloth being wet with 
it, laid along the course of the affected nerve and covered with oiled silk 



MENTHA VIRIDIS MEZEREUM. 287 

to restrain evaporation. It is also efficient in rheumatism as an anodyne 
counterirritant. Menthol is highly vaunted as an external application in 
various neuralgias, sciatica, pleurodynia, toothache, etc. For neuralgia it 
is used in saturated alcoholic solution painted over the affected nerve. 
For toothache a crystal introduced into the carious cavity is promptly ano- 
dyne. As an antiseptic it promises well as an application in parasitic skin 
diseases. As the Chinese have used their Oil of Peppermint for ages as an 
application in neuralgise, and as this oil contains a large quantity of 
Menthol, the latter preparation will probably prove a very efficient agent 
in these affections if the cupidity of the manufacturers will allow of its 
being obtained pure. 



MENTHA VIRIDIS, Spearmint,— the leaves and tops of Men- 
tha viridis, the " mint " of the kitchen garden, a plant of the nat. ord. 
Labiatae, indigenous to England, but naturalized in many countries. Its 
constituents and properties are identical with those of peppermint, but 
its odor and taste differ therefrom. 

Preparations. 

Oleum Mentha Viridis, Oil of Spearmint, — is the Volatile Oil distilled from the plant. 
Dose, rr^ij— v. 

Aqua Mentha Viridis, Spearmint Water 3 — has 2 parts of the Oil in 1000 of Distilled 
Water. Dose, indefinite. 

Spiritus Menthce Viridis, Essence of Spearmint, — is an alcoholic solution containing 
10 per cent, of the Oil and I per cent, of the powdered herb. Dose, Tr^x-xl. 

Spearmint corresponds in action to Peppermint, but is generally less 
powerful. It is usually employed to correct flatulence and to relieve 
colic, and makes an agreeable flavoring for many mixtures. 



MEZEREUM, Mezereon, — is the bark of Daphne Mezereum and 
of other species of Daphne, plants of the nat. ord. Thymelaceae, growing 
in mountainous districts of Europe and Asia and cultivated as a garden 
shrub in Britain. The bark occurs in long, thin bands, rolled into disks, 
brownish-yellow on the surface, whitish and silky within, inodorous, very 
acrid. It contains an inert, fixed oil, an inactive glucoside, Daphnin, and 
an acrid Resin, which is the anhydride of a resinous acid named Meze- 
reinic Acid. Mezereum is an ingredient of the compound decoction and 
the compound fluid extract of Sarsaparilla. Dose, gr. j-x. 

Preparations. 

Extractum Mezerei, — is only used to prepare the Linimetnum Sinapis Compositum. 

Extractum Mezerei Fluidum, — is too acrid for internal use, but from it is prepared the 
following. 

Unguentum Mezerei, — has of the preceding 25 parts, Lard 80, Yellow Wax 12. An 
irritant ointment. 



288 . MORRHILE OLEUM. 

Physiological Action. 
Mezereon is a sialogogue, and an intensely acrid, irritant poison, pro- 
ducing violent vomiting, purging, nephritis and gastro-enteritis. In 
small doses it is laxative and diuretic, and has had considerable reputation 
as an alterative. Externally the recent bark is a powerful local irritant, 
speedily producing vesication. 

Therapeutics. 
Mezereon is rarely used internally by itself, but is employed in mix- 
tures with Sarsaparilla, etc., as an alterative in syphilis, rheumatism and 
some skin diseases of chronic type, but with powerful efficacy. It has 
been used with good effect in toothache and as a masticatory in paralysis 
of the tongue. Its principal use is as a local irritant to keep up the dis- 
charge from issues or blisters, and to stimulate indolent ulcers. 

MORRHU^ OLEUM, Cod-liver Oil,— is a fixed oil obtained 
from the fresh livers of Gadus Morrhua (Cod-fish) or other species of 
Gadus. It is a colorless or pale yellow, thin, oily liquid, of slightly fishy 
odor and taste, and faintly acid reaction, soluble in ether; sp. gr. 0.920 
to 0.925. It consists chiefly of Olein and Margarin, with a peculiar prin- 
ciple named Gaduin, also Trimethylamine, free fatty Acids (oleic, pal- 
mitic, stearic), traces of Iodine, Bromine, Sulphuric and Phosphoric Acids, 
the ordinary inorganic salts of animal tissue and products, and perhaps 
bile constituents. When saponified it does not yield Glycerin but Oxide 
of Propyl. Three kinds or varieties are found in the market, the pale, 
the light-brown and the dark. The pale is the official oil and the purest. 
Dose, 3J-ij, on a full stomach, increased as assimilated. 

Unofficial Preparation. 
Glyconin Emulsion of Cod-liver Oil, — 01. Morrhuse t ^iv, Glyceritum Vitelli gix, 
Aromatic Spirit of Ammonia gj, Sherry Wine ^ij, Diluted Phosphoric Acid ^iv, Es- 
sence of Bitter Almond ( ^j of the Volatile Oil in Oss Alcohol) gij. The Cod-liver Oil 
is to be added to the Glyconin very slowly with brisk stirring, and the other ingredients 
added in the order named. 

Physiological Action. 
The action of Cod-liver Oil is that of any other fat, except that it is 
more easily assimilated than any member of the class. Fats in small quan- 
tity are necessary for the digestion of nitrogenous food, and form the 
molecular basis of the chyle, being prepared for absorption by the pancre- 
atic juice and the bile, especially the latter. Fat is an essential con- 
stituent of the products of tissue formation, whether physiological or path- 
ological, and is the principal material concerned in the production of 
force. After oxidation it is excreted as carbonic acid and water. Lo- 
cally applied fats reduce the body temperature. 



MORRHtLE OLEUM. 289 

Cod-liver Oil is the most easily digestible of fats, penetrating animal 
membranes with comparative ease after being emulsified by the pancreatic 
and biliary secretions, hence entering the lacteal vessels readily and ap- 
pearing to bring with it the oily and nitrogenous elements of the food. 
The result is facilitation of the digestive process, increase of the red 
blood-corpuscles and of the body-weight, and stimulation of healthy cell- 
formation throughout the tissues. The properties of this oil have been 
ascribed to its contained biliary constituent, Iodine, free Oleic Acid, etc., 
but no satisfactory explanation has yet been offered for the difference 
between its action and that of other animal or vegetable oils. 

Therapeutics. 

The use of Cod-liver Oil is that of a nutrient wholly, this action being 
most marked in wasting diseases. In high febrile states or catarrhal con- 
ditions of the gastro-intestinal tract its use is contraindicated, but in 
phthisis a slight degree of fever will not interfere with its beneficial em- 
ployment. It is found to be of most value in chronic forms of phthisis, 
chronic bronchitis and emphysema, chronic rheumatic disorders, atheroma 
of the arteries, strumous skin diseases and diarrhcea, syphilodermata, neu- 
ralgia, chorea and epilepsy. In many disorders referable to exhaustion 
or debility of the nervous centres it is of great value as a nerve tonic, and 
in convalescence from acute diseases it is of marked benefit. It should 
always be considered as a supplementary food, and if its use endangers the 
appetite for other food it should be abandoned. 

The administration of this valuable agent is a serious matter, as many 
patients cannot overcome their repugnance to its taste and smell. Various 
emulsions are on the market, but they are objectionable because in no case 
do they conceal the taste, and the efficacy of the oil is seriously impaired 
by the processes used in their preparation. Moreover, the temptation is 
very great to employ an inferior grade of the oil or to adulterate it with 
other fish-oils in the manufacture of these preparations, and when the 
commercial spirit of gain is remembered one can never be sure of the 
quality of the oil so prepared. The oil itself is the best form for use, in 
small doses, say a teaspoonful thrice daily for an adult, after meals, in 
black coffee, beer or lemon-juice. The essential Oil of Eucalyptus in the 
proportion of 1 part to 100 of cod-liver oil will effectually extinguish the 
odor and taste to many persons. Alkaline stomachics given before meals, 
the oil after, and a teaspoonful of the "Liquor Pancreaticus " given half 
an hour afterwards, would be a good routine in most cases, the latter 
agent preventing the fishy eructations which often give so much trouble. 
Extemporaneous emulsions may be prepared with Glycerite of Yolk of 
Egg (see ante, page 288), White of Egg, Mucilage of Tragacanth, Ex- 
tract of Malt, or any syrup, and flavored with Lemon, .Cinnamon or Bitter 
19 



29O MOSCHUS MYRCIA OLEUM. 

Almond. The addition of nviv of Ether to each 3 of the oil promotes 
its digestion by stimulating the pancreatic secretion, and enables a patient 
to take it with whom it had previously disagreed. 

Inunction by Cod-liver Oil is a method of value in the wasting diseases 
of children. A tablespoonful may be rubbed into the skin of the abdo- 
men twice a day, and covered with a flannel binder with oiled silk or 
mackintosh-cloth outside. It readily passes through the skin and is 
absorbed, producing valuable and lasting results. 



MOSCHUS, Musk, — is the dried secretion from the preputial 
follicles of Moschus moschiferus (the Musk Deer), an animal inhabiting 
the mountainous region of Central Asia. It occurs in irregular, unctuous 
grains, of a reddish-brown color, peculiar and penetrating odor and 
bitterish taste, contained in oval sacs about 2 inches in diameter, mem- 
branous on one side, hairy on the other. About 10 per cent, is soluble 
in alcohol, 50 per cent, in water. Chinese Musk in the pods or sacs is the 
most valuable, but all varieties are much adulterated, the price of the 
drug being very high. The odor is destroyed by drying, but returns 
again on the addition of moisture. Trituration with Camphor or Hydro- 
cyanic Acid also destroys it. The odorous principle has not been isolated, 
it is probably a product of decomposition which is constantly being 
formed. The constituents of Musk are a bitter resinous substance, 
ammonia, fat, cholesterin, etc. Dose, gr. ij-x. 

Preparation. 

Tinctura Moscki, — 10 per cent. Dose, Tt^ss-^jss. 

Physiological Action and Therapeutics. 
Musk is a very diffusible stimulant, acting directly on the nervous and 
circulatory systems, but without much energy. It is also an antispasmodic, 
and is used with benefit in general prostration of the system with nervous 
agitation or irregular muscular action. It has been used with advantage 
in laryngismus stridulus, insomnia, the collapse of typhoid and typhus 
fevers, spasmodic affections of the stomach, obstinate hiccough and con- 
vulsions of children due to intestinal spasms. The pure Musk is very 
difficult to obtain, and its high price makes it an extremely expensive 
medicine, so that it is seldom used except as a perfume. 



MYRCIiE OLEUM, Oil of Myrcia, Oil of Bay,— is a volatile 
oil distilled from the leaves of Myrcia acris, or Bayberry, a tree of the 
nat. ord. Myrtace3e, native of the West Indian Islands. It is a dark- 
brown liquid, of aromatic odor, pungent taste, slightly acid reaction, 



MYRISTICA. 29I 

and soluble in an equal weight of alcohol. Sp. gr. about 1.040. It 
contains a hydrocarbon and Eugenic Acid. Used as a perfume. 

Preparation. 
Spiritus Myrcice, Spirit of Myrcise, Bay Rum, — contains in 1800 parts Oil of Myrcia 
16, Oil of Orange-peel I, Oil of Pimento 1, Alcohol 1000, Water 782 paits, filtered 
through Carbonate of Magnesium. Used as a wash or perfume. 

The Oil of Bay is an agreeable perfume used to prepare bay-rum and 
in other cosmetic preparations. The spirit, known as "Bay-rum," is 
used principally as a refreshing perfume, and is thought to relieve head- 
ache, faintness, etc., by application to the forehead or to the nostrils. 



MYRISTICA, Nutmeg, — is the kernel of the seed of Myristica 
fragratis deprived of its testa. The nutmeg tree is cultivated extensively 
in the East and West India Islands, belongs to the nat. ord. Myristicaceae, 
and is a native of the Banda Islands in the Malayan Archipelago. The 
nutmeg is about an inch long, oval or roundish-ovate, reticulately fur- 
rowed, internally pale-brown or grayish-red with dark-brown veins, 
having a strongly aromatic odor and a somewhat bitter taste. It con- 
tains 4 to 9 per cent, of the official Volatile Oil, and 30 per cent, of a 
concrete oil, commonly called " Oil of Mace," which is a compound 
of fluid glycerides of Oleic and Butyric Acids, and the solid glyceride of 
Myristic Acid, some resin and volatile oil. Dose, gr. v-xx. . 

Macis, Mace, — is the arillus or fleshy covering of the fruit of Myristica 
fragrans, the Nutmeg-tree. It occurs in narrow bands about an inch long, 
branched and lobed, of brownish-orange color, fragrant odor, warm and 
aromatic taste. It yields a fixed oil by pressure and a volatile oil by 
distillation, the latter being probably identical with Oil of Nutmeg. 

Preparations. 

Oleum Myristicce, Oil of Nutmeg, — is the volatile oil, and consists chiefly of a terpene 
and an oxygenated oil Myristicol. It is colorless or pale-yellow, of hot, spicy taste and 
neutral reaction, and is soluble in alcohol. Dose, rnj-v. 

Spiritus Myristicce, Spirit or Essence of Nutmeg, — is a 3 per cent, solution of the oil 
in alcohol. Dose, ^j-ij. 

Nutmeg is an ingredient of Acetum Opii, Pulvis Aromaticus, Tr. Lavandulae Co., Syr. 
Rhei Aromat., Trochisci Cretae, Trochisci Magnesias and Trochisci Sodii Biearbonatis. 

Physiological Action and Therapeutics. 
Nutmeg is an aromatic stomachic of agreeable flavor. In small doses 
it stimulates the production of gastric juice, and thus promotes digestion 
and increases appetite. It also relieves intestinal spasm and flatulence. 
In large doses it is powerfully narcotic, acting directly on the cerebrum, 
and producing stupor and delirium. It is used chiefly for flavoring 
purposes, and generally in substance, grated as required, but has been 
employed as a carminative, anodyne and astringent in diarrhoeas and 



292 MYRRHA NAPHTHALINE. 

dysentery, as well as to relieve nausea and vomiting. The Volatile Oil 
is decidedly rubefacient when used externally, and has narcotic powers if 
used internally in sufficient quantity. It is occasionally employed as an 
external stimulant in paralysis and chronic rheumatism. 

Mace is stimulant, carminative and aromatic. It is used solely as a 
spice or condiment. Dose, gr. v-xx. 



MYRRHA, Myrrh, — is a gum resin obtained from Balsamodendron 
Myrrha, an Arabian tree of the nat. ord. Burseraceae, collecting spon- 
taneously upon the bark, and occurring in roundish tears, having a waxy 
fracture, a balsamic odor, and an acrid and bitter taste. Triturated with 
water it yields a brownish-yellow emulsion ; with alcohol it yields a 
brownish-yellow tincture which turns purple on the addition of nitric 
acid. It contains 60 per cent, of gum, 35 per cent, of Myrrhin, a resin, 
and about 2 per cent, of an oxygenated ethereal oil, My7-rhol, C 10 H n O. 
Dose, gr. x-xxx. 

Prepai'ations. 
Tinctura Myi-rhcz, — 20 per cent. Dose, TT^x-xxx. 

Myrrh is also contained in Mist. Ferri Co., Pil. Aloes et Myrrhse Pil., Ferri Co., Pil. 
Galbani Co., Pil. Rhei Co., and Tr. Aloes et Myrrhae. 

Physiological Action and Therapeutics. 

Myrrh in small doses stimulates the gastro-intestinal mucous membrane ; 
in large doses it is an irritant thereunto, producing vomiting and purging. 
It quickens the action of the heart and diminishes the bronchial secretion. 
It is a uterine stimulant and emmenagogue, a stimulant expectorant, and is 
thought to increase the number of leucocytes in the blood. Locally it is 
stimulant and disinfectant to mucous membranes and ulcerated surfaces. 

Myrrh is used internally in the various combinations noted above for 
anaemia and amenorrhcea, bronchial catarrh, etc. It has been supposed 
to diminish excessive secretion from the mucous surfaces of the uterus, 
vagina, bladder, and bronchi, and to have an especially beneficial in- 
fluence on chronic pharyngitis. Locally, the tincture has a good tonic 
action on diseased mucous surfaces, and is applied to spongy gums, relaxed 
throat, aphthous patches and unhealthy ulcers. The tincture diluted with 
water makes an excellent disinfectant and stimulant gargle in ulcerated 
sore-throat. Myrrh has long been used as an ingredient of dentifrices. 

NAPHTHALINE, C 10 H 8 (Unofficial),— is one of the many pro- 
ducts of the distillation of coal-tar, and is one of the benzene derivatives, 
being formed by the union of two benzene groups in an overlapping ring. 
(See ante, page 183.) It occurs as colorless, micaceous crystals, obtained 
from the destructive distillation of coal-tar, having a peculiar smell, — 



NAPHTHALINE. 293 

insoluble in water, dilute acids or alkalies, and but sparingly so in 
alcohol. 

The dose of Naphthaline is from gr. ij-gr. viij, up to gr. lxxx per diem 
for adults; — and for children gr. j-gr. iij, every three hours. Being quite 
insoluble in water it must be given in emulsion, or as a powder with sugar 
in wafers or capsules. It is best flavored with oil of bergamot. 

Derivatives. 

From Naphthaline we have these unofficial substances — 

Naphthol, C 10 H t OH, Beta- or Iso-naphthol, — one of several kinds of 
Naphthol : is sparingly soluble even in hot water, but is soluble in alco- 
hol, ether, chloroform, olive oil and vaseline. Used as ointment, 1 to 5 
for adults, but for children not over 2 per cent. 

Hydronaphthol, C 16 H 7 OH, — glistening, micaceous scales, sparingly 
soluble in water, freely soluble in alcohol, oils, etc. Used as an anti- 
septic, and in ointment or powder locally, diluted with oxide of zinc, 1 
to 50. 

Physiological Actions. 

Naphthaline is destructive to all forms of low life, and hence is anti- 
septic in a high degree, but must be intimately mixed with the substances 
upon which it is to act. Internally it is a stimulant expectorant of decided 
power, and disinfects the contents of the intestinal canal. Being so 
sparingly soluble, but little of it is absorbed, and hence it does no injury 
to the organism. What is taken up by the blood is excreted by the 
urine, partly unchanged, partly as naphthol and perhaps some as phenol. 
Naphthol is more easily absorbed, and causes vomiting, hematuria, con- 
vulsions, and unconsciousness. Hydronaphthol is a powerful and non- 
irritating antiseptic, non-poisonous, non-corrosive, freely soluble in alco- 
hol, glycerin, fixed oils, etc., in cold water, 1 to 2000; and in hot water 1 
to 100, precipitating as the water cools, but leaving a saturated solution 
of 1 to 1000, which is perfectly inhibitive of the germs of putrefaction in 
all putrescible fluids (Levis). The claims made for it are that it is 12 
times as effective as carbolic acid, 30 times as potent as salicylic acid, 60 
times as efficient as boric acid, 600 times as antiseptic as alcohol, and 
that it is entitled, as a true antiseptic, to stand next to mercuric chloride 
in the comparative tables (Levis). 

Therapeutics. 
Naphthaline is employed as an antiseptic for the intestinal canal in 
typhoid fever, diarrhoea, both acute and chronic, tubercular diarrhoea, 
etc. It renders the urine aseptic and maybe employed in vesical catarrh. 
It is also used internally for humoral asthma, verminous affections, and 
the chronic pulmonary catarrh of the aged. Locally, it has high value as 



294 NUX VOMICA. 

an antiseptic, for indolent ulcers, sloughing wounds, open cancers, pus 
cavities, etc. Painted over organic remains it effectually prevents the 
ravages of insects. Naphthol is employed like tar for a therapeutic 
action upon the skin, in hyperidrosis, scabies, eczema and local sweating, 
in ^ to 5 per cent, alcohol solution, or as a 10 per cent, ointment. 
Hydronaphthol is also highly esteemed for antiseptic purposes generally, 
by those who have used it, and is of benefit as an external application in 
many skin diseases. Its non-toxic and non-irritant qualities render it the 
most useful and most generally available of the three. 

NUX VOMICA, — is the seed of Strychnos Nux-vomica, an East 
India tree of the nat. ord. Loganiacese, having white, funnel-shaped 
flowers, and a fruit about the size of an orange, with many seeds in a 
juicy pulp. The seeds are flattened and nearly circular, about one inch 
in diameter, ashy-gray in color, covered with short, satiny hairs, internally 
translucent, tough and horny, with a large cavity, inodorous, taste in- 
tensely bitter. It contains two alkaloids, Strychnine, 0.2 to 0.5 per cent., 
and Brucine, 0.1 to 1.0 per cent., with 0.1 crystalline acid, Igasuric or 
Strychnic Acid, and a yellow coloring matter, a concrete oil, gum, starch, 
wax, earthy phosphates, etc. A third alkaloid, Igasurine, is claimed to 
exist by some authorities and is denied by others. 

Preparations. 

Abstr actum Nucis Vomica, — Dose, gr. y%, gradually increased. 

Extr actum Nucis Vomica, — Dose, gr. %-). 

Extractum Nucis Vomica Fluidum, — Dose, TT\j-v. 

Tinctura Nucis Vomica, — 20 per cent. Dose, TT^v-xx. 

Strychnina, Strychnine, C 21 H 22 N 2 2 , — is an alkaloid prepared from Nux Vomica, 
Ignatia, and other plants of the order Loganiacese; crystalline, intensely bitter even in 1 
to 700,000 solution, of alkaline reaction, soluble in 6 of chloroform, no of alcohol, 6700 
of water, almost insoluble in ether. It is a constituent of Ferri et Strychninse Citras, and 
of Syrupus Ferri Quininae et Strychninse Phosphatum. Dose, gr. Vo— 2V 

Strychnina Sulphas, Sulphate of Strychnine (C 21 H 22 N 2 2 ) 2 H 2 S(J 4 .7H 2 0, — crystalline, 
efflorescent, odorless, of intensely bitter taste even in I to 700,000 solution, neutral re- 
action, soluble in 10 of water and 60 of alcohol at 59 F. Dose, gr. e 1 —^' 

Brucina, Brucine, C 2S H. J6 N 2 4 (Unofficial), — colorless prisms, pearly flakes, or masses, 
soluble in water, less so in alcohol ; as compared with Strychnine it is less bitter, 12 times 
weaker and three times slower physiologically. Is thought to be a compound of strych- 
nine and resin, corresponding with the other alkaloid both physiologically and thera- 
peutically. Is seldom used. Dose, gr. -£$-\. 

Physiological Action. 
The actions of Nux Vomica are those of its alkaloid Strychnine. In 
small doses, it acts as a bitter tonic, stimulates respiration, secretion, 
appetite and digestion, and sharpens the vision. It increases peristalsis, 
stimulates both the motor and the inhibitory apparatus of the heart, and 
raises the arterial tension by stimulating the vaso-motor centres, thus con- 
tracting the arterioles, though by full doses the arterioles are relaxed. By 
a full dose (Strychnine, gr. -jL-), the pupils are dilated, the limbs jerk, 



NUX VOMICA. 295 

respiration becomes spasmodic and the lower jaw stiff, a sensation of 
cerebral tension, sudden shuddering and anxiety follow, the face wearing 
an unmeaning smile. A toxic dose (Strychnine gr. y 2 for an adult) on 
an empty stomach quickly produces heightened reflexes ; tonic spasms, 
especially of the extensor muscles, on the least irritation quickly succeed 
each other with intervals of repose, resulting after two or three hours at 
most in death by asphyxia, from tetanic fixation of the muscles of res- 
piration, consciousness being preserved until carbonic acid narcosis sets 
in. 

Strychnine exalts all the functions of the spinal cord, — reflex, motor, 
vaso-motor and sensory, — the latter being the least affected. It has a 
selective action on the large multipolar ganglia in the anterior columns, 
which it first stimulates and then paralyzes by over-stimulation. A large 
dose destroys the spinal functions as by one blow. It does not affect the 
brain directly. Thebaine, one of the alkaloids of Opium, is a powerful 
spinal exaltant and acts very similarly to Strychnine. 

From the spasms of tetanus those of Strychnine may be differentiated 
by their intermittency, the former being constant. Moreover, the mean- 
ingless smile, the less marked trismus, the absence of a wound, and the 
rapid course of the symptoms, all point to the action of Nux vomica. 

The excretion of Strychnine takes place very slowly, and by the urinary, 
salivary and cutaneous channels. Rapidly absorbed but very slowly 
excreted, it accumulates in the system if even a small dose be frequently 
repeated. 

On the eye Strychnine has marked effects, augmenting the excitability 
of the retinal elements, increasing the sharpness of vision and enlarging 
the visual field. 

Antagonists and Incompaiibles. 

The antidote is Tannic Acid, to form the very insoluble tannate, or a soluble salt of 
Iodine. Then emetics or the stomach pump, followed by perfect quiet which is very im- 
portant. Antagonists are Chloral, Tobacco, Chloroform inhalations or Ether, and Potas- 
sium Bromide, the latter being almost too slow of action to be of much use in practice. 
Chamomile oil should antagonize the rerlex excitability. The bladder must be frequently 
evacuated to prevent re-absorption of the poison, and artificial respiration maintained as 
necessary. 

Incompatibles are Bromides, Chlorides and Iodides in the same solution, the Strych- 
nine being precipitated as hydrobromafe, hydriodate, etc. 

Therapeutics. 
Nux Vomica and its chief alkaloid are used as a stomachic tonic and 
as a respiratory, cardiac, muscular and nervous stimulant. As the quan- 
tity of Strychnine in Nux Vomica varies greatly, it is best to use the alka- 
loid when its physiological action is desired, as more definite dosage may 
thus be obtained. The tincture in 5-drop doses is excellent in atonic 
dyspepsia and gastric catarrh, especially in drunkards, and in constipation 
from atony of the bowels it may be given in 10-drop doses with good 



296 NYMPH.EA ODORATA OLIV^E OLEUM. 

results, not as a purgative but to increase peristalsis. The extract is much 
used in laxative pills for habitual constipation. In the vomiting of preg- 
nancy the tincture is frequently an efficient remedy, and in the vomiting 
of phthisis Strychnine is one of the very best agents. Nux vomica is a very 
useful remedy in many nervous derangements, such as periodical coughs, 
especially night-coughs, irregular cardiac action and over-action of the 
heart, in asthma, the nervous movements of pregnancy, hypochondriasis, 
etc. Its undoubted action upon the pneumogastric makes it very valuable 
in all sorts of coughs, whether from bronchitis, pneumonia, phthisis or em- 
physema. Epidemic diarrhoeas and dysentery are well treated by Strych- 
nine, and in anaemia and chlorosis it is invaluable, combined with Iron 
and Quinine. In neuralgias, especially the visceral, tetanus of the idio- 
pathic type, cardiac failure from any cause, and in intermittents as an 
adjunct in Quinine, it is always a useful drug. Local paralyses of various 
forms are well treated by injecting Strychnine hypodermically into the 
affected muscles, and diphtheritic paralyses are almost invariably cured by 
it. Strychnine is an excellent remedy in hemiplegia when degeneration 
has not yet set in, and when the paralyzed muscles are completely relaxed ; 
but it is of no avail in recent cases, nor when the muscles have lost elec- 
trical contractility. In amaurosis from lead, tobacco or alcohol, it has 
proved remarkably useful, and in the dyspnoea of pulmonary affections it 
may be employed with benefit as a respiratory stimulant. Strychnine is 
a physiological antagonist to Chloral, Physostigmine and Morphine, and 
may be carefully administered in poisoning by these substances while the 
ordinary methods are also employed. 

In many eye diseases Strychnine is injected into the tissues about the 
temple with great benefit, especially in amblyopia due to functional dis- 
order of the retina without lesions, and in atrophy of the optic nerve. 
Used in the same manner it is highly recommended in infra-orbital neu- 
ralgia, and in other neuralgiae characterized by debility and anaemia. 



NYMPH^EA ODORATA, Sweet-scented Water-lily, (Un- 
official), — is a well-known American plant of the nat. ord. Nymphaeaceae, 
the root of which is very bitter and high'ly astringent, containing much 
Gallic and Tannic Acids, to which its actions and uses are due. A de- 
coction of gj to the pint may be used in doses of §ss-j, or a fluid extract 
in doses of ^ss-j. For the physiological actions and therapeutics of this 
vegetable astringent see Tannic Acid, ante, page 75. 



OLIViE OLEUM, Olive Oil, Sweet Oil, Salad Oil,— is a fixed 
oil expressed from the ripe fruit of Olea europcea, the olive tree (nat. ord. 
Oleaceae), which is cultivated in southern Europe, California and Austra- 



OLIV.E OLEUM. 297 

lia. It is a pale-yellow or greenish-yellow, oily liquid, of nutty, oleagin- 
ous taste, and neutral reaction, sparingly soluble in alcohol but readily 
soluble in ether. Sp. gr. about 0.916. 

Olive Oil consists of 72 per cent, of Olein (a fluid oil) and 28 per cent, of Palmitin 
(a solid oil or stearoptene), which are compounds of the base Glyceryl, C 3 H 5 , with Oleic 
Acid, C 19 H 34 2 , and Palmitic Acid, C 17 H 31 2 , respectively. It is frequently adul- 
terated with cheaper fixed oils, especially poppy oil, lard oil, and cotton-seed oil, quan- 
tities of the latter being exported every year to Italy, whence it is returned to us as Olive 
Oil under a French label. (See Gossypium, ante, page 235.) It is an ingredient of Ce- 
ratum Camphorae, Ceratum Cetacei, Emplastrum Plumbi, and Unguentum Diachylon, 
and is the source of the official Soap. Dose, ^ss-j. 



Physiological Action. 

Externally used Olive Oil is a good protective from the air, and ren- 
ders the skin soft and flexible. If rubbed into the integument it is ab- 
sorbed by the lymphatics and is directly nutritive in effect. Internally it 
is also nutritious and mildly laxative, and in quantity acts as a protective 
to the mucous membrane against acrid or poisonous substances. Like 
other oils it is partly emulsified, partly saponified in the intestines, its gly- 
cerin being set free and its fatty acids combining with the free alkalies to 
form soap, which with the emulsion forms the molecular basis of the chyle, 
entering the blood through the lacteals and being finally oxidized into 
carbonic acid and water, though an excess will appear unchanged in the 
urine. Oils are therefore a food within certain limits, increase the fat of 
the tissues, furnish force, and save the waste of nitrogenous tissue, but are 
unable of themselves to support life. 

Therapeutics. 

Olive Oil possesses no very marked therapeutic power above any other 
bland oil or fat. It is a good laxative for infants administered internally, 
and may be used as an enema followed by warm water. Its chief employ- 
ment is as a local application. Applied to burns and acute inflammations 
of the skin it is an excellent protective, coating the surface and excluding 
the air; and as an ingredient of liniments it acts as a diluent for more 
active agents. It is used to facilitate friction over enlarged or stiff joints, 
and in the desquamative stage of scarlet fever is a very useful and grateful 
application. As an antidote in corrosive poisoning it acts mechanically by 
protecting the mucous membrane of the stomach and preventing absorp- 
tion. In pharmacy its bland, unirritating qualities have procured its 
common employment as an ingredient of liniments, plasters, ointments 
and cerates, but the foreign article is so frequently adulterated with 
inferior oils that Cotton-seed Oil is now directed in its place in many 
official preparations. 



298 OPIUM. 

OPIUM, — is the concrete, milky exudation, obtained in Asia Minor 
by incising the unripe capsules of the White Poppy, Papaver sotnniferum, 
an annual herb of the nat. ord. Papaveracese, indigenous to Western Asia 
but cultivated extensively elsewhere. Its capsules are globular, two or 
three inches in diameter, and are crowned by a sessile, stellate stigma, 
which distinguishes them from Colocynth and Bael fruits. Opium occurs 
in irregular lumps or cakes, of dark-brown color, sharp, narcotic odor, 
and bitter taste ; and in its normal, moist condition should yield not less 
than 9 per cent, of Morphine when assayed by the process official in the 
Pharmacopoeia. 

Composition of Opium. 

Opium contains 17 alkaloids, 2 neutral substances and 2 organic acids, 
together with sugar, gum, resin, pectin, extractives, odorous principles, 
water and other constituents of plants. Its most important alkaloids are 
the following: — 

Morphine, C n H ig N0 3 , 5 to 20 per cent. — the principal alkaloid, occurring in the 
drug in the form of the tribasic meconate. Its properties are anodyne, hypnotic and nar- 
cotic. From it by a process of dehydration by heat and hydrochloric acid is prepared the 
artificial alkaloid Apomorphine, a powerful emetic. (See ante, page 109.) 

Codeine, C 18 H 21 N0 3 , 0.3 to 0.5 per cent., — is calmative and when pure a not very 
active alkaloid, but is frequently contaminated with other alkaloids. Apomorphine may 
be prepared also from it. 

Narcotine, C 22 H 23 N'0 7 , 2 to 10 per cent., — is antiperiodic and a tetanizer, but wholly 
devoid of narcotic properties. 

Thebaine or Paramorphine. C 19 H 21 N0 3 , 0.15 to 0.20 per cent., — is a powerful spinal 
exaltant and tetanizer, resembling Strychnine in its action. 

Narceine, C 22 H 29 N0 9 , 0.02 per cent., — closely resembles Morphine in action, but is 
probably more hypnotic, and is not followed by many of the disagreeable after-effects of 
Morphine. It is extremely difficult to obtain this alkaloid pure. 

Papaverine, C 2] H 21 N0 4 , I per cent.,— is reported inert on man by some observers, a 
narcotic and convulsant by others. 

Other Alkaloids at present acknowledged are — Cryptopine, Pseudomorphine, Protopine, 
Hydrocotarnine, Laudanine, Codamine, Rhceadine, Meconidine, Laudanosine, Lan- 
thopine and Gnoscopine. Many of them are probably to be regarded as derivatives 
from Morphine. 

Besides the above-named alkaloids the most important of the constitu- 
ents of Opium are the following acids and neutral principles, viz. : 

Acids are — Meconic Acid, C 7 H 4 Q 7 , 4 per cent., and Lactic Acid, C 3 H 6 3 , 1% per 
cent., which exist in combination with the alkaloids as meconates, bimeconates, etc. The 
second acid is generally called Thebolactic, but has been recently shown to be identical 
with lactic acid. 

Neutral Principles are — Meconin, C 10 H 10 O 4 , 0.01 per cent., white, crystalline, neutral, 
but very acrid; Meconoiosin, C 8 H 10 O 2 , also crystalline, and Porphyroxin, which is now 
said not to be a proximate principle but a very complex combination of several alkaloids. 

Smyrna, Turkey or Levant Opium is the best grade. Constantinople 
Opium is of uncertain quality, while of the other varieties in the market 
Egyptian, Persian and Indian samples are those most frequently met with. 
All varieties are more or less adulterated with fruits and leaves of other 
plants, starch, pitch, clay, wax, gum, liquorice, etc. 



OPIUM. 299 

Preparations of Opium. 

Pulvis Opii, Powdered Opium. — is Opium dried at a temperature not exceeding 185 
F., and reduced to a moderately fine powder. It should contain not less than 12 nor 
more than 16 per cent, of Morphine when assayed by the official process. Dose, gr. 
ss-iij, an average adult dose being about one grain. 

Opium Denarcotisalum, Denarcotized Opium, — is powdered Opium freed from the 
constituents which are soluble in ether, namely — the odorous matters and Narcotine, 
which are supposed to cause the unpleasant after-effects of Opium. It should yield 14 
per cent, of Morphine, and therefore is by no means " denarcotized," but is a good prepa- 
ration, being a purified Opium having a fixed Morphine standard. Dose, gr. ss-iij, an 
average adult dose being about one grain. The proprietary article named Svapnia is a 
similar preparation. 

Extractum Opii, — an aqueous extract containing Glycerin to keep it soft, and freed 
from some disturbing principles which are insoluble in water. Dose, gr. X~~J- 

Pilulcz Opii, — each pill containing gr. j of powdered Opium with gr. ^ of Soap. 
Dose, j-iij. 

Tinctura Opii, — Laudanum, — Opium-strength 10 per cent., average Morphine- 
strength gr. vj (equaling gr. vijss of the Sulphate) to the fl ^ . Has about gr. xliv of 
Opium to the J . TT^xj (gtt. xxij) = gr. j of Opium or gr. )/& of Morphine Sulphate. 
Sixty minims yield on the average 120 drops. Dose, mjv-xx as per effect required. 

Tinctura Opii Deodorata, Deodorized Tincture of Opium, — an aqueous extract 
shaken with ether, which being separated the residue is dissolved in water, and enough 
alcohol is added to preserve it. An excellent liquid preparation, being freed from all the 
noxious and useless ingredients, soluble in alcohol and ether. McMunn's Elixir is a 
similar preparation, so also is a recent nostrum named Papine. Opium strength 10 per 
cent., average Morphine strength gr. vj to the fl ^ . Dose, as Tinct. Opii. Drops of this 
preparation nearly equal minims. 

Vinum Opti, Wine of Opium, Sydenham's Laudanum, — Opium-strength 10 per cent., 
with the aromatics Cinnamon and Cloves of each 1 per cent., in Stronger White Wine. A 
vinous tincture decreased somewhat in strength from the wine of 1870. Dose, as Tinct. 
Opii. Drops of this preparation are larger than those of the tincture. 

Acetum Opii, Vinegar of Opium, Black Drop, — Opium strength 10 per cent., with Nut- 
meg and Sugar in Dilute Acetic Acid. Is now y^ weaker than formerly, having the 
same strength and dose as Tinct. Opii. 

Tinctura Opii Camphorata, Camphorated Tincture, Paregoric, — has of Powdered 
Opium 4, Benzoic Acid 4, Camphor 4, Oil of Anise 4, Glycerin 40, Diluted Alcohol q. s. 
ad 1000 parts. % ss contains nearly one grain of powdered Opium, and is about ^th 
the strength of Laudanum. Dose, for an infant gtt. v-xx, for an adult gj-iv. 

[Note. — According to the U. S. Pharmacopoeia of 1880 the official dried Opium should 
contain 12 to 16 per cent, of Morphine instead of 10 per cent, as required by the Pharma- 
copoeia of 1870. The liquid preparations, except Paregoric, are now directed to be of 
the uniform Opium-strength of 10 per cent, by weight, making the Wine less slrong by 
2 per cent., the Acetum fully ^ less in strength, and the other liquid preparations stronger 
by }4 in Morphine than formerly. So that if the full anodyne dose of Tincture or Deo- 
dorized Tincture be taken at 24 minims, equalling gr. *^ of Morphine Sulphate, the cor- 
responding dose under the new system will be 16 minims.] 

Liquor Opii Composihis, Compound Solution of Opium (Squibb), Unofficial, — has the 
same strength as the official tinctures, namely gr. vj of Morphine (equalling gr. vijss of the 
Sulphate) to each fluidounce. rr^xvj = gr. j( of Morphine Sulphate. 

Tinctura Opii Composita, Squibb's Diarrhoea Mixture (Unofficial), — has of Tinct. Opii, 
Spt. Camphorse and Tinct. Capsici ^j of each, Purified Chloroform giij, Stronger 
Alcohol q. s. ad % v. Each fl 3 or teaspoonful contains about 100 drops or m^xij of each 
of the first three ingredients and mjvss or 18 drops of Chloroform. Dose, for infants gtt. 
j-x, for children gtt. x-xxx, for adults 3 j. 

Emplastrum Opii, — Extract of Opium 6, Burgundy Pitch 18, Lead Plaster 76 parts. 

Pulvis Ipecacuanha' el Opii, Dover's Powder, — Ipecac 10, Powdered Opium 10, Sugar 
of Milk 80, triturated to a fine powder. Dose, gr. v-xv, ten grains equalling one grain 
each of Ipecac and Opium. 

Tinctura Ipecacuanhce et Opii, — Deodorized Tincture of Opium 100 parts evaporated 
to 85, Fluid Extract of Ipecac 10, Diluted Alcohol q. s. ad 100. Intended to represent 
Dover's Powder in a liquid form. Dose, TTLv-xv. 

Trochisci Glycyrrhiza et Opii,— each troche contains Extract of Opium gr. -^ with 
Extract of Liquorice, Acacia, Sugar and Oil of Anise. Dose, j-iv. 



300 OPIUM. 

Preparations of Morphine. 

Morphina, Morphine, C 17 H 19 N0 3 .H 2 0, — white, prismatic crystals or a crystalline 
powder, odorless, of bitter taste and alkaline reaction, almost insoluble in water, soluble 
in ioo of alcohol. Its comparative insolubility makes the salts preferable for use, and as 
a very small proportion of acid neutralizes it, the dosage is about the same for the alkaloid 
and its salts, viz., gr. ^-gr. j. Gr. %-\ is about equal to one grain of Opium of 
medium Morphine-strength. [Compare Morphines Sulphas, below.] 

Morphince Acetas, Acetate of Morphine, — a white, crystalline or amorphous powder of 
faintly acetous odor, bitter taste, neutral or faintly alkaline reaction, soluble when fresh in 
12 of water and in 68 of alcohol at 59 F. Dose, gr. -£$-). 

Morphince Hydrochloras, Hydrochlorate of Morphine, — white, feathery crystals of silky 
lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 63 of alcohol at 

59 F. Dose, gr. ^V-J- 

Morphince Sulphas, Sulphate of Morphine, — white, feathery, acicular crystals of silky 
lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 702 of alcohol at 
59 F., and in 0.75 of boiling water. Contains about 80 per cent, of Morphine. Dose, 
§ r - Yo~% v ' J ; -io~H being a small dose for an adult, %-% a moderate one, l X—}4 a full 
dose, and ^-j a large one. 

Pulvis Morphince Compositus, Tuliy's Powder, — has of Morphine Sulphate I part to 20 
each of Camphor, Liquorice and Calcium Carbonate. A similar preparation to Dover's 
Powder minus the Ipecac. Dose, gr. v-xv, ten grains containing gr. 1 of Morphine Sul- 
phate. 

Trochisci Morphince et Ipecacuanha, — each troche contains gr. ^ of Morphine Sul- 
phate with about gr. ^ of Ipecac, also Sugar, Oil of Gaultheria and Mucilage of Traga- 
canth. Dose, one every hour or so, cautiously with children. 

Injectio Morphince Hypodermica (B. P.), — is a solution of the Acetate, containing gr. j 
in each ten minutes, being thrice as strong as Magendie's solution. Dose, TT\j-iij. 

Liquor Morphina Sulphalis, Magendie's Solution (Unofficial), — has gr. xvj of Mor- 
phine Sulphate in each fl ^ or gr. j in IT^xxx, or gr. *^ in TTLvijss. If made with Benzoic 
Acid, the solution will not spoil, and is not irritant hypodermically. The same result is 
attained by adding of Carbolic Acid, mjij to the % . 

Tinctura Chloroformi et Morphince (B. P.), — a substitute for Chlorodyne. See ante, 
page 173. 

Oleatum Morphina, Oleate of Morphine (Unofficial), — Morphine-strength 10 per cent, 
with Oleic Acid 90. For local use. 

Preparations of Other Alkaloids. 

Codeina, Codeine, C 18 H 21 NO s .H 2 0, — white or yellowish-white, rhombic prisms, efflor- 
escent in warm air, of bitter taste and alkaline reaction, soluble in 80 of water at 59 
F. and in 17 of boiling water, very soluble in alcohol, chloroform and ether. This alka- 
loid is official. Dose, gr. ss-ij, but gr. \ has caused alarming symptoms in children. 

The Phosphate of Codeine is sufficiently soluble for hypodermic use, and comparatively 
unirritant. One part in twenty of water forms the usual solution for hypodermic employ- 
ment. 

Narcotince Hydrochloras, Hydrochlorate of Narcotine (Unofficial), — Dose, gr.ij-x, as an 
antiperiodic. 

The Tincture of Opium is an ingredient of Mistura Magnesiae et Asafcetidae, and the 
Camphorated Tincture is an ingredient of Mistura Glycyrrhizse Composita. (See ante, 
pages 234, 278. 

Children bear Opium badly, and for them its proportionate dosage 
should be much below that for other agents. Morphine should not be 
given to children below 10 years of age, and never hypodermically to 
those beneath the age of 15. Opium given to a nursing mother will 
affect the child, being partly excreted in the milk. 

Reactions and Incompatibles. 
An aqueous or alcoholic preparation of Opium reddens litmus paper (free meconic 
acid); — gives a deep red color with Perchloride of Iron (meconic acid); — forms precipi- 
tates with Acetate and Subacetate of Lead, Nitrate of Silver, Zinc, Copper, and Arsenic 



OPIUM. 3OI 

(meconates, sulphates and coloring matter) ; — forms a precipitate with tincture of Galls or 
astringent preparations (tannates of morphine and codeine) ; and becomes turbid with 
the fixed Alkalies, Carbonates, Alkaline Earths, and Ammonia (precipitated morphine 
and narcotine). 

Tests for Morphine. 

Nitric Acid produces a blood-red, turning orange, then yellow, then disappearing. 
Test-solution of Ferric Chloride gives a blue color changing to green with excess of the 
reagent, and destroyed by free acids or alcohol, but not by alkalies.- Iodic Acid liberates 
Iodine which may be tested by starch. 

Physiological Action. 

Opium is analgesic, hypnotic, antispasmodic, diaphoretic and narcotic. 
It first stimulates then depresses the cerebrum, heart and respiratory appa- 
ratus, and is classed among the cerebral depressants. 

In medium dose (gr. j) it arrests all the secretions except the milk and 
sweat, the latter being increased ; producing dryness of the mouth and 
throat, retarded digestion from stoppage of the gastric juice, and decided 
loss of appetite. The action of the heart is increased, arterial tension 
raised and the pupils slightly contracted. The cerebral faculties are 
stimulated by increased blood-supply to a pleasant activity, ideas follow 
each other rapidly through the mind, and an exhilaration bordering on 
mild intoxication is experienced, succeeded by a calm of variable length. 
Sleep generally follows, disturbed, however, by dreams, and after waking, 
headache, malaise, constipation, digestive disturbance and some depression 
result. The conductivity of the nerves is not affected. Frequently the 
stage of mental activity is absent, but in persons habituated to the use of 
Opium it is usually well marked. In some subjects a lengthened period 
of calm repose takes the place of sleep, in others neither calm nor sleep 
occurs, but the stimulant action of the drug prevails, the spinal function 
as well as the cerebral are exalted, and great restlessness is the result. 

In full dose (gr. iij-v) the same symptoms are produced but in greater 
intensity; the stage of stimulation is much shorter, digestion is arrested, 
nausea and vomiting produced, also profuse diaphoresis. The conduc- 
tivity of the nerves is more or less impaired, the heart and circulation 
depressed, oxidation being interfered with and the body-temperature 
lowered. The pupils are contracted by stimulation of the motor oculi 
through the basal ganglia, intense pruritus is produced especially at the 
nose, and often spasmodic retention of the urine. Profound sopor soon 
comes on, with irregular and slow respiration, but in some subjects this is 
replaced by coma-vigil and delirium. After-effects are nausea, depression, 
constipation, racking headache, vertigo, anorexia, nasal pruritus, and fetid 
pathological secretions. 

A toxic dose produces cold and clammy sweat, very slow pulse, slow 
and stertorous respiration gradually becoming feeble and irregular,cyanosed 
face, abolished reflexes, coma gradually deepening, the pupils minutely 



302 OPIUM. 

contracted but dilating as the end approaches, and finally death by 
paralysis of the respiratory centre due to direct action on the medulla. 
Post-mortem shows only a wet brain, congested lungs, and engorgement 
of the venous trunks and of the right heart. 

The principal action of Opium is exerted upon the nervous system, 
first affecting the cerebral convolutions which are briefly stimulated and 
soon depressed, — next the perceptive and censory centres in the higher 
brain are more or less blunted and the conductivity of the afferent nerves 
impaired, — soon the ganglia at the base of the brain are involved, evinced 
by the contraction of the pupils, vomiting, and slowing of respiration, — 
the cardiac, vascular and other centres are depressed but to a less degree 
than the respiratory and perceptive, — the gray matter of the cord, at first 
stimulated, as shown by the increase of reflex excitability, is also 
depressed, and locomotion becomes difficult, the motor nerves becoming 
paralyzed from the centre outwards, but muscular irritability is never lost. 
Death generally occurs by paralysis of the respiratory centre, rarely by 
sudden cardiac failure. 

Metabolism is greatly reduced in activity by Opium, the quantity of 
urea excreted being markedly lessened, and the biliary and glycogenic 
functions of the liver being affected, resulting in whitish stools, perhaps 
jaundice, and certainly decided decrease of the sugar excreted by dia- 
betics, when given by the stomach. 

On the uterine and generative functions Opium exerts a marked influ- 
ence, stopping menstruation if its use be continued, and in men causing 
impotence. Both male and female functions, however, return as soon as 
the drug is discontinued. 

The hypnotic action of Opium is now believed to be produced by a 
double influence, (i) on the vascular system, causing anaemia of the brain, 
(2) on the cerebral cells, diminishing their activity, and consequently 
lessening their demand for blood. 

Its constipating action is shown experimentally to be produced by 
stimulation of the inhibitory nerves of the intestines through the splanch- 
nics. 

Morphine acts similarly to Opium in general, being the principal alka- 
loid therein, but when used alone its influence is not complicated with 
that of the convulsant alkaloids (Thebaine, Codeine, Narcotine), which 
must affect to a considerable degree the action of Opium. Consequently, 
as compared with the latter, Morphine acts more quickly, and for a 
shorter time, has less influence on the intestines and skin, is less constipa- 
ting, less stimulating, less convulsant and less diaphoretic, but more seda- 
tive, more anodyne and hypnotic and produces more intense pruritus. 
Its excretion commences quickly but may not be completed for as much 
as 48 hours, and is affected by most of the secretions, especially by the 



OPIUM. 303 

urine. It is probably retained in the system when the action of the 
kidneys is defective, and hence when given in renal disease may accumulate 
with fatal results. 

Codeine may chemically be considered a Methyl-morphine, and like 
all methyl compounds, has an action like that of Curare, viz., — a motor- 
paralyzant. It exalts the spinal cord more than Morphine and affects the 
cerebrum less, producing muscular tremor in excess of the sedative action. 
It is anodyne and analgesic, especially to abdominal and pelvic pain, 
also hypnotic with less general disturbance than produced by Morphine. 
It markedly reduces the amount of sugar excreted by diabetics, and has 
a special sedative influence on the pneumogastric nerve. 

Narcotine should be named Anarcotine, as it has little or no narcotic 
power. It is a convulsant in animals and an antiperiodic in man. 

Narceine is said by some observers to be remarkably hypnotic, and 
free from convulsant action — by others equally deserving of credit it is 
considered almost inert. This alkaloid is difficult to obtain pure; hence 
the samples heretofore used have probably been contaminated with other 
alkaloids. « 

Thebaine is a powerful convulsant, exalting the spinal cord almost like 
Strychnine and Brucine. It is not used medicinally. 

Fatal Doses. 

In a child one day old rnj of Laudanum caused death. A medicinal 

dose given to a nursing mother proved fatal to the infant. A few drops 

of Paregoric have killed a child of nine months. In the adult gr. y§ of 

Morphine in one case, and gr. ,iv of crude Opium in another, have proved 

fatal. 

Antagonists and Treatment of Poisoning. 

Atropine antagonizes the cerebral action of Morphine, also its action on the pupils, 
respiration, heart and arterial tension, but if given too freely will endanger the case by 
substituting Belladonna- narcosis for Opium- narcosis. Gr. ji^- hypodermically every 15 
minutes for three doses, is generally sufficient. Caffeine is also physiologically antago- 
nistic, and is generally used in the form of btrong black coffee frequently administered. 
The chief indications in Opium-poisoning are — to evacuate the stomach, maintain respir- 
ation and keep up the circulation. Faradization of the chest muscles, cold affusion, and 
artificial respiration are of great value, and evacuation of the bladder is important. Fla- 
gellation is a very dangerous procedure, from the exhaustion which may be produced; 
strong faradic currents are much more efficient. The anode should be placed over the 
lowest conjoined root of the phrenic nerve— the cathode three inches below the ensiform 
cartilage, and a little to the left of the median line. 

Strychnine is an efficient antagonist to the respiratory paralysis, and may be used in 
lieu of Atropine, or in connection therewith. Amyl Nitrite should also be used when 
the heart shows signs of failure. 

Some of the cerebral effects of Opium, as vertigo and mental confusion, are removed 
by a full dose of Potassium Bromide, others are antagonized by Quinine, and the general 
intra-cranial effects of the drug are to some extent opposed by Digitalis and Tartar Emetic. 

Atropine may be advantageously combined with Morphine in solution for hypodermic 
injection, in the proportions of gr. T \^ to T ^ 7 of the former to gr. % of the latter, pre- 
venting the sickness and depression and many other unpleasant after- effects of Morphine 
while increasing its anodyne, hypnotic and antispasmodic powers. 



304 OPIUM. 

Therapeutics. 
The chief indications for the use of Opium are (1) to relieve pain from 
any cause except acute inflammation of the brain, — (2) to produce sleep, 
particularly in the insomnia of low fevers with delirium, in which the 
combination of Morphine and Chloral is very efficient, — (3) to allay irri- 
tation in the various forms of acute nervous erethism, — (4) to check ex- 
cessive secretion, as in diarrhoeas, dysentery, diabetes, ptyalism, etc., — 
(5) to support the system in low fevers and other adynamic conditions, 
when sufficient food cannot be retained, — (6) as a sudorific, to produce 
sweating in coryza, etc. It is considered of especial value in any irrita- 
tion of the stomach, bladder or bronchi, in severe vomiting, both forms 
of diabetes, gastralgia, colic and muscular spasm. In diabetes mellitus 
Morphine per orem reduces the sugar promptly, but when used hypodermi- 
cally it has little or no effect thereon, even in the same case. In perito- 
nitis and inflammations, of other serous membranes, used freely even to 
narcotism it has often saved life. In cerebro-spinal meningitis it is the 
one remedy if given early, before exudation has set in. Cholera morbus 
and dysentery are efficiently treated by Morphine and Atropine hypoder- 
mically (gr. y 1 ^ with gr. t ^-q-) after the ingesta have been removed by purg- 
ing. In acute uraemia its use in large doses is recommended by Loomis 
to control convulsions and promote diuresis, but here it is a dangerous 
agent. In muscular rheumatism and acute colds Dover's povtfder as a 
diaphoretic, conjoined with hot drinks and foot-baths, is old but excel- 
lent treatment. In delirium tremens, acute and chronic mania and melan- 
cholia, nervous prostration and the delirium of fevers, Opium is probably 
the best hypnotic, Severe pain from any cause (except cerebritis). is 
relieved by Opium with an efficiency possessed by no other drug, as the 
pain of sciatica, neuralgia, lumbago, cancer, renal and hepatic colic from 
calculi, etc. Cough of harassing and frequent character with but little 
secretion is best treated by Opium, but when there is profuse expectora- 
tion it should not be used, as the lowering of excitability of the respira- 
tory centre which it produces would in such a case be dangerous. In 
nearly all acute inflammations it is valuable, especially where it becomes 
advisable to lock up the bowels. Its tranquillizing power over the circu- 
lation makes it invaluable in the various forms of hemorrhage, while in 
that from uterine fibroids and cancer the implanting of the Opium-habit 
is deserving of serious consideration as a most beneficial measure, as it 
checks and even stops the bleeding, as soon as established. Dyspnoea 
from any cause is relieved by Morphine, especially that of cardiac disease. 
" It gives the power to breathe ' ' (Huchard). In cardiac disease, especially 
aortic stenosis or insufficiency, with dyspnoea, paroxyms of angina pectoris, 
or signs of cerebral anaemia, — Morphine hypodermically presents the 
greatest advantages. 



OPIUM. 305 

Applications of the Various Preparations. 

Intense pain, as from the passage of calculi, is best met by hypodermic 
injection of Morphine Sulphate in full doses (gr. %-}£) with Atropine 
Sulphate (gr. T ^~g-). Either the solution of Morphine or the liquid prepa- 
rations of Opium may be given by the mouth in corresponding doses for 
the same purpose. Severe pain enables the system to resist the action of 
Opium, which in such cases should be repeated at short intervals for effect, 
regardless of dosage. 

Superficial pain is often alleviated by the Plaster or by extemporaneous 
liniments containing Laudanum or some other fluid preparation. It is, 
however, very doubtful whether such applications are of direct value, as 
Morphine is not absorbed by the unbroken integument ; but the Oleate 
of Morphine is said to be very penetrating. 

To produce sleep the most efficient preparations are the Deodorized 
Tincture, the Solution of Morphine, Pil. Opii and Dover's Powder, in 
doses corresponding to the degree of insomnia and restlessness present. 

Cough is relieved by the two Trochisci, the Deodorized and Camphor- 
ated Tinctures, and by the Solution of Morphine in small doses with 
Syrup of Wild Cherry or Syrup of Tolu. 

Diaphoresis is best obtained by the use of Dover's Powder in either of 
its three forms. 

Sedative action is obtained by different preparations for different organs. 
The stomach is best affected by the Solution of Morphine in effervescing 
mixtures, the Extract in a small pill, or Morphine hypodermically over 
the epigastrium. The intestines may be influenced by Laudanum in a 
starch enema, or internally by Dover's Powder, PulvisOpii, or Pil. Opii, 
especially the latter with or without Calomel, as an astringent when the 
bowel must be paralyzed, as in peritonitis, hernia, intussusception, etc. 
The rectum and other pelvic organs are promptly affected by a suppository 
of the Extract of Opium, gr. ^ with gr. -^ of the Extract of Belladonna. 
The ovaries and the abdominal and pelvic organs generally are markedly 
susceptible to the analgesic action of Codeine in doses of gr. ss to gr. j 
for an adult in severe pain. 

Administration. 
Probably no drug in the Materia Medica is so useful as Opium, or has 
so wide a range of application. At the same time no drug requires such 
careful handling, by reason of the many influences which modify its action 
and uses. As before pointed out, children are extremely susceptible to 
its narcotic action, and women are more easily affected by it than men. 
Many persons are found with idiosyncrasies in respect to Opium, some 
being easily narcotized, others being remarkably insusceptible to its action, 
and many suffer from a decided shock after its hypodermic administra- 



306 ORIGANUM PANCREATINUM. 

tion, which may even produce alarming symptoms of collapse. In sub- 
jects of kidney disease it may accumulate and act more powerfully than 
expected, and generally it may be said to be contraindicated or to be used 
with great care in alcoholism, congestion of the brain, and advanced 
disease of the respiratory organs, heart and kidneys. 

The conjoint administration with opiates, of the Spiritus ^Etheris, 
Spiritus Athens Comp., or Spiritus ^Etheris Nitrosi, an equal part with 
Tinctura Opii Deodorata, will prevent the nausea often excited by the 
latter, and correct the " drying-up " effects of opium, due to its checking 
secretion. 

Morphine and Atropine are sufficiently antagonistic to each other to make their 
combination extremely valuable as a therapeutic measure, and their use as mutual anti- 
dotes in poisoning by either a most efficient procedure if employed with due precautions. 
When Morphine is given as a hypnotic or an anodyne, Atropine should always be admin- 
istered at the same time in the proportion of gr. t ^q~t^o °*" tne l atter to gr. % of the 
former. By this means the anodyne and hypnotic qualities of Morphine are increased, 
while the nausea and depression with the subsequent dyspepsia and constipation due to 
it are avoided. Moreover, as in the doses above mentioned Atropine is a cardiac and 
respiratory stimulant, it will counteract the depressing tendency of Morphine on the 
heart and respiration in subjects who have undue susceptibility to its action. 



ORIGANUM, Wild Marjoram, — is the plant Origanum vulgare, a 
perennial herb of the nat. ord. Labiatse, native of Europe and America, 
having a stem branched above, petiolate leaves about an inch long and 
hairy beneath, pale purple flowers, aromatic, pungent, and bitterish. It 
contains a Volatile Oil, some tannin, resin, and a bitter principle. The 
oil was formerly much used and was official, but it is now entirely super- 
seded by the Oil of Thyme. Origanum is an ingredient of Vinum Aro- 
maticum. There are no official preparations. Dose, 3j-ij, in infusion. 

Origanum is gently tonic, also carminative, stimulant, and emmena- 
gogue. It was formerly much employed as a diaphoretic, etc., but is 
now rarely administered. 

PANCREATINUM, Pancreatin (Unofficial),— is the juice of the 

pancreas, and consists of four ferments : (i) Pancreatic Diastase, the 
amylolytic ferment, (2) Trypsin, the proteolytic ferment, (3) a fat emul- 
sifying, and (4) a milk-curdling ferment. It is marketed in various forms, 
named Pancreatine, Pancreatic Emulsion, and Liquor Pancreaticus, of 
which the last-named is the most efficient preparation. 

Liquor Pancreaticus, Pancreatic Solution (Unofficial), — prepared by digesting a finely- 
chopped pig's pancreas with 4 times its weight of dilute alcohol. Is a nearly clear 
alcoholic solution, with little taste or smell. Dose, 3J - ^ SS - 

Physiological Action and Therapeutics. 
Pancreatic preparations are active digestives of proteid and amyloid 
foods, converting proteids into peptones, and emulsifying fats, in the 



PAPAIN PARALDEHYDE. 2>°7 

presence of an alkaline solution (Pepsin requiring an acid one). Pan- 
creatin is digested by Pepsin, and hence probably never passes into the 
duodenum in its own character. Trypsin affects albuminoids even in a 
slightly acid solution. Liquor Pancreaticus is used to partially digest 
(peptonize) milk, gruel, soups, and other foods, before their administra- 
tion in cases of great digestive debility. These peptonized foods may 
be administered per orem vel rectum, and are valuable in intestinal dys- 
pepsia, wasting diseases, and convalescence from acute affections. A tea- 
spoonful taken after the administration of Cod-liver Oil will prevent the 
disagreeable eructations which are so offensive to some patients, and will 
aid in the digestion of the oil. 

Trypsin, unlike Pepsin, will dissolve mucin, and like Pepsin it is inert 
towards nuclein, horny tissues, and amyloid matter. Used as a spray on 
diphtheritic membrane it has proved a very efficient solvent. 

PAPAIN, Papaiva (Unofficial), — is a ferment obtained from the 
milky juice of Carica Papaya, a S. American fruit-tree of the nat. ord. 
Papayacese. It is soluble in water but not in alcohol, and has active 
digestive powers. It softens and dissolves fibrin in liquids which may 
be either acid, or neutral, or slightly alkaline, in this respect differing 
greatly from Pepsin. It also acts at higher temperatures and more rap- 
idly than Pepsin. It is a rapid solvent of false membranes and intestinal 
worms. It has been injected into tumors, dissolving the tissues in its 
vicinity, but with much pain and considerable febrile reaction. It is not 
used internally, as it is feared that it may digest the gastro-intestinal 
mucous membrane as well as its contents. 

Papaw Milk is the milky juice of the fruit, coagulating into two parts, a pulpy mass 
and a liquid serum. When mixed with alcohol an amorphous powder is precipitated, 
which when dried forms Papain. 



PARALDEHYDE, C 6 H 12 3 (Unofficial),— is a polymeric modifi- 
cation of Aldehyde, fluid above 51 F., solidifying below that tempera- 
ture, soluble in 50 of water. Dose, 3ss-3ijss. It is powerfully hypnotic 
and diuretic, but has no diaphoretic action. It possesses many of the 
qualities of Chloral with none of its dangers, strengthening and slowing 
the heart, instead of weakening it. A toxic dose paralyzes the medulla 
and the respiratory centre. As compared with Chloral its action is 
not so persistent and it requires more frequent repetition, but it is 
unquestionably safer. As a hypnotic it has been used with great benefit 
in fevers, rheumatism, acute mania, hysteria, and insomnia from various 
causes. The above-mentioned maximum dose has frequently been given 
without any ill-effect, and with no digestive or cerebral disturbances 
afterwards. 



308 PAREIRA PEPO. 

PARE IRA, Pareira Brava, — is the root of Chondodendron tomen- 
tosum, a climbing, woody vine of the nat. ord. Menispermaceae, with 
very large leaves and grape-like fruit, inhabiting Peru and Brazil. Occurs 
in sub-cylindrical, tortuous pieces, 4 to 6 inches long, dark brownish- 
gray externally, with transverse ridges, fissures and furrows; internally 
pale-brown, interior woody, porous, in concentric circles with medullary 
rays. It contains Pelosine or Cissampeline, an alkaloid identical with the 
Berberine of Nectandra and the Buxine of Buxus sempervirens (Box- 
wood). 

Several other Pareiras are on the market, that from the West Indies 
(Cissampe/os Pareira) being the plant formerly official in the Br. Phar- 
macopoeia. 

Preparations. 

Extractum Pareirce Fluidum, — Dose, gss-^j. 

Infusum Pareirce (Unofficial), — I in 17. Dose, ^j-ij. 

Physiological Action and Therapeutics. 

Pareira is diuretic and laxative, stimulating peristalsis and the action of 
the kidneys. It is eliminated by the renal secretion, and passing over 
the mucous membrane of the genito-urinary tract, it acts thereon in a 
tonic and soothing manner, especially on the bladder. 

It is particularly useful in chronic cystitis, suppurative kidney diseases, 
gonorrhoea and gleet, but must be used internally, as when injected locally 
for gonorrhoea and cystitis it has not proved successful. Formerly 
Pareira was considered an efficient lithontriptic, and in Brazil it is used 
as a cure for bites of poisonous serpents, being employed both internally 
and locally to the wound. 

PEPO, Pumpkin-seed, — is the seed of Cucurbita Pepo, or common 
Pumpkin (nat. ord. Cucurbitacese), about ^ inch long, white, flat, oval, 
inodorous, bland and oily. The active principle is a resin contained in 
the endopleuron or envelope immediately surrounding the embryo. It 
also contains an alkaloid Cucurbitine, a fixed oil, starch, sugar, etc. There 
are no official preparations. Dose, of the resin, gr. xv ; of the seeds, 
3j-ij, beaten up in emulsion with sugar and water. 

Physiological Action and Therapeutics. 
Pumpkin-seed is an efficient agent for the removal of tapeworm (tsenia- 
fuge), and its use is not followed by unpleasant symptoms. The outer 
coat of the seed should be removed, and an emulsion then made by tritu- 
ration with sugar and water. This, if taken on an empty stomach and 
followed by a brisk cathartic, will generally prove effective. Dr. Squibb 
maintains that the seeds should not be decorticated, but that husks and 
all should be swallowed. According to some observers the expressed oil 



PEPSINUM. 3O9 

is equally efficient in doses of gss repeated twice or three times, and fol- 
lowed by a cathartic. 



PEPSINUM, Pepsin, — is a hypothetical name for the digestive 
principle of the gastric juice, and as a definite body is unknown, the vari- 
ous preparations, official and unofficial, being mere approximations, and 
vary much from each other. They are usually obtained from a solution 
prepared by digesting the mucous membrane scraped from the rennet-bags 
of sheep or the stomach of the pig in acidulated water for several days. 
The so-called "Pepsin" is then precipitated by Chloride of Sodium 
{Scheffer), Acetate of Lead {Boudauti), or by drying the peptones on glass 
plates (Bea/e). It may also be precipitated by alcohol. By Schefifer's 
process it occurs as a tough, gray, leathery substance, partially soluble in 
water, one grain dissolving 3000 grains of albumen in a few days. Jen- 
sen's "Crystal Pepsin," probably prepared after Beale's method, is in 
yellowish, translucent scales, soluble in water, and reputed to be many 
times stronger than any other preparation yet obtained. 

Preparations. 

Pepsinum Saccharatum, Saccharated Pepsin, — is Pepsin obtained from the mucous 
membrane of the hog, and mixed with powdered Sugar of Milk. One part dissolved in 
500 of water acidulated with 7^ of Hydrochloric Acid, should digest at least 50 parts of 
hard-boiled egg-albumen in 5 or 6 hours at a temperature of ioo° to 104 F. Dose, gr. 
v-^j, soon after meals. 

Liquor Pepsini, Liquid Pepsin, — contains of Saccharated Pepsin 40 parts, Hydrochloric 
Acid 12, Glycerin 400, Water q. s. ad 1000 parts. Dose, ^ij-iv, after meals. 

Lactopeptine (Unofficial), — claimed to contain Pepsin, Diastase or Ptyalin, Pancreatin, 
Lactic and Hydrochloric Acids, and that £j will digest ^ viij-x of albumen, fibrin, casein, 
or gelatin, will emulsionize 25 xvj of cod-liver oil, and convert ^ iv of starch into glucose. 
A proprietary preparation. Dose, gr. v-xv. Is said to break a glass, if stirred therein 
with water. 

Ingluvin (Unofficial), — is a preparation obtained from the gizzard of the domestic 
fowl, which owes its activity to no ferment corresponding to Pepsin, but to a peculiar 
bitter principle. Dose, gr. x-xxx. 

[Every manufacturer has his own preparation of Pepsin, and his peculiar name there- 
for, such as " Liquid Pancreopepsine," " Lacto-peptine," " Gluco-pepsine," " Golden 
Scale Pepsin," " Peptogenic Milk Powder," etc. They vary considerably in their prop- 
erties, but all have the power in some degree of digesting albumen or fibrin.] 

Physiological Action. 
Pepsin is not a solvent but a ferment, and is a normal constituent of 
the gastric juice, converting albuminoids (casein, albumen, fibrin, etc.) 
into peptones for assimilation, with the aid of the Lactic and Hydro- 
chloric Acids associated with it. This it will do out of the body or in 
cavities, as the rectum, if warmth, acidity and moisture be present. Pan- 
creatin, on the other hand, is destroyed by acids and requires an alkaline 
medium in which to exercise its powers. As the food passes out of the 
stomach in 2 or 3 hours, Pepsin should be administered within, and 
Pancreatin after that period, to be effective. 



3IO PETROLATUM PHENACETINUM. 

Incompatibles. 
Alcohol destroys the activity of Pepsin. Alkalies and many mineral salts precipitate it. 

Therapeutics. 

Dyspepsia in its various forms is the malady for which Pepsin is chiefly 
employed, but it is also extremely useful in the apepsia of infants, gas- 
tralgia, anaemia, chlorosis, gastric ulcer and cancer, the diarrhoea of 
infants and vomiting of pregnancy. It is added to nutritive enemata, 
the rectum not being a digestive organ, and is injected into the substance 
of morbid growths which are homologous to the tissues, particularly fatty 
tumors, for the purpose of arresting their growth and promoting their 
absorption. It has been injected into the bladder to break down a blood- 
clot, and has been suggested as an atomized inhalation in diphtheria and 
croup to digest the membrane without injuring the living tissues. 

Ingluvin is particularly useful against vomiting and has been found 
exceptionally efficient in the vomiting of pregnancy, given in 20-grain 
doses before meals. [Compare Pancreatin, ante, page 306.] 

PETROLATUM, Petroleum Ointment,— is a semi-solid sub- 
stance, consisting of hydrocarbons, obtained from Petroleum by distill- 
ing off the lighter portions and purifying the residue. It is a yellowish, 
fat-like mass, somewhat fluorescent, amorphous, odorless and tasteless, of 
neutral reaction, insoluble in water or alcohol, soluble in ether, chloro- 
form, fixed and volatile oils, benzin, etc. Its melting point is from 104 F. 
to 125 F., the first being the softer, and the second the firmer variety. 
Commercially, it is known as Cosmoline, Vaseline, etc., and is largely 
prepared from residuums or sediments deposited in tanks containing 
crude petroleum. 

Physiological Action and Therapeutics. 
Petrolatum is a valuable protective dressing, and an excellent basis for 
ointments, having no acridity and no liability to become rancid. It is 
readily miscible with many active agents, as the alkaloids, phenol com- 
pounds, etc., but it does not penetrate the skin as readily as animal fats 
and fixed oils. Uncombined, it forms an excellent bland application in 
all irritated conditions and injuries of the skin. 

PHENACETINUM (B. P.), Phenacetine, Phen6dine, Acet- 
phenetidine, C 10 O 2 H 13 N, — is a crystalline compound closely allied in 
chemical composition to Acetanilide (g. v.~), and produced by the action 
of glacial acetic acid on para-phenetidin, a body obtained from phenol. 
It occurs in colorless, tasteless, inodorous, glistening, scaly crystals, 
sparingly soluble in cold water, more freely in boiling water, also in about 



PHOSPHORUS. 3 1 I 

1 6 fluid parts of alcohol. Dose, as an antipyretic, gr. x hourly or every 
two hours, in powder or tablets ; against neuralgia and rheumatism, gr. 
xx, repeated if necessary up to gjss in 24 hours. 

Physiological Action and Therapeutics. 

The physiological action of Phenacetine is analogous to that of Acet- 
anilide. It is probably the safest of the new synthetical antipyretics, 
reducing pyrexia without producing collapse, and causing perspiration. 
It is also anodyne and hypnotic, soothing pain and inducing sleep. 

Phenacetine has been given with benefit, in 2-grain doses with 12 grains 
of Caffeine Citrate, for migraine ; also in epidemic influenza, both as a 
prophylactic and as a remedy. As an antipyretic it is extensively em- 
ployed in phthisis, peritonitis, abdominal typhus, polyarthritis, etc., also 
in endocarditis, typhus and typhoid fevers ; and as an antineuralgic in 
vaso-motor neuroses, for the lancinating pains of locomotor ataxia, and in 
neuralgia and hemicrania. It is highly praised in whooping-cough, 
rheumatic and other fevers, and, though slower in action than Antipyrine 
or Acetanilide, is deemed fully as efficient in reducing pyrexia, while 
usually free from the depressant after-effects of these latter agents. 

Methyl Phenacetine, an allied compound, is an active narcotic, 
even in small doses. 



PHOSPHORUS, Phosphites and Phosphates,— are best 
studied together, as the supplying of the element Phosphorus to the body 
is the aim of the administration of these agents. 

Phosphorus, P, — is a non-metallic element obtained from bones, and 
occurs as a translucent, nearly colorless solid, of waxy lustre, and usually 
the consistence of beeswax, insoluble in water, soluble in 50 parts of any 
fatty oil, in 80 of absolute ether, 350 of absolute alcohol, and freely in 
carbon bisulphide. It has a disagreeable odor and taste, melts at ni° F., 
is luminous in the dark, ignites in the air, and should be kept under 
water in a cool place, protected from light. It usually contains Arsenic 
and sometimes Sulphur, the limits of which are fixed by the pharma- 
copceial tests. Dose, gr. tto~ tV> tni "i ce daily. 

Preparations of Phosphorus. 

Pilulce Phosphori, Pills of Phosphorus, — each contains gr. T ^ of Phosphorus, dis- 
solved in Chloroform, mixed with Althaea and Acacia in Glycerin and Water, and coated 
by shaking with a solution of Balsam of Tolu in Ether. Dose, j-v. 

Oleum Phosphoratum, Phosphorated Oil, — has of Phosphorus I part, ^Ether Fortior 8, 
Expressed Oil of Almond q. s. ad 100 parts. Dose, mj-v thrice daily. 

Acidum Phosphoricum and Acidum Phosphoricum Dilutum, — are described on page 
72, ante. 

Tinctura Phosphori (Thompson's), Unofficial, — Phosphorus gr. j, Absolute Alcohol 
^v, Glycerin §j^, Alcoho^ij, Spt. Menthae Piperita? n\xl. Of this 3J contains gr. 
-gJj of Phosphorus. 



312 PHOSPHORUS, PHOSPHITES AND PHOSPHATES. 

Tincturi Phosphori (Bellevue Hospital), Unofficial, — Phosphorus gr. xxxij. Absolute 
Alcohol ^xlvj, Essence of Vanilla Jj, Oil of Orange ^iij, Alcohol q. s. ad ^ xlviij. Of 
this 3J contains gr. ^ of Phosphorus. 

Zinci Phosphidum, Phosphide of Zinc, Zn 3 P 2 , — crystalline fragments or a gray-black 
powder, insoluble in water or alcohol, but completely soluble in hydrochloric or sulphuric 
acids with evolution of phosphoretted hydrogen. Is very irritant to the stomach. Dose, 

g r - 3V-2V 

Preparations of Phosphites. 

Cakii Hypophosphis, Hypophosphite of Calcium, Ca 4 (P0 2 ) 3 , — colorless prisms, or thin, 
pearly scales, of nauseous taste, soluble in 6.8 of water, insoluble in alcohol. Is an in- 
gredient of the Syrupus Hypophosphitum. Dose, gr. x-xxx. 

Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 ^ 6 , — a white or grayish-white 
powder, odorless and tasteless, slightly soluble in water, freely so in hydrochloric acid or 
a solution of sodium nitrate. Dose, gr. v— x. A ferruginous tonic. 

Potassii Hypophosphis, KH 2 P0 2 , — white masses, or a white, granular powder, deli- 
quescent, odorless, of saline taste and neutral reaction. Soluble in 0.6 of water and in 
7.3 of alcohol at 59 F. Dose, gr. v-x. 

Sodii Hypophosphis, NaH 2 P0 2 H 2 0, — small plates, or a white, granular powder, deli- 
quescent, odorless, of sweetish, saline taste, and neutral reaction. Soluble in 1 of water 
and 30 of alcohol at 59 F. Dose, gr. v-x. 

Syrupus Hypophosphitum, Syrup of Hypophosphites, — has of the calcium salt 35, of 
the Sodium and Potassium salts each 12, Citric Acid I, Spirit of Lemon 2, Sugar 500, 
Water q. s. ad 1000 parts. Dose, %'}-% ). 

Syrupus Hypophosphitinn cum Ferro, Syrup of Hypophosphites with Iron, — has of the 
preceding 99 parts with 1 of the Lactate of Iron, dissolved by trituration. Dose, 3J-^j. 

Preparations of Phosphates. 

Cakii Phosphas Prcecipitatus, Precipitated Phosphate of Calcium, Ca 3 (P0 4 ) 2 , — alight, 
white, amorphous powder, odorless and tasteless, insoluble in water or in alcohol. Dose, 
gr. ij-x. 

Syrupus Cakii Lactophosphatis, has of the preceding 22 parts, Lactic Acid 43, Orange- 
flower Water 80, Sugar 600, Hydrochloric Acid, Water of Ammonia, Water, aa q. s. ad 
1000. The Phosphate of Calcium is dissolved by the acid, but does not enter into the 
chemical combination suggested by the title. Dose, ^j-^j- 

Sodii Phosphas, Na 2 HP0 4 .i2H 2 0, — large, monoclinic prisms, efflorescent, of saline 
taste and alkaline reaction. Soluble in 6 of water at 56 F., insoluble in alcohol. Dose, 

Sodii Pyrophosphas, Na 4 P 2 7 .ioH 2 0, — colorless, monoclinic prisms, of saline taste and 
alkaline reaction. Soluble in 12 of water at 59 F., insoluble in alcohol. Dose, £ss- 
gss. 

Syrupus Fern, Quinince et Strychnine? Phosphatum; — has of the Phosphate of Iron 
133, Quinine 133, Strychnine 4, Phosphoric Acid 800, Sugar 6000, Distilled Water q. s. 
ad 10,000 parts. A powerful tonic. Dose, ^j-ij. 

Syrupus Phosphatum Compositus, Compound Syrup of Phosphates, Parrish's Chemical 
Food (Unofficial), — has in each g Phosphate of Iron gr. 2^, Phosphate of Calcium gr. j. 
Dose, *3J-ij. 

Ammonii Phosphas, Ferri Phosphas and Ferri Pyrophosphas are respectively described 
on pages 95 and 222. 

Physiological Action. 
Phosphorus in small doses stimulates the brain and circulation, the 
functions of the stomach and the genital organs, and the growth of bones. 
It aids digestion by irritating the end-organs of the gastric nerves, and 
produces eructations of Hydrogen Phosphide. Its fumes cause necrosis 
of the upper or lower maxillae, especially in those whose teeth are decayed, 
but they may be prevented by the inhalation of fumes from old acid tur- 
pentine. In poisonous doses it is a powerful irritant of the gastro-intestinal 
tract, causing vomiting and purging with great depression of the vital 



PHOSPHORUS, PHOSPHITES AND PHOSPHATES. 313 

forces. Reaching the blood as Phosphorus, it is partly oxidized at the 
expense of the oxygen of the red corpuscles, causes acute hemorrhages 
from fatty, degeneration of the arterial walls, rapid steatosis of the stomach, 
liver and heart, with deep jaundice, — then delirium, convulsions, coma 
and death usually from gradual failure of the respiration and circulation. 
Acute yellow atrophy of the liver resembles acute phosphorus poisoning 
so much that it is generally impossible to distinguish between them. 

Its effect on metabolism is to increase the nitrogenous products, to 
diminish the excretion of carbonic acid, reduce the glycogen of the liver 
to almost nothing, and to raise the temperature. While generally increas- 
ing metabolism it so influences that process as to arrest it at the stage of 
conversion of proteids into urea and oil, instead of allowing it to proceed 
to the final oxidation of oil into carbonic acid and water, hence leading 
to fatty degeneration of epithelial, glandular and muscular protoplasm 
throughout the body. 

Phosphate of Calcium is an essential ingredient of all the tissues and 
fluids of the body, and forms more than 50 per cent, of the bones. Lactic 
and Hydrochloric acids dissolve it in small quantities. It increases the 
alkalinity of the blood as well as its power of holding Carbonic Acid, and 
diminishes the excretion of urea. 

Phosphate of Sodium acts on the blood and on the excretion of urea 
similarly to the calcium salt. It increases secretion generally, especially 
of the bile, being an excellent cholagogue and thereby aiding in the 
digestion of fats. In ounce doses it is laxative. It is a normal constituent 
of the blood, and possesses the property of increasing the capacity of any 
fluid to hold Carbonic Acid in solution. 

The Hypophosphites are generally tonic, and are supposed to consti- 
tute a safer form in which to administer Phosphorus than in the unoxid- 
ized state. They are probably converted into phosphates in the stomach. 

Antidotes and Antagonists. 

Antidotes are hydrated magnesia, lime-water, powdered charcoal, sulphate of copper 
and old acid turpentine. Sulphate of Copper is the best emetic, forming a comparatively- 
insoluble phosphide of copper; 3-grain doses should be given every 5 minutes in dilute 
solution until emesis occurs. Hydrated Magnesia as a quickly-acting purgative. Lime- 
water or Charcoal to prevent the action on the tissues. Crude French Acid Turpentine 
is the best antidote, which may be given rapidly in an emulsion of gum. Opium to 
counteract the depression of the heart and system. Transfusion has proved efficient 
where the blood is affected. No oils or fats should be used, as they dissolve Phosphorus 
and promote its absorption. 

Therapeutics. 

Phosphorus is chiefly used to promote the nutrition of osseous and 
nervous tissue. It is useful in chronic nervous exhaustion when the nerve 
centres are implicated, in osteomalacia, rachitis and progressive locomotor 
ataxia. In threatened cerebral softening it affects the nerve centres as no 



3 14 PHYSOSTIGMA. 

other drug does, and in paraplegia of myelitic origin from excessive venery 
it is often very efficient. Progressive pernicious anaemia has sometimes 
been arrested by Phosphorus in very small doses, while in impotence of 
functional character there is no remedy so effective. In wakefulness of the 
aged and that due to cerebral anaemia small doses of the pill or tincture 
are sometimes remarkably beneficial. In certain skin diseases (acne, 
psoriasis, lupus), it is an excellent substitute for Arsenic. Neuralgia is 
often cured by Phosphorus, but large doses are necessary, at least gr. ^ 
every four hours. 

Phosphate of Calcium and the Hypophosphites are used with benefit 
in all diseases of mal-nutrition, and where the repair or development of 
the bones is required. They are particularly useful in protracted suppu- 
ration, osteomalacia, rachitis, caries, scrofulosis, chronic phthisis, and in 
the anaemia and bone-softening of lactation. The Hypophosphites are 
much employed in nervous and general debility and in chronic lung dis- 
eases, and are supposed to act in the same manner as free Phosphorus, but 
without irritation. They are probably converted into Phosphates in the 
stomach, and hence may be expected to promote the growth and healing 
of bones, to stimulate the hepatic and intestinal secretions, and to affect 
the lymphatic glands and adenoid tissue. The Compound Syrup of the 
Hypophosphites is an excellent remedy in acne indurata. 

Phosphate of Sodium in drachm-doses thrice daily for adults, gr. 
x-xxx for children, is extremely useful as a laxative in conditions depend- 
ing on catarrh of the bile-ducts and duodenum, as headache, jaundice, 
chalky stools, etc. Gall-stones may be prevented from forming by 
scruple or drachm doses before meals for months at a time. It is also 
an efficient agent in obesity, hepatic diabetes, incipient hepatic sclerosis, 
chronic infantile diarrhoea, cerebral debility, bilious sick-headache, and 
the pasty, white stools of ill-conditioned children. Vichy- water contains 
this salt in the proportion of gr. ^ to the pint, and is considered a valu- 
able water in hepatic colic and kindred conditions. Finally for the con- 
dition of the system producing a crop of boils, Phosphate of Sodium is 
probably the best remedy. 



PHYSOSTIGMA, Calabar Bean,— is the seed of Physostigma 
venenosum (nat. ord. Leguminosae), a woody creeper of Calabar, West 
Africa, where it is used by the natives as an ordeal for witches, etc., vom- 
iting after its ingestion being held to establish the innocence of the 
accused. It is about an inch long, irregularly kidney-shaped, with two 
flat sides and a furrow along its convex margin ending in an aperture near 
one end. It contains an alkaloid, variously named Eserine, Physostig- 
mine, and Calabarine, C 15 H 21 N 3 02, which is obtained as a crystalline, an 
amorphous or a syrupy body. Some authorities apply the above names 



PHYSOSTIGMA. 315 

to different bodies, but acknowledge that they agree in physiological action 
though not in physical qualities. 

Preparations. 
Extractum Pkysostig?natis, — an alcoholic extract, of which the dose is from gr. *4 to 

gr-j- 

Tinctura Physostigmatis, — strength 10 per cent. Dose, TT\v-xx. 

Physostigmincz Salicylas, Salicylate of Physostigmine, — colorless, columnar crystals, of 
bitter taste and neutral reaction, soluble* in 130 of water and in 12 of alcohol at 59 F. 
Dose, gr. t^s-vo- 

Eserina, Eserine (Unofficial), — perhaps the same as Physostigmine, but is considered 
as representing the powers of the plant. Dose, gr. ^Vtt" 

Physiological Action. 
Physostigma is a direct spinal paralyzer, producing complete general 
paralysis, and abolished reflexes, but not affecting muscular irritability or 
the cerebral functions. It stimulates secretion, excites nausea and vomit- 
ing, salivation and diaphoresis, and is laxative by stimulating the muscular 
coat of the intestines to increased peristalsis as well as by increasing the 
intestinal secretions. It first lowers then raises arterial tension, increases 
the frequency of the heart-beat, but depresses the power of the cardiac 
muscle though not destroying it. It produces dyspncea by a tetanic ac- 
tion on the respiratory muscles, causing carbonic acid narcosis and death 
by paralysis of respiration. It contracts the pupil (how, is disputed), and 
the ciliary muscle, producing marked myosis. It is eliminated chiefly by 
the kidneys, the urine of the animal affected poisoning another. 

Antagonists and Incompatibles. 
Atropine is antagonistic as to the effects on the respiration, heart and pupils. Chloral 
is also antagonistic and over a greater field of action, but to be effective must be admin- 
istered before the ingestion of the Physostigma. The vegetable astringents, tannic acid 
and the caustic alkalies are chemically incompatible. 

Therapeutics. 

The applications of Physostigma are not many. It is efficient in con- 
stipation due to torpor of the bowels, in which condition it is usually 
combined with Belladonna and Nux-vomica. In tetanus it has been used 
with advantage to diminish reflex excitability in grain-doses of the extract 
repeated every 2 hours and the dose modified according to the effect pro- 
duced. Progressive paralysis of the insane is apparently retarded by it, 
and while antagonistic theoretically in atropine and strychnine poisoning, 
practically it is not of much value. 

Eserine is now used locally by ophthalmologists for many purposes in 
affections of the eye. In a solution of gr. ij to the § of water dropped 
into the eye, it is efficient in breaking up or preventing adhesions of the 
iris, diminishes intraocular tension, prevents suppuration after operations, 
contracts the pupil, diminishing the entrance of light in photophobia, 
etc., and empties the vessels of the eye. It is very useful in keratitis, 



3l6 PHYTOLACCA. 

glaucoma, strumous ophthalmia, and neuralgia of the eye-ball. The 
salts of Eserine or Physostigmine in neutral solution may be used for 
these purposes, as well as to counteract the effects of Atropine on the 
pupil. Gelatin disks medicated with Eserine may be obtained in the 
shops, and are a convenient form in which to use the drug for ophthalmic 
purposes. 



PHYTOLACCA, Poke,— is official under two forms, the berry and 
the root of Phytolacca decandra, a. plant of the nat. ord. Phytolaccaceae, 
found in all parts of the United States. It contains a neutral principle 
Phytolaccin, and an acid Phytolaccic Acid, also tannin, starch, fixed oil, 
etc. There are no official preparations. 

Phytolacca Bacca, Poke Berry, — dark-purple, depressed globular, 
about Yi inch in diameter, composed of 10 carpels, each containing one 
black seed ; juice purplish-red, sweet and slightly acrid. 

Phytolacca^ Radix, Poke Root, — large, conical, branched, fracture 
fibrous, wood-bundles in concentric circles, inodorous, sweetish and acrid. 
Dose, as emetic, gr. x-xxx, — as an alterative, gr. j-v. 

Preparations. 
Extractum Phytolacca Fluid um (Unofficial), — Dose, rt\v-£>j. 
Tinctura Phytolacca (Unofficial), — Dose, rt^x-^j. 

Physiological Action. 
Phytolacca is an emeto-cathartic, acting slowly but persistently, with 
great nausea and considerable depression. It lowers the rate of respira- 
tion and of cardiac action, and is a motor depressant, paralyzing the 
spinal cord and the medulla, death occurring from paralysis of respira- 
tion, preceded by tetanic convulsions. Several cases of poisoning by 
this plant have occurred. Its action is antagonized by Alcohol, Ether, 
Opium, Digitalis, etc. 

Therapeutics. 

Alterative powers have been ascribed to Phytolacca, and competent 
observers have reported curative results from its use in malignant tumors, 
varicose and other ulcers, obstinate eczema, sycosis, favus and other skin 
affections, employing it both internally and externally. It is a very 
serviceable remedy in chronic rheumatism, and given internally has 
undoubtedly cured cases of granular conjunctivitis. Mastitis is some- 
times aborted and suppuration of the breasts prevented by the use of the 
fluid extract internally while a solid extract is locally applied to the seat 
of the impending inflammation. In tonsillitis and diphtheritic sore throat, 
also in chronic follicular pharyngitis, it has been much used with good 
results, especially when there is high fever and pains in the head, back 
and limbs. In true adynamic diphtheria it will do little good. 



PICHI PICROTOXINUM. 317 

PI CHI is the shrub Fabiana imbricata, a member of the nat. ord. 
Solanaceae, and a native of S. America. Among the Chilians it has been 
much prized as a remedy in cystitis with calculi and gravel, and in 
chronic catarrh of the bladder. It seems to have considerable power over 
the hematuria and pain of renal calculus. It is also highly praised in dys- 
peptic disorders. Its medicinal virtues reside in oleo-resinous constitu- 
ents which are insoluble in water. An extract is prepared from the leaves, 
of which the dose is gr. v-x in capsules. Dose of the fluid extract, gj, 
but it should not be added to water. 



PICROTOXINUM, Picrotoxin, Picrotoxic Acid, C 9 H 10 O 4 ,— 
is a poisonous, neutral principle obtained from the seeds contained in the 
berries ( Cocculus Indicus, Fish- berries), of Anamirta paniculata (Anamirta 
Cocculus, Menispermum Cocculus), a climbing shrub of the nat. ord. Meni- 
spermaceae, a native of the East Indies. The berries are somewhat kid- 
ney-shaped, of blackish-brown color, wrinkled, brittle, inodorous and 
nearly tasteless, except the shrivelled embryo which is bitter. They con- 
tain, besides Picrotoxin, a large quantity of fixed oil and other substances 
of less interest. In the shell are found Menispermin, an alkaline princi- 
ple, Paramenispermin, which is neutral and crystalline, and Hypopicrotoxic 
Acid. 

Picrotoxin occurs in colorless, flexible crystals, of prismatic form, 
bitter taste and neutral reaction, soluble in 150 of water and in 10 of al- 
cohol at 59°F., also in acids and in alkaline solutions. Dose by the 
stomach gr. ^V-^o, cautiously. For hypodermic use a solution in water 
of gr. ij in 3j may be used, in doses of gr. ^V~¥TF of the principle, niiv, 
equalling gr. -gL 

Unofficial Preparations of Cocculus. 

Tinctura Cocculi, — I in 8. Dose, TT^ij-xv. 

Extractum Cocculi Fluidu7?i, — Dose, TT\j-iij. 

Planafs Tincture of Cocculus, — I ia 4. Dose, rry-v. 

Physiological Action. 
Picrotoxin is a cerebo-spinal exaltant, affecting especially the centres 
in the medulla oblongata, and in its action representing the combined 
actions of Belladonna and Nux-vomica. It stimulates all the secretions, 
especially the cutaneous, the salivary and intestinal ; produces nausea and 
vomiting, and slows the heart and the respiration after transiently accelera- 
ting both. It causes muscular twitching, incoordination, stupor, delirium, 
epileptiform convulsions, tonic spasms of the flexor muscles alternating 
with clonic ones, exalted reflexes and trembling, — then coma, insensibil- 
ity and death by paralysis of the heart, which is arrested in diastole. 
The action of the drug is on the spasm and vagus centres in the medulla, 
and on Setchenow's inhibitory centre, as well as on the cerebellum and 



3 18 PILOCARPUS. 

spinal cord, paralyzing the first-named centres and stimulating the reflex 
centres in the cord. It is eliminated by all the excretory channels, 
chiefly by the kidneys. 

The spasms caused by Picrotoxin are choreic and chiefly affect the flexor 
muscles, — those from Strychnine are tetanic, affecting principally the 
extensors. The order, succession and character of the phenomena pro- 
duced by Picrotoxin resemble in marked degree those of the epileptic 
paroxysms. 

Cocculus berries are used to stupefy fish, being thrown into ponds con- 
taining them. They are also employed to adulterate beer and porter in 
order to make these drinks more intoxicating. 

Antagonists. 

Chloral is antagonistic to its cerebral and spinal actions, but synergistic to its depressant 
power over the heart and the respiration. Acetic Acid gives relief in overdosing, and 
may have some antidotal power. Anesthetics antagonize its spasm-producing action. 

Therapeutics. 
Picrotoxin is used chiefly in nervous diseases. Epilepsy is amenable to 
it, especially when the attacks are nocturnal, and in anaemic cases and 
those attributable to onanism. Paralyses of several forms have been 
greatly benefited by it, especially paralysis of the sphincters, hemiplegia 
from cold, glosso-labio-laryngeal paralysis, and paralysis agitans. Chorea 
is well treated by it but requires full doses. It is remarkably efficient in 
controlling the night sweats of phthisis, and in flatulent colic, also in dys- 
pepsia with flatulence and severe epigastric pain, and in vomiting with 
giddiness, headache and intolerance of light and sound. Dysmen- 
orrhea is often benefited by Cocculus administered for two days before 
the period ; and leucorrhcea, when the discharge is sero-purulent, with 
lumbar pains, is frequently controlled by it. Parasitic skin diseases are 
well treated by an ointment of Picrotoxin (gr. x to the §), which will 
also kill pediculi, but it must be used cautiously and with special care to 
avoid an abraded surface. The tincture of Cocculus may be used as a 
wash to kill body-lice, undiluted. 



PILOCARPUS, Jaborandi,— the leaflets of Pilocarpus pennatifo- 
lius, a Brazilian plant of the nat. ord. Rutacese. They are about 4 inches 
long, ovate-oblong, coriaceous, pellucid-punctate, mostly smooth, some- 
what pungent and bitter. It contains two alkaloids, — Pilocarpine) C u 
H 16 N 2 2 , soft and viscous, slightly soluble in water but soluble in alco- 
hol, ether and chloroform ; Jaborine, isomeric with Pilocarpine, to which 
it is antagonistic in action ; also a Volatile Oil and probably a peculiar 
acid. 



PILOCARPUS. 3I9 

Preparations. 

Extractum Pilocarpi Fluidum, — Dose, fiVv-^j. 

Pilocarpines ffydrochloras, — minute, white, deliquescent crystals, very soluble in water 
and in alcohol, almost insoluble in ether or chloroform. Dose, gr. Y%-y 2 . 

Physiological Action. 

Pilocarpus is a paralyzer of the vaso-motor system, and a stimulant of 
the peripheral terminations of nerves supplying glands and involuntary 
muscular fibre, subsequently paralyzing the latter. It is therefore a power- 
ful diaphoretic and sialogogue, a cardiac depressant by stimulation of the 
vagus ends, — also myotic, emetic, and under some circumstances aborti- 
facient. Its taste is hot and pungent. It causes prompt and profuse 
perspiration (^ix-xv, in quantity) and salivation (^x-xxvij), after a pre- 
liminary flushing of the skin. The nasal, bronchial and lachrymal secre- 
tions are much increased ; sometimes watery diarrhoea occurs ; the action 
of the heart, at first increased, is afterwards lowered, the arterial tension 
is reduced, and the temperature falls from i° to 4 . Drowsiness, pallor, 
chilliness and debility succeed, and last several hours; the pupil is con- 
tracted and accommodation impaired. The elimination of urea is greatly 
increased, but not the quantity of urine. The respiratory power is low- 
ered, and apnoea may occur, from increase of the bronchial mucus. 

Pilocarpus is rapidly diffused, and is eliminated by the skin and the 
salivary glands. Its effects pass off usually in from three to six hours. 
Children are less affected than adults, by proportionate doses. It causes 
contractions of the bladder, uterus and spleen, in the latter case whether 
the organ is enlarged or of normal size. 

Pilocarpine is the principle to which the foregoing actions are due, 
but Jaborine, though chemically identical, is perfectly antagonistic 
thereto in its effects on the heart, pupils, lungs and salivary glands, acting 
precisely like Atropine on these organs. The difference is probably due 
to a different molecular arrangement. 

Antagonists and Incompatibles . 

Atropine is the antagonist to Pilocarpine in dose of gr. yi-g- for gr. \ of the latter. The 
antagonism between these two alkaloids extends over the whole range of their action, 
and is the most complete known to physiological experimentation. Conversely Pilocar- 
pine is exactly antagonistic to Atropine, but Jaborine acts similarly to the latter drug. 
Morphine controls the nausea and vomiting. Caustic alkalies, the persalts of Iron and 
salts of the metals generally, are chemically incompatible. 

Therapeutics. 
Jaborandi is used with great benefit in dropsies, especially the renal 
form, also in eclampsia of renal origin, in uraemia, pleuritis, meningitis 
and other inflammations of serous membranes, but it is contraindicated 
when from any cause there is weak heart. In diabetes insipidus it reduces 
the quantity of urine remarkably, relieving the kidneys by throwing the 



320 PIMENTA PIPER. 

work on the skin. In the acute and chronic forms of Bright's disease it 
has been used with great advantage, but being so depressant it must be 
employed with great caution in this disorder. For alopecia it is the most 
efficient remedy known, stimulating the skin and improving the color and 
condition of the hair. In agalactia it stimulates the secretion of the milk, 
and it often gives prompt relief in parotitis. Ptyalism is frequently re- 
lieved by minute doses of Pilocarpine (gr. J-q), which, acting on the same 
gland, antagonizes the morbid action ; and similar doses used thrice daily 
will check profuse perspiration. The hypodermic use of Pilocarpine will 
arrest a paroxysm of spasmodic asthma, and is equally efficient in hic- 
cough. Atropine-poisoning is best combated by the use of Pilocarpine 
hypodermically. 

Ophthalmologists employ Pilocarpine with most excellent results in the 
amblyopia of alcoholism and that from the abuse of tobacco, in detach- 
ment of the retina, chronic iritis, keratitis, glaucoma, hemorrhage into 
the vitreous, atrophic choroiditis, white atrophy, to promote resolution 
and absorption in inflammatory conditions with exudation, and instead of 
Eserine as a myositic. 

Erysipelas and diphtheria are diseases in which Pilocarpine has recently 
proved very efficient, but its depressant action on the heart and respira- 
tion must not be lost sight of. In the writer's experience the fluid extract 
is one of the best agents for breaking up a common cold. It may be 
given in doses of tt^x-5J, according to age, at bedtime. Children bear 
the drug well in respect to all its physiological actions. 

PIMENTA, Allspice, — is the nearly ripe fruit of Eugenia Pinienta, 
a West Indian tree of the nat. ord. Myrtacese. The berries are nearly 
globular, about % inch in diameter, crowned with the remnants of the 
calyx, two-celled, each cell containing one reniform seed, odor and taste 
pungent and aromatic. They contain a Volatile Oil which is official, a 
green fixed oil, fat, tannin, gum, resin, etc. Dose, gr. x-xl. 

Oleum Pimentce, the volatile oil, colorless or pale yellow, of aromatic odor, pungent 
taste and slightly acid reaction. Is a constituent of Bay Rum (Spt. Myrcise). Dose, 

Allspice is a warm, aromatic stimulant, very useful as a condiment, 
improving digestion by increasing the vascularity of the gastric mucous 
membrane and by stimulating the salivary secretion. The oil is an agree- 
able remedy for flatulence, nausea, and intestinal colic, and is used to 
prevent the griping of purgatives and to cover the taste of nauseous med- 
icines. 

PIPER, Pepper, Black Pepper,— is the unripe fruit of Piper 
nigrum, or Pepper-vine, a perennial plant of the nat. ord. Piperacese, grow- 



PIPERAZINE. 321 

ing in India, Siam, Java, Borneo, etc. It is about y& inch in diameter, 
of globular shape, reticulately wrinkled, aromatic, of pungent, spicy taste, 
and contains an alkaloid, Piperine, which is official, also a green, acrid, 
concrete oil, a balsamic volatile oil, starch, lignin, gum, extractive, etc. 
Dose, gr. v-xx. 

Preparations. 

Oleoresina Piperis, Oleoresin of Pepper, — contains almost all the volatile oil and acrid 
resin extracted by ether, with little of the Piperine. Dose, TT^-j. 

Piperina, Piperine, C 17 H 19 N0 3 , — a proximate principle of feeble alkaloidal power, 
prepared from Pepper, and occurring also in other plants of the natural order Piperacese. 
Occurs in colorless or pale-yellowish prisms, of neutral reaction, almost insoluble in water, 
slightly so in ether, but soluble in 30 of alcohol at 59 F. Dose, gr. j-x. 

Physiological Action and Therapeutics. 
Pepper when applied to the skin acts as an irritant ; internally its effects 
are similar to those of other aromatics, being a warm carminative and 
stimulant, increasing slightly the action of the heart, stimulating the kid- 
neys somewhat, and toning up the mucous membrane of the urinary and 
intestinal passages, by which channels it is eliminated. It has been 
thought to possess antiperiodic powers, and was formerly much employed 
in intermittents. Its chief medical use is to correct flatulence, and to 
excite action of the stomach, being very commonly taken as a condiment 
with food. It is occasionally employed in gleet, but more extensively in 
hemorrhoids and other diseases of the rectum. Its active constituents 
are the concrete oil of resin and the volatile oil, the alkaloid having very 
slight action on the system, except as an antiperiodic and antipyretic, 
qualities which it certainly possesses. 



PIPERAZINE, Piperazidine,Dispermine,C 4 H 10 N 2 (Unofficial), 
— is a synthetical basic compound which corresponds very closely in its 
properties to the organic base Spermine, C 2 H 3 N, obtained from spermatic 
fluid and advocated by Brown-Sequard as a nerve-stimulant. Piperazine is 
formed by the action of Ammonia upon Ethylene Bromide or Chloride ; 
and occurs as a white, crystalline powder, readily soluble in water, and 
liquefying when exposed to the air, from which it greedily absorbs water 
and carbon dioxide. Dose of the base or its hydrochloride, gr. v-x. It 
may be injected hypodermically in 3 to 5 percent, solution. 

Piperazine possesses the valuable property cf forming with uric acid a 
very soluble compound, the piperazine urate formed being seven times 
more soluble in water at 17 C. than is lithium urate, the former requiring 
but 50 parts and the latter 368 parts of water for solution. It is non- 
toxic, and devoid of powerful physiological effects, being well borne 
without ill results, even when administered for prolonged periods. It is 
non-irritant to mucous membranes, is readily absorbed from the stomach, 



322 PISCIDIA. 

and circulates in the blood unchanged, reaching the parts affected by 
gouty deposits in a condition in which it readily neutralizes and dissolves 
the latter, thus facilitating their removal from the body. 

In 15-grain doses daily Piperazine administered in gout promptly 
reduces the redness and swelling of the affected joints, and is frequently 
followed by a discharge of gravel. It gives marked relief in the pruritus 
of the uric acid diathesis due to the irritation of imperfect nitrogenous 
elimination. In solution it may be introduced into the bladder in order 
to dissolve vesical calculi of the uric character, and in gout it may be 
locally employed by hypodermic injection. It should be tried in rheu- 
matic arthritis of difficult diagnostic differentiation. 

As a solvent for uric acid and urate concretions Piperazine is far superior 
to all other agents, but its extremely high price prevents its general use. 

PISCIDIA, Jamaica Dogwood (Unofficial), is the bark of the root 
of Piscidia erythrina y a tree of the nat. ord. Leguminosse growing in the 
West Indies. It occurs as a tough, fibrous bark, externally blackish, in- 
ternally greenish, of a heavy, narcotic odor, and a bitter, acrid and astrin- 
gent taste, containing a yellowish, resinoid substance named Piscidin. 
Its active principle has not yet been isolated. A fluid extract is on the 
market, of which the dose is gss-j, carefully increased. 

Physiological Action. 
Tiscidia has a narcotic effect on many animals, and has been used in 
Jamaica for many years to stupefy fish, that they may be easily taken. It 
produces muscular relaxation, incoordination of movement, lowered sensi- 
bility, increased action of the heart and increase of the arterial tension by 
stimulation of the vaso-motor centre. Soon, however, the heart is weak- 
ened, vascular tension falls, and a tetanoid state results from stimulation 
of the spinal cord, with reduced reflex action. On the brain its effects 
resemble those of Opium, causing deep sleep without any unpleasant after 
results. It relieves pain in less degree, however, than Opium does, but 
its hypnotic action is greater. It also relieves cough and spasm, produces 
diaphoresis and salivation, and dilates the pupil. From toxic doses death 
occurs by asphyxia. In man it probably causes the same effects but in 
decidedly less marked degree. 

Therapeutics. 
Jamaica Dogwood is used chiefly as a general nervous sedative. Its 
hypnotic and anodyne powers are somewhat uncertain, but have in many 
cases been very decided. It is useful in whooping-cough and spasm, and 
has proved almost specific in many cases of neuralgia, while in others it 
has caused great gastric distress without the least anodyne effect. 



pix. 323 

PIX, Pitch, — is a resinous exudation from the stem of certain trees 
of the genera Pinus (Pines) and Abies (Firs and Spruces) ; and may also 
be obtained by the evaporation of wood-tar. [See Pix Liquida below.] 
The following varieties are official, viz. : — 

Pix Burgundica, Burgundy Pitch, — the prepared, resinous exudation 
of Abies excelsa or Norway Spruce (nat. ord. Coniferae), a native of 
Europe and Northern Asia. Occurs in hard, brittle, opaque or translu- 
cent mass, with a shining, conchoidal fracture, reddish-brown color, 
aromatic and somewhat empyreumatic, not bitter, almost entirely soluble 
in glacial acetic acid. It is very fusible, and at the body-heat it softens 
and becomes adhesive. Used for plasters. 

Pix Canadensis, Canada or Hemlock Pitch, — the prepared resinous 
exudation of Abies canadensis (nat. ord. Coniferse), the Hemlock Spruce 
of the U. S. and Canada. Its properties are much the same as those of 
the preceding. 

Pix Liquida, Tar, — is an empyreumatic oleo-resin obtained by the 
destructive distillation of the wood of Pinus palustris and other species 
of Pinus (nat. ord. Coniferae). Is thick, viscid, semi-fluid, blackish- 
brown, of acid reaction, terebinthinate odor, and sharp, empyreumatic 
taste, slightly soluble in water, soluble in alcohol, oils, and in solution of 
potassa or of soda. By distillation it yields an acid liquor named Pyro- 
ligneous A cid and an empyreumatic oil called Oil of Tar (see Oh. Picis 
Liquids, below), the residue being pitch. Its granular appearance is 
due to crystals of Pyrocatechin, C 6 H 4 (OH) 2 , which occur either in the 
Pyroligneous Acid or in the tarry mixture. Dose 3j - ij daily, in ten- 
grain doses. 

Preparations. 

Oleum Picis Liquids, Oil of Tar, — a volatile oil distilled from Tar. Dark, reddish- 
brown (almost colorless when fresh), of tarry odor and taste, and acid reaction, readily 
soluble in alcohol. Contains a great variety of compounds, including Hydrocarbons, 
Phenols, Paraffin, etc., among the phenols being Creasote and Carbolic Acid. Is used 
locally and as an atomized inhalation. 

Syrnpus Picis Liquids, Syrup of Tar, — has of Tar 6 per cent., and is a sweetened 
Tar-water. Dose, 3 ij- % ss. 

Unguentum Picis Liquida, Tar Ointment, — contains equal parts of Tar and Suet. 

Emplastrum Picis Burgundies, Burgundy Pitch Plaster, — has of Burgundy Pitch 90, 
Yellow Wax 10 parts. 

Emplastrum Picis Canadensis, Canada Pitch Plaster, — has of Canada Pitch 90, Yel- 
low Wax 10 parts. 

Emplastrum Picis cum Cantharide, Warming Plaster, — has of Burgundy Pitch 92, 
Cerate of Cantharides 8 parts. 

Infusum Picis Liquidce, Tar Water (Unofficial), — made by shaking Tar 1 with Water 
4 frequently during 24 hours, decanting and filtering. Is stimulant and. diuretic. Dose, 
Oj-ij daily. 

Vinum Picis Liquidce, Wine of Tar (Unofficial), — Tar § xvj, Glycerin, White Wine, 
Honey, aa J viij, Acetic Acid ^ j, Boiling Water*Ovj, shaken together and digested in a 
close vessel for two hours at 150 to 160 , then macerated for a few days, frequently 
shaken, strained and filtered. 

Oleum Pini Sylvestris, Oil of Scotch Fir (Unofficial), — a colorless, fragrant oil, dis- 
tilled from the leaves of Pinus sylvestris, resembling" Turpentine in action. Used by 
inhalation (^ss to Oj of boiling water), or locally. 



324 PIX PLANTAGO. 

Conce?ttrated Extract of Finns Canadensis (Unofficial), — is an aqueous, non-irritant 
astringent, prepared from the Abies Canadensis or Hemlock Spruce. It is said to have a 
specific tonic action upon mucous membranes. Two kinds are sold, one being called 
the " White " Extract, — in reality a golden yellow, — and the other the " Dark " Extract, 
— the former intended for use when it is desirable to avoid staining the linen. This 
preparation received the endorsement of Dr. J. Marion Sims, and has been extensively 
employed both locally and internally, as a topical application in uterine and vaginal 
catarrhs, and as a systemic remedy in catarrhal inflammation of the gastro-intestinal and 
broncho pulmonary mucous membranes. 

Physiological Action and Therapeutics. 

Pitch is a gentle rubefacient when applied to the skin, but in some 
constitutions the Burgundy variety causes a vesicular and pustular inflam- 
mation if used extensively. It is generally employed as a basis for 
plasters, and is of benefit in lumbago, rheumatism, chronic pleurisy pain- 
ful joints, superficial neuralgias, etc., protecting the part from variations 
of temperature, and perhaps by the gentle pressure exercised stimulating 
the lymphatics and promoting absorption. It is supposed to have a 
special influence on the rectum, and in pill with Tar has been employed 
as a remedy for hemorrhoids. In applying adhesive plasters the hair 
should first be shaved off, and when about to be removed the plaster 
should be warmed, and a little Oil of Turpentine inserted between its 
edge and the skin. 

Canada Pitch is too soft for plasters, but is employed for the same 
purposes as the preceding. A volatile oil obtained from the same tree 
(Oil of Spruce, Oil of Hemlock) has been used for abortifacient pur- 
poses, endangering the life of the subject. 

Tar is a complex mixture of resins and hydrocarbons, containing 
Creasote and Carbolic Acid which give to it irritant qualities. Internally 
it is expectorant and produces gastro-intestinal irritation, sometimes 
severe headache, giddiness and febrile phenomena. It is eliminated by 
the kidneys chiefly, which it stimulates, and may cause their congestion 
and increased diuresis. Externally it is a decided stimulant to the skin, 
often giving rise to considerable irritation and pain. It is also antiseptic, 
and in most of its effects it resembles the turpentines. 

Tar is used as a local application in chronic scaly skin diseases, 
especially psoriasis and chronic eczema. As an atomized inhalation it is 
of decided benefit in bronchitis, pharyngitis, laryngitis and winter cough. 
Internally it may be employed with advantage in these affections, in 
hemorrhoids, bronchial catarrh, and phthisis. The best preparation for 
internal administration is the syrup, which is a sweetened tar-water, the 

sugar forming with the Tar a soluble compound. 

• 

PLANTAGO, Plantain (Unofficial), — is the leaf of Plantago major, 
and Plantago lanceolata (nat. ord. Plantaginaceae), the common " Ribbed 
Gra-s." The pounded leaves applied as a paste, or the dry leaf powdered, 



PLUMBUM. 325 

are actively hemostatic, stopping hemorrhages speedily. Among the 
ancients it had a good reputation as a remedy for toothache and earache, 
which still adheres to it in Switzerland and many other parts of Europe. 
In many other painful affections it is extremely efficient, especially in 
mastitis, rhus-poisoning, erysipelas, burns, scalds, wounds and bruises. A 
poultice of the leaves may be applied to the affected part, and an infusion 
administered internally. A fluid extract is sold in the shops, of which 
the dose is n^v-xv. 

PLUMBUM, Lead, Pb, — is not official, but several of its salts are, 
namely, — the Acetate, Carbonate, Iodide, Nitrate and Oxide, of which 
the Acetate is the only one administered internally, the solutions of the 
Subacetate are the only liquid preparations, the Oxide (Litharge) is used 
as Emplastrum Plumbi, the Nitrate is used as a local stimulant or escha- 
rotic, the Iodide as an ointment for absorbent purposes, and the Carbonate 
as an astringent locally to inflamed surfaces. The metal occurs in nature 
chiefly as a Sulphide named Galena, also as an Oxide rarely, and in various 
saline combinations. 

Official Salts of Lead. 

Plumbi Acetas, Acetate of Lead, Sugar of Lead, Pb(C 2 H 3 2 ) 2 3H 2 0, — colorless, 
shining, prismatic crystals or scales, efflorescent, of faintly acetous odor and acid reaction, 
and a sweetish, astringent and metallic taste. Soluble in 1.8 of water and in 8 of alcohol 
at 59 F., in 0.5 of boiling water and in I of boiling alcohol. Dose, gr. ss-v. 

Plumbi Carbonas, Carbonate of Lead, White Lead, (PbC0 3 ) 2 Pb(HO) 2 , — a heavy, 
white, opaque powder, odorless, tasteless and insoluble in water or alcohol, but soluble 
with effervescence in dilute nitric acid. Used locally as ointment, powder, or white paint. 

Plumbi Iodidum, Iodide of Lead, Pbl 2 , — a heavy, bright citron-yellow powder, odor- 
less and tasteless, fusible and volatilizable by heat, soluble in about 2000 of water at 59 
F., and in about 200 of boiling water. Used externally as an ointment. May be given 
internally in doses of gr. A twice daily. 

Plumbi Nitras, Nitrate of Lead, Pb(N0 3 ) 2 ,— colorless, opaque, octahedral crystals, 
odorless, of sweetish, astringent and metallic taste and acid reaction, soluble in 2 of water 
at 59 F. , almost insoluble in alcohol. Used locally as an astringent and deodorizer in 
solutions up to 1 per cent., also as an escharotic and a disinfectant. 

Plunibi Oxidum, Oxide of Lead, Litharge, PbO, — a heavy, yellowish or reddish-yellow 
powder, odorless, tasteless and insoluble in water or alcohol, but almost wholly soluble 
with slight effervescence in dilute nitric acid. When heated in contact with charcoal it is 
reduced to metallic lead. Used as Lead-Plaster and sometimes with oil as an external 
application. 

Preparations. 

Liquor Plumbi Subacetatis, Solution of Subacetate of Lead, Goulard's Extract, — an 
aqueous solution containing about 25 per cent, of the salt, prepared from Acetate of Lead 
170, Oxide of Lead 120, and Distilled water q. s. ad 1000 parts. It is a clear, colorless 
liquid, of sweetish, astringent taste and alkaline reaction, of sp. gr. 1. 228, and when added 
to a solution of acacia it produces a dense, white precipitate. Used locally as an astrin- 
gent and cooling lotion, diluted usually with an equal quantity of water. 

Liquor Plumbi Subacetatis Dilutus, Lead Water, — has of the preceding 3 parts to 97 
of Distilled Water. Used locally as a mild astringent and cooling lotion. 

Linimentum Plumbi Subacetatis, — contains of Liquor Plumbi Subacetatis 40 parts to 
60 of Cotton-seed Oil. Used as an anodyne application for itching, etc. 

Ceratum Plumbi Subacetatis, Goulard's Cerate, — has of the same solution 20 parts with 
80 of Camphor Cerate, freshly prepared, as it becomes rancid easily. Used as an astrin- 
gent and protective application. 



326 PLUMBUM. 

Emplastrum Plumbi, Lead plaster, Diachylon Plaster, — Oxide of Lead 32, Olive Oil 
60, rubbed together and boiled with 10 parts of water. Is white, pliable and tenacious, 
free from greasiness or stickiness, and should be entirely soluble in warm oil of turpentine. 
A good protective in abrasions and bed-sores, and the basis of many other plasters. 

Ungiientum Diachylon, Diachylon Ointment, — has of Lead Plaster 60, Olive Oil 39, 
Oil of Lavender I. Used locally in eczema and other cutaneous disorders. 

Ungiientum Plumbi Carbonatis, — has of the Carbonate in very fine powder 10, Benzo- 
inated Lard 90. Used as a dressing for burns. 

Ungiientum Plumbi Iodide, — has of the Iodide in very fine powder 10, Benzoinated 
Lard 90. Used locally to promote absorption of glandular tumors. 

Oleatum Plumbi, Oleate of Lead (Unofficial), — a 20 per cent, solution of Oxide of Lead 
in Oleic Acid. A soft, yellowish ointment, for local use. 

Physiological Actions. 

Lead-salts are all more or less poisonous, but metallic Lead is inert 
until converted into a soluble salt by the acids of the stomach. The 
Acetate in large doses is emetic, so that acute lead-poisoning is rare. Its 
chief phenomena are intense gastro-intestinal irritation, vomiting, paraly- 
sis, coma and collapse. 

Chronic lead-poisoning (plumbism) has its principal sources in pure 
water conveyed by leaden pipes, the use of hair-dyes, handling of print- 
ing-type, working in the smelting of lead ores, etc. It produces loss of 
appetite, emaciation, pallor and constipation, followed by slowing of the 
heart's action, and accompanied by violent colic (enteralgia), muscular 
impairment evinced by paralysis of the extensor muscles of the forearm 
(drop-wrist), impaired sensibility and albuminuria. Occasionally apho- 
nia, vertigo, gastralgia, headache, stupor and convulsions are manifested. 
Rheumatism without fever or tenderness in the joints, which however are 
red and swollen, is a frequent symptom. A blue line (sulphide) is seen 
along the margin of the gums in those who do not clean their teeth. 
Neuralgic troubles may arise, and amaurosis often occurs from impairment 
of the optic nerve. The metal becomes deposited in the affected muscles 
and other tissues, and probably acts by impairing the isolating power of 
the nerve-fibres, thus enfeebling the nerve-currents. It also produces con- 
traction of the smaller vessels, and may affect any muscles of the body, 
also the brain, producing delirium, coma, and convulsions. Abortion is 
a frequent result, either through an influence on the muscular tissue of the 
uterus, or from a toxic action on the foetus. Death may occur from ex- 
tension of the paresis to the muscles of respiration, from gradual impair- 
ment of nutrition, or from convulsions and coma, a form of disease known 
as Lead -encephalopathy. 

Astringency is the chief quality of the lead salts; they lessen secretion, 
contract muscular tissue and then destroy its contractile power, slow both 
the heart and the respiration, and in time destroy the red blood-corpus- 
cles. Lead enters the blood as an albuminate, in which form also it is 
retained by the tissues. It is slowly excreted by the liver, kidneys, skin 
and mammary glands. That which escapes by the bile is reabsorbed by 



PLUMBUM. 327 

the bowel, is again excreted by the intestinal glands, escaping with the 
faeces as a sulphide. It lessens the excretion of uric acid. 

Antidotes and Incompatibles. 

In acute poisoning, as by the Acetate, the antidotes are Sulphate of Sodium or of Mag- 
nesium, and Phosphate of Sodium. The stomach should be evacuated, and albuminous 
drinks and Opium given to allay irritation. Chronic poisoning is best treated by Iodides 
to saturation of the system. Sulphurated Potassa baths ( ^j or more in water) are also 
very useful. Incompatibles are mineral acids and salts, vegetable acids, alkalies, vege- 
table astringents, Iodide of Potassium, albuminous solutions, Opium, and all natural waters 
containing lime, sulphates, carbonates, and Carbonic Acid. 

Therapeutics. 

Lead salts are chiefly used as astringents and hemostatics. The solu- 
tion of the Subacetate diluted with 4 parts of glycerin and water is locally 
employed in many skin-diseases, especially in eczema, lichen, impetigo, 
and erythema ; also in catarrhal discharges of muco-purulent character 
from the ear, vagina, and the urethra, particularly in gonorrhoea and leu- 
corrhcea. Inflammations of external parts are constantly treated by the 
lotion of " Leadwater and Laudanum" (Liquor Plumbi Subacetatis Di- 
lutus, 7 parts to 1 of Tinctura Opii). Though the constituents of this 
lotion are chemically incompatible, it is a valuable sedative and astringent. 
The Acetate, in 5 -grain doses every three hours, is an efficient internal 
styptic in various hemorrhages, particularly in hemoptysis, hematemesis, 
and gastric ulcer, lowering the action of the heart and constringing the 
vessels. Its astringent action is well manifested in bronchorrhcea and 
other pulmonary affections with excessive secretion. It is well used in 
diarrhoeas, gr. ij with gr. j of pulverized Opium in choleraic diarrhoea, 
and smaller doses for the summer complaint of children. In caseous 
pneumonia the Acetate is highly recommended as the best remedial agent, 
combined with Opium and Digitalis; and in cardiac hypertrophy it may 
be often used to lower the action of the heart. It is also serviceable in 
whooping-cough with profuse" bronchial secretion, and in humid asthma. 

Carbonate of Lead is only used externally to protect irritated sur- 
faces, as erythema, erysipelas, intertrigo, etc., in which it may be dusted 
over the surface if unbroken. The official ointment, or white paint mixed 
with linseed oil, is an excellent application to burns or scalds, but if ap- 
plied on the broken cuticle it may prove rapidly poisonous. 

The Iodide is employed externally as an ointment to enlarged lym- 
phatic glands and enlarged spleen, also to chronic eczema and psoriasis. 
It has been used internally to reduce a malarial spleen. 

The Nitrate is an efficient application to fissured nipples, gr. x to gj 
of glycerin. In powder, dusted over unhealthy granulations, and sani- 
ous ulcers resulting from onychia, it gives prompt relief after a brief period 
of pain. It is said to have cured cases of epithelioma when used in the 



328 PODOPHYLLUM. 

same manner. In solution (gr. x to the g) it is a most efficient deodor- 
izer against the fetor from gangrenous sores, ozaena and other offen- 
sive discharges. Pharmaceutical^ it is used in the preparation of the 
Iodide. 

The Oxide is used in the preparation of plasters, most of the other 
salts of lead, and Digitalin. It is not employed internally, but may be 
used as an external application mixed with sweet oil in superficial burns, 
but care should be taken that it is only applied to the unbroken skin. 

PODOPHYLLUM, May Apple, — is the rhizome and rootlets of 
Podophyllum peltatum (Mandrake), an herbaceous perennial of the nat. 
ord. Berberidaceae, growing in the woodlands of Canada and the U. S., 
having a pale-green stem about a foot high, with a single white flower at 
its summit. The rhizome is horizontal, \ inch thick, consisting of joints 
about 2 inches long, of orange-brown color externally, white and mealy 
internally, inodorous, taste bitter and acrid. Its active principle is a 
Resin which is official, and is a compound of several resins. It probably 
contains the alkaloid Berberine, which is also found in Berberis, Hydrastis 
and several other plants. Dose, gr. v-xx. 

Preparations. 

Abstractum Podophylli, — Dose, gr. %-]. 

Extractum Podophylli, — Dose, gr. v-x. 

Extraclum Podophylli Fluidum, — Dose, TT\j-xxx. 

Resina Podophylli, Podophyllin, — is precipitated from a concentrated tincture by acidu- 
lated water. Soluble in alkaline liquids and partly so in ether. Contains Podophyllotoxin , 
Picropodophyllin, Podophyllinic and Protocatechuic Acids. Dose, gr. }£-), in pill. 

Physiological Action and Therapeutics. 

Podophyllum is a tonic-astringent and resin-bearing purgative, having 
an action similar to that of Jalap but slower, like Calomel, taking 6 to 10 
hours to produce its cathartic effect. It increases the intestinal secretions 
and the flow of bile, causing copious watery stools, with considerable 
griping pain and some nausea. The powder is irritant to the respiratory 
passages and the skin. 

Resina Podophylli is an excellent purgative in cases of habitual con- 
stipation or portal congestion, and is a useful cholagogue. Laxative 
effects are produced by small doses (gr. }i-}{), but grain-doses are 
necessary for its full action. It should be combined with Hyoscyamus, 
Belladonna or Cannabis Indica, in order to counteract its griping ten- 
dency. It is an efficient derivative in cases of catarrhal or malarial jaun- 
dice, and is recommended in very small doses for prolapse of the rectum, 
remittent fevers of children, dyspepsia, hepatic derangement, bilious 
vomiting and headache, and in the vomiting and diarrhoea of gastro- 
enteritis. 



POLYGONUM HYDROPIPEROIDES PONGAMIA POTASSIUM. 329 

POLYGONUM HYDROPIPEROIDES, Water-pepper, 
Smart-weed (Unofficial), — is a plant of the nat. ord. Polygonaceae, 
indigenous to the U. S., having narrow, lanceolated leaves and slender 
spikes of whitish flowers. It contains Tannin and an active principle, 
Polygonic Acid, which is green, crystallizable, insoluble in water, but 
soluble in alcohol, ether, and chloroform. 

Preparations. 

Extractum Polvgoni Fluidum (Unofficial), — Dose, rc\x-%]. 
Extr actum Polygoni (Unofficial), — Dose, gr. j-v. 

Physiological Action and Therapeutics. 

Smart-weed has a pungent, acrid taste, producing a sensation of heat 
in the stomach, and a peculiar tingling throughout the system. It stimu- 
lates the action of the heart, raises the arterial tension, increases the 
warmth of the surface, promotes the cutaneous, bronchial and renal secre- 
tions and the menstrual flow. It is an efficient diuretic, emmenagogue 
and aphrodisiac. The juice applied to the skin excites inflammation and 
vesication. 

Amenorrhcea from functional inactivity of the uterine system is remark- 
ably benefited by this remedy in 5ss doses of the fluid extract four times 
daily for a week before the expected period. It has considerable influ- 
ence over functional impotence, but produces aching pains in the hips and 
loins, and a sense of weight and fullness within the pelvis. It has also 
been used with benefit in diarrhoea, dysentery, gravel, and locally in mer- 
curial salivation and the sore mouth of nursing women. 

PONGAMIA, Kurung Oil (Unofficial), — is a yellow oil expressed 
from the seeds of Pongamia glabra, an Indian tree of the nat. ord. Legu- 
minosae. It has been used for many years in India for skin affections, 
and in professional hands has proven an excellent application in pityriasis 
versicolor, rubbed in twice daily. It promises to be a valuable remedy 
in parasitic diseases of the skin, is not irritating and does not discolor the 
surface to which it is applied. 
1 

POTASSIUM, Kalium, K, — is represented by a number of official 
salts, which are colorless or white, sometimes anhydrous, and generally 
readily soluble in water. The metal itself is not official. The chief 
source of its salts is the ash remaining after the combustion of plants or 
trees, which contains the Carbonate, from which most of the others are 
prepared. There are also two subsidiary sources, viz. — the Nitrate, 
which is found native; and the Bitartrate, which, under the name of 
Crude Tartar or Argol, is deposited during the fermentation of wine. It 



330 POTASSIUM. 

is distinguished from all other bases (except Magnesium, Sodium and 
Ammonium) by not being precipitated by Ammonium Sulphide or Am- 
monium Carbonate. It is positively known by the violet color it imparts 
to flame, by its very sparing solubility when converted into the Bitartrate, 
and by its precipitation by Platinum Perchloride. 

Potassium Compounds and their Preparations. 

Potassa, Potassium Hydrate, Caustic Potash, KHO, — a very deliquescent, white, hard 
and dry solid, of very acrid and caustic taste and strongly alkaline reaction, soluble in 
0.5 of water and in 2 of alcohol. It is a powerful and deeply-acting escharotic, and 
should be kept in well-stoppered bottles made of hard glass. 

Potassa cum Calce, Potassa with Lime, Vienna Paste, — a grayish- white, deliquescent 
powder, consisting of equal parts of Potassa and Lime rubbed together. A milder and 
more manageable caustic than the preceding. 

Liquor Potasses, Solution of Potassa, — contains about 5 per cent, of Potassium Hy- 
drate, and is prepared by dissolving 90 parts of Potassium Bicarbonate in 400 of Dis- 
tilled Water, 40 of Lime in the same quantity of Distilled Water, boiling, mixing the 
solutions gradually, again boiling, and when cold adding Water up to 1000 parts, strain- 
ing, settling, and decanting the clear solution. Or, by dissolving 56 of Potassa in 944 of 
Distilled Water. Is a clear, colorless, odorless liquid of acrid and caustic taste, and 
strongly alkaline reaction. Dose, Y(\v-^ ss, well diluted with water. 

Potassii Aceias, Acetate of Potassium, KC 2 H 3 2 , — a white, satiny, crystalline mass, 
or a granular powder, very deliquescent, odorless, of pungent, saline taste, and a neutral 
or faintly alkaline reaction, soluble in 0.4 of water and in 2.5 of alcohol at 59 F. Dose, 

g r - V -3J- 

Potassii Carbonas, Carbonate of Potassium, (K 2 C0 3 ) 2 .3H 2 0, — a white, crystalline or 
granular powder, very deliquescent, odorless, of alkaline taste and reaction, soluble in 
I of water at 59 F., insoluble in alcohol. It is a constituent of Unguentum Sulphuris 
Alkalinurn. Dose, gr. ij-xx. 

Potassii Bicarbonas, Bicarbonate of Potassium, KHC0 3 , — colorless prisms of saline 
and alkaline taste and alkaline reaction, soluble in 3.2 of water at 59 F., decomposed by 
boiling water, almost insoluble in alcohol. Dose, gr. v-xxx. 

Potassii Chloras, Chlorate of Potassium, KC10 2 , — colorless prisms or plates, of pearly 
lustre, of cooling, saline taste and neutral reaction, soluble in 16.5 of water at 59 F. and 
in 2 of boiling water; slightly soluble in alcohol. It should not be triturated with 
readily oxidizable or combustible substances, nor combined with glycerin in the presence 
of a free acid. Dose, gr. v-xx. 

Trochisci Potassii Ch/oratis, — each troche contains gr. v of Potassium Chlorate, with 
Sugar, Tragacanth and Spirit of Lemon. Dose, j-iij, slowly dissolved in the mouth. 
• Potassii Citras, Citrate of Potassium, K 3 C 6 H 5 7 .H 2 0, — a white, granular, deliques- 
cent powder, of cooling, alkaline taste, and a neutral or faintly alkaline reaction, soluble 
in 0.6 of water at 59 F., slightly soluble in alcohol. Dose, gr. x-xxx. 

Liquor Potassii Citratis, — contains about 9 per cent, of the salt, with some free Citric 
Acid and Carbonic Acid gas. Prepared by dissolving 6 of Citric Acid and 8 of Potas- 
sium Bicarbonate each in 40 of water, filtering and adding to the filters in each case 
enough water to bring to 50 parts, then mixing the two solutions. Dose, ^ss-^j. 

Mistura Potassii Citratis, Neutral mixture, — Lemon -juice, fresh and strained 100, Bi- 
carbonate of Potassium about 10 parts or enough to neutralize the Lemon-juice. Should 
be freshly made. Dose, ^ss-^j. 

Potassii JVitras, Nitrate of Potassium, Saltpetre, Nitre, KN0 3 , — colorless, transparent 
prisms of a crystalline powder, of pungent, cooling and saline taste and neutral reaction ; 
soluble in 4 of water at 59 F. and in 0.4 of boiling water; almost insoluble in alcohol. 
Is a constituent of Argenti Nitras Dilutus. Dose, gr. v-xx, well diluted. 

Charta Potassii Nitratis, Nitrate of Potassium Paper, — is unsized paper immersed in 
a solution of 20 parts of the salt in 80 of distilled water, and dried. Used for inhalation, 
the fumes from the burning paper being inhaled in asthma. 

Potassii Sulphas, Sulphate of Potassium, K 2 S0 4 , — colorless, hard, rhombic prisms, of 
sharp, saline and bitter taste and neutral reaction, soluble in 9 of water at 59 F., and in 
4 of boiling water, insoluble in alcohol. Dose, gr. xx- t ^ss, well diluted. 

Potassii Tartras, Tartrate of Potassium (K 2 C 4 H 4 6 ). 2 H 2 0,— small, transparent crystals, 



POTASSIUM. 33I 

or a white powder, somewhat deliquescent, of saline, bitter taste, and neutral reaction, 
soluble in 0.7 of water, almost insoluble in alcohol. Dose, gr. xx-^ss. 

Potassii Bitartras, Bitirtrate of Potassium, Acid Tartrate of Potash, Creamor Tartar, 
Cream of Tartar, KHC 4 H 4 6 , — colorless rhombic crystals, or a white, gritty powder, of 
acidulous taste and acid reaction; soluble in 210 of water at 59 F., and in 15 of boiling 
water, very slightly soluble in alcohol. Is a constituent of Puivis Jalapas Compositus. 
Dose,gr. xx-^ss. 

Potassii et Sodii Tartras, Tartrate of Potassium and Sodium, Rochelle Salt, — 
KNaC 4 H 4 6 .4.H 2 0, — colorless, rhombic crystals, or a white powder, of cooling and 
slightly saline and bitter taste, and neutral reaction ; soluble in 2.5 of water at 59 F., 
very soluble in boiling water, almost insoluble in alcohol. Is a constituent of the follow- 
ing preparation. Dose, % ss-j. 

Puivis Effervescens Compositus, Compound Effervescing Powder, Seidlitz Powder, — 
each has of the preceding salt 120 grains, of Sodium Bicarbonate 40 grains, mixed in 
one paper; and of Tartaric Acid 35 grains in another paper. Dose, I or 2 pair, dissolved 
separately in water and the solutions poured together. 

Potassii Silicas, Silicate of Potassium, Soluble Glass, K 2 Si0 3 (Unofficial), — is used 
in solution of a syrupy consistence for the preparation of immovable dressings for frac- 
tured limbs, etc. (See under Silicates.) 

[The Arsenite of Potassium is described under Arsenic, page 119; — the Bromide 
under BROMUM,page 136; — the Bichromate under AciDUM Chromicum, page 63; — 
the Iodide under Iodum, page 257 ; — the Cyanide and Ferrocyanide under AciDUM 
Hydrocyanicum, page 68 ; — the Hypophosphite under Phosphorus, page 312, — the 
Permanganate under Manganum, page 281 ; — the Sulphite under Acidum Sulphu- 
rosum, page 74 ; — the Nitrite under Amyl Nitris, page 99 ; — and Sulphurated 
Potassa under Sulphur.] 

Physiological Action. 

Caustic Potash, like other caustic alkalies, destroys the tissues by 
combining with their water, dissolving the albumen and saponifying the 
fats, and converting the tissue to which it is applied into a moist, gray 
slough, with considerable surrounding inflammation. Internally ifactsas 
a powerful corrosive poison, destroying the mucous membrane of the parts 
with which it comes in contact, and giving rise to intense pain, diarrhoea, 
convulsions and delirium. Unless speedily rejected or neutralized it 
causes death from inflammation of the larynx, the gastro-intestinal lesions, 
or after some time from stricture of the oesophagus. Liquor Potass^e, 
containing over 5 per cent, of the pure Potash, possesses in a degree the 
same caustic properties, and should never be administered undiluted. It 
neutralizes the acids in the stomach, and in the blood exists chiefly as the 
Carbonate, being eliminated with the urine, which it renders alkaline. If 
its use be continued too long it impairs the blood, and renders the subject 
anaemic. 

Potassium Salts in large doses are cardiac poisons, muscular para- 
lyzers, poisonous to protoplasms, especially nerve-tissue, and destructive to 
the ozonizing functions of the blood. They increase the saliva, promote 
oxidation and stimulate retrograde metamorphosis ; and are therefore 
waste-producers. In small doses on an empty stomach they promote the 
formation of acid gastric juice by favoring the outward osmosis of its con- 
stituents from the blood ; in larger doses they act chemically on the 
stomach contents, neutralizing its free acids, and disordering digestion. 
The Bicarbonate, given on an empty stomach, enters the blood un- 



33,2 POTASSIUM. 

changed, meets the neutral phosphate of sodium and is decomposed, acid 

phosphate of sodium being formed, which renders the urine more acid. On 

a full stomach it is decomposed by the acids of the gastric juice, increases 

the alkalinity of the blood and makes the urine less acid. The Salts of 

Potassium with Vegetable Acids (Acetate, Citrate, Tartrate, etc.) 

enter the blood in their own form, are there decomposed, forming free 

C0 2 , and are converted into alkaline carbonates, in which form they are 

eliminated, alkalinizing the blood and the urine. They are diuretics also, 

increasing the urinary water and solids, but decreasing the uric acid by 

causing increased oxidation. The Mineral Salts (Nitrate, Chlorate, 

etc.) are not decomposed in the blood, but are eliminated in their own 

form, the Nitrate being a most active diuretic, the Chlorate irritating the 

kidneys, depressing the heart, causing albuminuria, and impairing the 

ozonizing function of the blood. In large doses these salts decompose 

the red blood-corpuscles and paralyze the motor ganglia of the heart. 

The Chlorate does not part with its oxygen in the system, as generally 

believed. The Sulphate is chiefly purgative in its action, but acts 

harshly, and in overdoses has caused death. 

[The action of the remaining Potassium salts is described under the 

titles of their acid and other constituents, to which their effects are chiefly 

referable.] 

Antagonists and Incompatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, 
lemon-juice; — then demulcent drinks and oils to protect the mucous membrane, and the 
usual measures to support vitality. The alkalies and their carbonates are incompatible 
with the acids and also with metallic salts, and the caustic alkalies decompose most of the 
alkaloids. 

Therapeutics. 

Caustic Potash is used locally to destroy morbid or cicatricial tissue, 
to cauterize the wounds resulting from bites of animals or stings of insects, 
to form issues or to open deep-seated abscesses, and to destroy chancres, 
malignant pustules, naevi, warts, etc. Its action is deep and severe, and 
it is best employed in the form of Potassa cum Calce, which is far more 
manageable. 

Liquor Potass^e is used internally as a free alkali to neutralize excess 
of acid in the stomach, blood and secretions, as an antilithic in the uric 
acid diathesis, also for acne, boils, and obesity. Locally it is employed 
to soften the nail in in-growing toe-nail, and diluted to relieve pruritus 
and remove scales in various skin diseases. In small doses with a vegetable 
bitter tonic before meals it acts well in atonic dyspepsia, increasing the 
flow of the gastric juice by direct stimulation of the gastric mucous mem- 
brane. If given after meals in acid dyspepsia large doses are necessary 
for temporary alleviation by neutralizing the food acids. These remarks 
concerning acidity and dyspepsia apply equally well to the Bicarbonate, 



potassium. 333 

which is used for the same purpose, and while possessing all the virtues of 
the potassium salts, is without any corrosive or irritant action. It is also 
useful in simple gastralgia or cardialgia; and in cystitis, gonorrhoea, etc., 
where there is acid urine, it renders the urine less irritating and soothes 
the inflamed surfaces. Acute and chronic rheumatism and rheumatoid 
arthritis are much benefited by an alkaline treatment in patients of suffi- 
cient bodily vigor to stand its lowering effects. The Bicarbonate is also 
used to alkalinize the blood and secretions in lithaemia, jaundice, many 
cutaneous eruptions, and in diabetes ; also locally as a lotion for fetid 
perspiration of the feet and axillae, acne and acute eczema. The Car- 
bonate is diuretic, antacid and antilithic, but is seldom used internally, 
being too irritant, and the Bicarbonate having all its virtues without its 
objectionable qualities. Locally a solution (3j to the g) is said to be 
effectual as a remedy for pruritus vulvae, and one of half the above strength 
is used in freckles, sunburn and tan of the epidermis, in moist eczema and 
the itching of urticaria. 

The Acetate, Citrate and Tartrate are good purgatives in doses of 
^ij to giv, and in smaller doses are much employed as alkalinizers of the 
blood and urine, diuretics, etc. Of these vegetable potassium salts the 
Acetate is the most certain diuretic, the Bitartrate is the most active ca- 
thartic, while the Citrate is the most reliable diaphoretic and the best 
agent to use to alkalinize the urine for any length of time, it having the 
least injurious effect on the blood or on the digestion. In lithaemia these 
salts are given to promote oxidation, and by keeping the urine alkaline 
they may reduce small calculi of the uric acid variety. In acute rheuma- 
tism and fevers they act as antacids in the blood, as febrifuges by promot- 
ing diaphoresis, and as sedatives to the general nervous system. As an 
agreeable laxative no preparation surpasses the Bitartrate in 2 to 4 drachm 
doses made into a paste with orange marmalade or any other conserve. 
It is also used in Infusion of Juniper as a diuretic in general cardiac dropsy, 
and without the Juniper in acute desquamative nephritis. 

Potassium Chlorate is much employed locally in solution (gss to the 
j§) as a deodorizer and detergent wash in inflamed, ulcerated and aphthous 
conditions of the mouth. On unhealthy mucous membranes generally it 
exercises an alterative action for the better, but if too long used it will 
keep up a state of chronic irritation. In mercurial salivation it is of great 
benefit, and in dilute solution (gr. x to the g) it is an efficient application 
to unhealthy sores and ulcers, as a wash for foul sinuses or cavities, and as 
an injection in chronic affections of the bladder. The powdered salt may 
be applied to aphthae, and dusted over epithelioma will alter the action, 
diminish the pain, check the growth and promote cicatrization. Inter- 
nally this salt has been administered in the mistaken idea that it parts 
with its oxygen in the system, but it is now shown that it is excreted un- 



334 prinos. 

changed. Setting up congestion and irritation of the kidneys it is highly 
dangerous in large doses or if used for any length of time, but is constantly 
administered in diphtheria, chronic bronchitis, purpura, hematuria, ova- 
rian tumor, pseudo-membranous laryngitis, scarlatina, typhoid fever, 
chronic cystitis, etc. When used internally it should be given in small 
doses (gr. xx in 24 hours for an infant, gr. xxx in 24 hours for a child of 
2 to 4 years, and 3iss for an adult in the same time), and the action of 
the heart and the kidneys should be carefully watched. It should never 
be prescribed with the Iodide of Potassium lest the poisonous Iodate be 
formed, nor with the Syrup of the Iodide of Iron, lest it liberate the 
Iodine, and cause severe gastritis. Strong acids and acid sulphates de- 
compose it, and it forms explosive compounds with easily oxidizable sub- 
stances as Sugar, Sulphur, Tannin, Sodium or Potassium Hypophosphites, 
Catechu, Glycerin, etc. 

For the combination of the Chlorate of Potassium with the Tincture of 
the Chloride of Iron, as a gargle, see ante, page 178, under Chlorum. 

Potassium Nitrate has been much employed as a refrigerant diapho- 
retic and diuretic in febrile and inflammatory affections, especially in 
inflammation of the trachea and bronchi, pneumonia and rheumatism, but 
its action is uncertain and it is now giving place in these disorders to more 
efficient agents. The fumes of burning nitre paper (Charta Potassii Ni- 
tratis) are a useful inhalation in some forms of spasmodic asthma. 

Potassium Sulphate is used in teaspoonful doses in water as an hepatic 
stimulant and a mild cathartic, increasing the secretions of the intestinal 
glandular apparatus. Its action is sometimes harsh, and death has resulted 
from overdoses. 

The Tartrate of Potassium and Sodium, or Rochelle Salt, is the 
chief aperient agent in Seidlitz Powders. In doses of gss-j it is a gentle 
and cooling laxative, and in drachm doses frequently repeated it is used 
to render the urine alkaline, and as an antilithic. 

[The uses of. the other Potassium Salts are described as noted on page 

33<>] 

PRINOS, Black Alder, — is the bark of Prinos verticillatus , or Win- 
ter-berry, a shrub of the nat. ord. Aquifoliacese, indigenous in Canada and 
the U. S., having small, white flowers, and a globose, six-seeded, bright- 
red berry, which grows in clusters and is persistent all winter. The bark 
occurs in thin, slender fragments, of a brownish-ash color externally, and 
a pale-green or yellow internally; taste bitter and slightly astringent. It 
contains an amorphous, yellow and bitter principle, also tannin, sugar, 
starch, wax, resin, etc. There are no official preparations, but the bark 
may be given in substance in doses of 35s, or a decoction (gij in Oiij 
boiled to a quart) in doses of lj-ij. 



PRUNUM — PRUNUS VIRGINIANA. 335 

Black Alder is astringent and tonic, and has been used in intermittent 
fever, diarrhoea, and chronic cutaneous diseases. In the latter class of 
disorders it may be applied locally. 



PRUNUM, Prune, — is the fruit of Prunus domestica, the Plum 
tree (nat. ord. Rosacea^), indigenous to Western Asia, but cultivated in 
most countries of temperate climate. The dried fruit (Prune) is oblong, 
shrivelled, of blackish-blue color, having an almond-shaped seed. Prunes 
contain sugar, pectin, albumen, malic acid and salts. They are a constitu- 
ent of Confectio Sennae. 

Prunes are laxative and nutritious, and are freely used as a food and 
sweetmeat, but in excess may give rise to flatulent colic from the indiges- 
tibility of their skins. Stewed prunes is an excellent dish for constipation 
in children, and may be made more effective by the addition of a little 
Senna. 



PRUNUS VIRGINIANA, Wild Cherry,— is the bark of 
Prunus serotina, or Wild Cherry, a large forest tree of the nat. ord. 
Rosaceae, growing in Canada and the U. S. The bark should be col- 
lected in autumn from the large branches only, and comes in curved 
pieces y 1 ^ inch or more thick, of greenish or yellowish-brown color exter- 
nally, and astringent, aromatic and bitter taste. On maceration in water 
it develops a distinct odor of bitter almonds. It contains tannin, gallic 
acid, resin, starch, etc., also Amygdalin and Emulsin, which by their 
mutual reaction in the presence of water, produce Hydrocyanic Acid and 
a Volatile Oil resembling that of Bitter Almond. [See ante, Amygdala, 
page 98, and Acidum Hydrocyanicum, page 68.] Dose of the powdered 
bark, 3ss-j. 

Preparations. 

Extractum Pruni Virginiana Fluidum, — Dose, gss-j. 

Infusum Pruni Virginians, — 4 per cent. Dose, t ^ss-ij. Should be made with 
cold water. 

Syrupm Pruni Virginiancc, — 1 2 percent. Dose, 3J-iv. 

Physiological Action. 
Wild Cherry is an "aromatic bitter tonic, increases appetite, aiding 
digestion, and thus promoting constructive metamorphosis. The presence 
of a volatile oil gives it a local stimulating action on the alimentary 
canal in common with Serpentaria, Cascarilla and other members of the 
same class. Hydrocyanic Acid being yielded by it in the presence of 
cold water, results in imparting a sedative action to its preparations, calm- 
ing irritation and diminishing nervous excitability. Very large doses 
reduce the action of the heart. 



336 PULSATILLA. 

Therapeutics. 
The preparations of Wild Cherry are used in catarrhal conditions of 
the bronchial mucous membrane, in the hectic of phthisis and scrofula, 
palpitation of the heart, and debilitated stomach, a collection of symp- 
toms often observed in consumptive subjects, to whom it is a very useful 
palliative. Cough is supposed to be especially amenable to its influence, 
and hence it has become a matter of daily routine to prescribe the syrup 
as an ingredient of cough-mixtures. The infusion is an excellent stom- 
achic tonic, and may be administered with great benefit in dyspepsia and 
in convalescence from acute disease. 



PULSATILLA, Pasque-flower, Meadow Anemone, — is the 

herb, collected soon after flowering, of Anemone Pulsatilla and Anemone 
pratensis (Pulsatilla nigricans), and of Anemone patens (Pulsatilla Nuttal- 
liana), small herbal plants of the same natural order (Ranunculacese) to 
which Aconite belongs. The first-named species inhabit Europe and 
Siberia, and have large, purple flowers ; the last-named is an inhabitant 
of the United States, and sometimes has whitish-colored flowers ; all are 
inodorous and very acrid. Pulsatilla contains a very acrid yellow oil, 
which in the presence of water is gradually changed to Anemonin, C 15 H ]2 6 , 
a volatile, crystallizable, camphoraceous principle, soluble in chloroform, 
nearly insoluble in ether or water ; and Anemonic Acid, C 15 H u 7 , a 
white, crystalline, tasteless powder, which may be formed also by the 
action of alkalies on Anemonin. 

There are no official preparations, but a tincture may be made according to the phar- 
macopoeial directions for Tincturse Herbarum Recentium (1 in 2), of which the dose is 
Tr^yL-rr^x. 'The imported homoeopathic tincture has equal parts of the expressed juice 
and alcohol, and is generally a very good preparation. 

Anemoninum, Anemonin (Unofficial), — the active principle. Dose, gr. T ^ — ij in pill. 

Physiological Action. 
Pulsatilla is a local irritant, the fresh juice producing numbness and 
tingling in the part to which it is applied, and may excite violent inflam- 
mation of the skin with vesicular or pustular eruption, and if swallowed 
severe irritation of the gastro-intestinal mucous membrane. On the 
tongue it produces symptoms like those from Acoriite, viz. — tingling and 
burning, followed by numbness. Internally it lowers the heart and 
arterial tension, reduces respiration and temperature, dilates the pupils, 
produces nausea and vomiting, diaphoresis and diuresis, and paralyzes the 
motion and sensibility. Stupor, coma and convulsions may be caused by 
a toxic dose. Most of these effects have been observed on rabbits. The 
active principle (Anemonin) is volatile, hence the herb must be fresh to 
be suitable for medicinal use. 



PYRETHRUM. 337 

Antagonists and Incompatibles. 

Alcohol, Opium and Digitalis are the physiological antagonists. Incompatibles are 
the caustic alkalies, Tannic Acid and the metallic salts. 

Therapeutics. 

Pulsatilla is a very efficient remedy if a fresh preparation be employed. 
It was highly praised by Storck for amenorrhcea, corneal opacities, cata- 
ract, paralyses, rheumatism, old ulcers, constitutional syphilis and scaly 
skin diseases. On the generative organs it seems to have a specific action, 
and is an excellent remedy in functional amenorrhcea, dysmenorrhcea, 
menstrual suppression from fright or .chill, leucorrhoeal discharges with 
back-pains and nervous depression. Epididymitis and orchitis are often 
controlled and even dissipated by very small doses (^lyV'/i) everv 2 
hours. It quickly relieves dyspepsia or subacute gastritis, with white- 
coated tongue, no taste or a greasy sensation in the palate, nausea, flatu- 
lence, heartburn, etc. Many acute inflammations of mucous surfaces 
with mucous or muco-purulent discharges, as coryza, otitis (externa and 
interna), rhinitis, bronchitis, conjunctivitis, etc., are greatly benefited by 
5 to io-drop doses every 4 hours and locally gj-ij of tincture to %\v 
water as a lotion. A similar use of this remedy has proven of great bene- 
fit in many cutaneous affections, especially eczematous eruptions, syphil- 
ides, and ulcers of indolent character. It is also said to be efficiently 
employed in acute cerebral and spinal meningitis, subacute rheumatism 
of the small joints, rheumatic gout, chronic vesical and nasal catarrhs, 
gastro-enteric symptoms of remittent fever and measles, ophthalmia 
neonatorum, strumous ophthalmia with profuse but bland discharge, 
acute and subacute inflammations of the middle ear, and in left-sided 
clavus, hemicrania and infra-mammary pain. An extract of the root 
has proved efficient against tapeworm. 

Coughs which are loose by day but dry and tickling on lying down at 
night are greatly benefited by Pulsatilla, and Anemonin in doses of gr. 
y 2 -) has been found extremely useful in whooping-cough and other coughs 
of irritative character. 



PYRETHRUM, Pellitory,— is the root of Anacyclus Pyrethrum, 
a plant of the nat. ord. Composite, native of Northern Africa, but culti- 
vated in Europe. The root is 2 to 4 inches long, }i inch thick, annu- 
late above, wrinkled below, externally a dark grayish-brown, internally 
brownish-white; the bark thick, containing two circles of resin-cells sur- 
rounding slender wood-bundles and medullary rays ; inodorous, pungent 
and acrid. It contains an alkaloid, Pyrethrine, also inulin, tannin, mucil- 
age, etc., with a brown Resin and two fixed oils. Dose, as a mastica- 
tory, 3ss-j. 
22 



338 QUASSIA. 

Pyrethrum Roseum, Persian Pellitory (Unofficial), — is indigenous to 
Western Asia, and resembles Chamomile in appearance. The flower- 
heads are used in powder to kill insects, 4 grains killing a fly in a vial in 
2 or 3 minutes. 

Preparation. 

Tinctura Pyrethri, — 20 per cent. Not used internally. 

Physiological Action. 

Pellitory is an irritant sialogogue. When chewed it causes a pricking 
sensation in the tongue and fauces, with heat, acridity, pungency and a 
copious flow of saliva and buccal mucus. Large doses may cause bloody 
diarrhoea, tetanoid spasms, accelerated pulse, and profound stupor. Ap- 
plied to the skin it acts as a rubefacient, the powder inhaled as a sternuta- 
tory. It stimulates the local nerves and vessels of the mouth and salivary 
glands by direct irritant action, but soon depresses the nerves and blunts 
their sensibility. 

Therapeutics. 

Pellitory is chewed as a masticatory and sialogogue in paralysis of the 
tongue, rheumatic and neuralgic affections of the head and face, and pain 
from carious teeth. Its powder has been recommended as a sternutatory 
in chronic catarrh of the frontal sinuses. As a gargle or lotion (giij to 
Oj) it is very useful for relaxed uvula and as a mouth-wash. When used 
for toothache a few drops of the tincture should be inserted into the 
cavity on cotton or wool. Used as a sialogogue it is an efficient agent 
to secure the rapid elimination of Iodine from the system in chronic 
poisoning thereby. 

QUASSIA, — is the wood of Picrcena excelsa, a large tree of the nat. 
ord. Simarubaceae, indigenous to Jamaica and other West Indian islands. 
Surinam Quassia, used in Europe, is the wood of Quassia amara. Both 
varieties, as met with in the shops, are in the form of chips or raspings, 
of a yellowish-white color, inodorous but of intensely bitter taste. The 
wood is also turned into cups, which are sold under the name of quassia- 
or bitter-cups. It contains a bitter principle, Quassin, C 31 H 42 9 , which is 
crystalline, soluble in hot alcohol and in chloroform, slowly in cold water, 
faster in alkaline or acidulated water. Dose of the powdered wood, gr. 
xx-xxx. 

Preparations. 

Extractum Quassia, — aqueous. Dose, gr. j-iij. 

Extractum Quassia Fluidum, — Dose, gss-j. 

Tinctura Quassice, — strength 10 per cent. Dose, V\v— gj. 

Infusum Quassia (Unofficial), — made with cold water % x, Quassia chips gj, macerated 
for y z hour and strained. Or water poured into a quassia-cup and left standing will give 
a good infusion. Dose, ^ j-iij. 



quebracho. 339 

Physiological Action. 
Quassia is a simple bitter, having no flavor, but is intensely bitter and 
less agreeable than either Gentian or Chiretta. It is fatal to flies and fish, 
and makes an excellent anthelmintic enema against the thread-worm. A 
concentrated preparation is poisonous to rabbits and dogs, and has pro- 
duced very alarming narcotic symptoms in a four-year old child. As usually 
administered its action is that of a bitter stomachic tonic, as described 
under Calumba (see ante, page 149). 

Therapeutics. 
The preparations of Quassia contain no tannin and hence may be pre- 
scribed with salts of Iron. It is chiefly employed in atonic dyspepsia with 
pain after eating, and vomiting or regurgitation of food, also in atonic 
diarrhoea depending on indigestion or an irritable condition of the intesti- 
nal mucous membrane. It is useful in convalescence to promote the 
appetite and digestion, and with Sodium Bicarbonate in gastric vertigo. 
As an enema the strong infusion is an effective remedy for ascarides of the 
rectum. It has been used as a feeble antiperiodic, and in hysteria its 
repulsiveness is an aid to its medicinal action. 



QUEBRACHO (Unofficial),— is the bark of Aspidosperma Que- 
bracho, a large evergreen tree of the nat. ord. Apocynaceae, growing in 
Chili and the Argentine Republic. The name is one given in S. America 
to any very hard wood {quebrar hacho, to break the axe), and the par- 
ticular tree above named is known as Quebracho bianco, from the white 
color of its wood. It contains several alkaloids, no one of which repre- 
sents the action of the bark itself ; the most important being Aspidosper- 
mine, C 22 H 30 N 2 O 2 , and Quebrachine, C 21 H 26 N 2 3 . Several false Quebrachos 
are found on the market, that most frequently seen being the bark of 
Loxopterygium Lorentzii, or Quebracho Colorado, an Argentine tree of the 
order Terebinthaceae. 

Preparations. 

Tinctura Quebracho (Unofficial), — 20 per cent. Dose ^j-^fss. 

Extractum Quebracho Fluidum (Unofficial), — Dose, TT^v-^j. 

Vinum Quebracho (Unofficial), — Quebracho 1, Alcohol 2, White Wine 16 parts. Dose, 

Extractum Quebracho (Unofficial), — Dose, gr. ij-viij. 

Physiological Action. 

Quebracho is a bitter tonic of disagreeable taste, promoting appetite 
and increasing digestion. It lowers the action of the heart, reduces arte- 
rial tension, and slows respiration, also decreasing the sensation of need 
of air after active exercise. In large doses it causes severe salivation, 



340 QUERCUS ALBA. 

nausea, vomiting, vertigo and headache. In animals it paralyzes the motor 
nervous system and lowers the reflexes, producing great dyspnoea and 
finally death, apparently from asphyxia. 

Aspidospermine is actively poisonous to the respiratory apparatus and 
circulation in both cold- and warm-blooded animals, in the former the 
respiration being chiefly affected, in the latter the motor ganglia of the 
heart. Lowered temperature, dyspnoea, stupor and convulsions occur 
before death. 

Therapeutics. 

Quebracho has long been used in Chili as an antiperiodic, a stomachic 
tonic, and a remedy for dyspnoea In the latter condition it is reported 
to be remarkably palliative, especially when due to emphysema, uraemic 
and spasmodic asthma, spasmodic cough and chronic bronchitis. It is 
not efficient in dyspnoea from organic diseases of the heart, nor in that of 
aged subjects of atheroma. 

Aspidospermine has been used as an antipyretic, also in cardiac neu- 
roses and in asthma. Its salts are freely soluble in water, but the alkaloid 
itself is only soluble in oils and fats, 6 to 8 parts being readily incorpo- 
rated with ioo of cod-liver oil by the aid of heat. Its average dose is 

g*. Hi- 



QUERCUS ALBA, White Oak,— is the bark of Quercus alba, 
the White-oak tree (nat. ord. Cupuliferae), and occurs in nearly flat pieces 
deprived of the corky layer, of pale-brown color, tan-like odor, and 
strongly astringent taste ; or as a coarse, fibrous powder, which does not 
tinge the saliva yellow. It contains a variety of Tannin named Querci- 
tannic Acid, C 28 H 24 12 , also Pectin and a bitter principle named Quercin, 
but no Gallic Acid. There are no official preparations, but a decoction 
(gj ad Oj) may be used in doses of ^ss-j. 

Quercus Tin ctoria, Black Oak Bark, — was formerly official. It contains a coloring 
principle Quercitrin, which stains the saliva yellow when the bark is chewed, also Quer- 
citannic Acid, etc. 

Quercus Lusitanica is the source of Galls (see ante, Galla, page 229). 

Physiological Action and Therapeutics. 
Oak-bark is astringent and tonic, but is seldom used internally. Its 
action and uses are those of Tannic Acid (see ante, page 75). The decoc- 
tion is much used in country practice as a cheap astringent application for 
injection in leucorrhcea, prolapsus ani, hemorrhoids, etc., and as a gargle 
in faucial inflammation and prolapsed uvula. It has also been used as an 
injection into dropsical cysts, and as a lotion for flabby ulcers and suppu- 
rating wounds. The powdered bark as a poultice has proved an excellent 



QUILLAIA RESINA. 34 1 

application in gangrene, and in finely pulverized state it is a useful ingre- 
dient of tooth-powders. A concentrated fluid extract is used in the Hea- 
ton-Warren operation for the radical cure of hernia, by injection into the 
tissues around the margin of the ring, with the object of exciting inflam- 
mation and occlusion of the opening. 



QUILLAIA, Soap-Bark, — is the inner bark of Quillaia Saponaria, 
a tree of the nat. ord. Rosacea^, indigenous to Peru and Chili. It occurs 
in large, flat pieces, about -J inch thick, of a brownish-white color exter- 
nally, very acrid and sternutatory, but inodorous. It contains Calcium 
Sulphate crystals, starch, and the glucoside, Saponin, C 3 2H 54 18 , a white, 
amorphous, sternutatory powder, soluble in water and in dilute alcohol. 
There are no official preparations, but a tincture may be prepared by ex- 
hausting one part of the bark with sufficient dilute alcohol to make 5 parts 
of tincture. 

Physiological Action and Therapeutics. 

Quillaia in powder is sternutatory and causes the water in which it is 
macerated to froth, making emulsions of oils, and being used instead of 
soap for washing purposes in various affections of the skin, and to stimu- 
late the growth of the hair in alopecia. Its properties are due to the glu- 
coside Saponin, which is found also in Senega and in a number of other 
plants, and is a violent irritant of the respiratory passages, a local anaes- 
thetic, an antipyretic, a powerful paralyzant of the heart and respiration, 
and a poison to the voluntary muscles. It has not been made use of in 
practical medicine. 

A decoction of the bark (5 to 200) has been employed in doses of ^j-ij 
according to age, as a substitute for Senega in the treatment of diseases of 
the respiratory organs where a pleasant expectorant is indicated. Its ex- 
pectorant properties are well established, and children take it readily. It 
does not provoke diarrhoea or vomiting, and has a sweetish, agreeable 
taste. 



RESINA, Resin, Rosin, Colophony, C 44 H 62 4 , — is the residue 
left after distilling off the volatile oil from Turpentine. It is a transparent, 
amber-colored substance, of sp. gr. 1.070 to 1.080, hard and brittle, with 
a glossy and shallow conchoidal fracture, and a faintly terebinthinate odor 
and taste, soluble in alcohol, ether, fixed or volatile oils, and in its own 
weight of oil of turpentine. Chemically it is considered as the Anhydride 
of Abietic Acid, C 44 H 64 3 , into which acid it is converted by agitation with 
warm diluted alcohol. Silvic, Pinic, and Palmaric Acids are decomposi- 
tion products, not constituents of the resin as formerly taught. Other 
official resins are Resina Copaiba, Resina Jalap^e, Resina Podophylli 



34 2 RESORCINUM. 

and Resina Scammonii, which are severally described under the titles of 
the plants forming their respective sources. 

Preparations. 

Ceralum Resina, Resin Cerate, Basilicon Ointment, — consists of Resin 35, Yellow Wax 
15, and Lard 50 parts. It forms 65 per cent, of Turpentine Liniment, and is a constitu- 
ent of Savine Cerate. 

Emplastrum Resina, Resin Plaster, Adhesive Plaster, — consists of Resin 14, Lead 
Plaster 80, Yellow Wax 6 parts. Is the common adhesive plaster of surgery, and an 
ingredient of the official Arnica, Belladonna and Capsicum Plasters. 

Resin itself is an ingredient of Mercurial Plaster, Cantharides Cerate, and Cerate of 
the Extract of Cantharides. 



Physiologigal Action and Therapeutics. 
Resin gives consistence and adhesiveness to plasters and cerates, and 
generally acts as a mild local stimulant, but the writer has seen persons 
with so susceptible a skin that the ordinary adhesive plaster would pro- 
duce on them a high degree of cutaneous irritation. It is never employed 
internally, but in chronic bronchial catarrh the fumes from boiling resin 
are inhaled with considerable advantage. Resin Cerate is one of the 
most commonly used applications to promote the healing of indolent 
ulcers, blistered surfaces, burns, scalds, chilblains, etc. 

RESORCINUM, Resorcin, Meta-di -hydroxy -benzene, C 6 H 4 - 
(HO) 2 (Unofficial), — is a diatomic phenol, isometric with Pyrocatechin 
and Hydroquinone (see ante, page 184), obtained by fusing certain resins 
with a caustic alkali, but best prepared by fusing Potassium Benzol-disul- 
phonate with Caustic Potassa, the salt being decomposed into Potassium 
Sulphite and Resorcin. It crystallizes in colorless, rhombic prisms or 
plates of neutral reaction, odorless, and of sweetish, acrid taste, soluble 
in \% of water, also in alcohol, ether, etc. Dose, gr. v-xv ; — as an anti- 
pyretic 3J, not repeated for several hours, or gr. v every 2 hours. 

Physiological Action. 
Resorcin is closely allied to Carbolic Acid, but possesses the advantage 
over the latter in that it is odorless, more soluble and almost non-irritant. 
It is equally powerful as an antiseptic and antiferment, arresting decom- 
position and destroying low organisms. Injected beneath the integu- 
ment in solution it produces very little irritation, and never causes 
inflammation or abscess. Vesication results from its application to the 
mucous membrane. Internally a 30- to 60-grain dose causes a sense of 
heat, discomfort and oppression, followed by profuse perspiration and 
languor; if fever be present the temperature of the body is lowered 
several degrees, but rises again after a rigor in from 2 to 4 hours. Larger 
doses (150 grains) have produced deafness, dizziness, salivation, confused 



RHEUM. 343 

vision, vertigo, unconsciousness, general clonic convulsions, and tetanic 
rigidity of the muscles of the neck, with no decline of temperature in 
feverless subjects. Toxic doses (gr. xv to each ^xxxv of weight) cause 
in animals trembling succeeded by epileptiform convulsions, which 
increase in severity and then decline, the respiration is quickened and 
enfeebled, the heart's action becomes rapid, weak, and irregular, and 
death results from paralysis of respiration, the drug paralyzing the motor 
tracts in the spinal cord, but not affecting the general sensibility. It is 
eliminated chiefly by the urine, which it colors a bluish-violet hue and 
with great rapidity, about one hour serving for its excretion. The best 
test of its presence is the solution of the Perchloride of iron, which 
produces with it a dark-violet, almost black color. 



Antagonists. 

Atropine and other cardiac and respiratory stimulants, cerebral excitants and agents 
hich raise the arterial tension are physiologically antagonistic. 



Therapeutics. 
Resorcin is employed as an antipyretic and antiseptic, being preferred 
to Carbolic Acid for internal and subcutaneous use. A 3 per cent, solu- 
tion gives good results in stomach complaints, as gastralgia, gastric catarrh, 
gastric ulcer, fermentative indigestion, etc. It has given great satisfac- 
tion to some observers in intermittent fevers and malarial diseases gener- 
ally, while others have been much disappointed with its action therein. 
As an antipyretic it has been used in erysipelas, puerperal fever, septicae- 
mia and diphtheria, and in the latter disease it has been employed locally 
in crystals with decided benefit. A 2 per cent, solution has given great 
satisfaction as a local antiseptic application to wounds, parasitic skin 
diseases, cystitis, gonorrhoea, anthrax, and syphilitic sores of unhealthy 
character. As spray a similar solution is well applied to catarrhal or ulcer- 
ative affections of the respiratory passages. As a caustic it maybe applied 
in undiluted form to chancres, papillomata, carbuncles, etc. A saturated 
ethereal solution is a good application where the caustic action of the 
drug is required. 



RHEUM, Rhubarb, — is the root of Rheum officinale, a perennial 
plant of the nat. ord. Polygonaceae, a native of Thibet, and of other 
undetermined species of Rheum, many of which are cultivated in Europe 
and America, their leaf-stalks being used as a fruit. The commonly 
accepted medicinal Rhubarb is the Chinese variety, and is imported from 
Shanghai and Canton. It occurs in cylindrical or conical segments, 
sometimes flattened and bored with a hole, of a dirty-brown-yellow color 
externally, internally marbled with fine waving lines, of peculiar odor, 



344 RHEUM. 

gritty between the teeth, and of a bitter astringent taste. It imparts its 
virtues to water and alcohol, and contains several substances of greater 
or less activity, the least important being Phceoretin, C 32 H 32 O u , the rhu- 
barb-resin, — Erythroretin, C 38 H 36 O u , and Chrysophan, C 27 H 30 O u , the latter 
of which is split by acids into Sugar and Chrysophanic Acid. (See ante, 
Chrysarobinum, page 178.) It also contains Rheo-tannic Acid, C 52 H 52 28 , 
Rheumic Acid, C 40 H 32 O 18 , and probably a principle which is identical 
with Cathartic Acid (see Senna), on which its purgative activity may 
depend. Dose of Rhubarb' as a stomachic, gr. j-v; as a purgative, gr. 
x-xx. 

Preparations. 

Extractum Rhei, — Dose, gr. x-xv. 

Extractum Rhei Fluidum, — Dose, ^ss-ij. 

Pilules Rhei, — composed of Rhubarb 3, Soap I ; each pill containing gr. iij of pow- 
dered Rhubarb. Dose, j-iij. 

Piiulce Rhei Compositce, — each contains of Rhubarb gr. ij, Aloes gr. \y z , Myrrh gr. j, 
Oil of Peppermint gr. -±§. Dose, ij-v. A safe and efficient laxative. 

Tinctura Rhei, — has of Rhubarb 12, Cardamom 2, with diluted Alcohol to 100 parts. 
Dose, ^j-^ss. 

Tinctura Rhei Aromatica, — has of Rhubarb 20, Cinnamon 4, Cloves 4, Nutmeg 2, 
Diluted Alcohol to 100 parts. Dose, 3 j- 3 iij. 

Tinctura Rhei Du/cis, — has of Rhubarb 8, Licorice 4, Anise 4, Cardamom 1, Diluted 
Alcohol to 100 parts. Dose, ^ss-^ij. 

Syrupus Rhei, — has of Rhubarb 90, Cinnamon 18, Potassium Carbonate 6, Sugar 600, 
Water to 1 000 parts Or, it maybe made extemporaneously thus : — Fluid Extract ^iij, 
Simple Syrup ^ xxix. Dose for an infant gj; for older children 3 ij- ^ ss. 

Syrupus Rhei Aromaticus, — has of the Aromatic Tincture 10, Syrup 90 parts. Dose, 
as the Syrup. 

Vinum Rhei, — has of Rhubarb 10, Calamus I, Stronger White Wine to 100 parts. 
Dose, g j- ^ ss. 

Pulvis Rhei Compositus, — has of Rhubarb 25, Magnesia 65, Ginger 10. Dose, a tea- 
spoonful. 

Mistura Rhei et Soda, — Sodium Bicarbonate 30, Fluid Extract of Rhubarb 30, Spirit 
of Peppermint 30, Water to 1 000 parts. Dose, spj-^ij. 

Physiological Action. 
Rhubarb is classed among the tonic-astringent and resin-bearing pur- 
gatives, which increase the secretions of the glandular appendages of the 
intestinal canal, and stimulate the muscular layer of the bowel. In small 
doses (gr. j-v) its action is that of a stomachic and intestinal astringent, 
the influence of the bitter principle and the rheo-tannic acid probably 
predominating. In larger doses (gr. xxx-lx), its cathartic action prevails, 
producing in 6 to 8 hours copious yellow, pultaceous stools, with some 
griping and considerable hepatic stimulation. After the cathartic prin- 
ciple is expelled, the astringent quality of its tannin asserts itself and 
constipation is likely to result. The yellow color of the stools is partly 
due to the rhubarb pigment and partly to excess of bile, the drug having 
marked cholagogue properties, in all probability due to its resin, Phseore- 
tin. Its pigment stains the milk, urine and sweat, the milk acquiring a 
bitter taste and purgative properties. The cathartic action of Rhubarb 



RHINACANTHUS RHUS AROMATICA. 345 

may be obtained from its application locally to ulcers, by being rubbed 
into the moist skin, or applied to the abdomen as a poultice. 

Therapeutics. 
Rhubarb is highly esteemed as a cathartic for children, from the mild- 
ness of its action, as, though occasionally producing quite severe griping, 
it never inflames the gastro-enteric mucous membrane. Its tonic and 
astringent action following its catharsis makes it a valuable agent in 
diarrhoeas due to the presence of irritating matter in the bowel, and to 
correct atonic indigestion accompanied by diarrhoea. For hemorrhoids 
with constipation its gentle action makes it peculiarly suitable, its astrin- 
gent after-effect being entirely overcome by 2 to 4 drachm doses of olive 
oil nightly. It may be combined with a mercurial or with Bicarbonate 
of Sodium, the latter being supposed to overcome its astringent action 
and to disguise its taste in some degree. In small doses the tincture is 
a very efficient stomachic tonic, improving appetite, increasing the flow 
of the gastric juice, assisting digestion, and promoting the action of the 
liver without producing any cathartic results. The preparations most in 
use for children are the Aromatic Syrup and the Mistura Rhei et Sodae. 

RHINACANTHUS (Unofficial),— the leaves and root of Rhina- 
canthus communis, a shrub of the nat. ord. Acanthaceae, indigenous to 
India and China. The root contains a quinone-like body named Rhina- 
canthin, C u H 18 4 , which forms with alkalies intensely red compounds 
which are decomposed by benzin. It is known in China as Hong-Pang- 
Chong, and is employed as a local remedy for ringworm and parasitic 
skin diseases, the leaves being bruised and mixed with lime-juice. Used 
internally a tincture of the root has some reputation as a feeble tonic and 
antiperiodic. The same preparation is applied locally in chronic eczema, 
tinea and psoriasis. 

RHUS AROMATICA, Sweet Sumach (Unofficial),— is an in- 
digenous shrub of the nat. ord. Terebinthacese, growing about 5 feet 
high, and having yellow flowers in spikes. The root-bark contains a 
volatile oil, several resins, fat, tannin, etc. A fluid extract is prepared 
from the bark of the root according to the general pharmacopceial rule, 
and may be given in doses of n^x-xxx, every 2 or 3 hours. 

Physiological Action and Therapeutics. 
Rhus Aromatica has astringent properties, and seems to possess a selec- 
tive action upon the urinary tract. Its action is not yet clearly made out. 
Therapeutically it has been used with advantage in cystitis, night-sweats, 



34-6 RHUS GLABRA RHUS TOXICODENDRON. 

hematuria, menorrhagia, diabetes insipidus, diarrhoea and dysentery. As 
a remedy for incontinence of urine in children it has attracted consider- 
able attention, having been extremely efficient in doses of n^xv of a good 
fluid extract four times daily, administered in glycerin and water, or any 
other suitable excipient. It is reported to be equally effective in hysteri- 
cal enuresis of adults, but larger doses (nrxx-xxx several times a day) are 
required. Diabetes insipidus is remarkably benefited by its continued 
use, and even in diabetes mellitus its employment has occasionally seemed 
to have been followed by curative results. 



RHUS GLABRA, Smooth Sumach,— is the fruit of Rhus 
glabra, an indigenous shrub of the nat. ord. Terebinthaceae, growing in 
rocky and barren soil to a height of 8 to 12 feet. The berries are about 
Y% inch in diameter, subglobular, densely hairy, of crimson color and 
acidulous taste, but inodorous. The leaves and bark have an astringent 
and bitter taste, and are also used medicinally. It contains tannin, 
coloring matter, potassium and calcium malates. 

Preparation. 
Extractum Rhols Glabra Fluidum, — Dose, 3J— ij. 

Physiological Action and Therapeutics. 
Sumach-berries form a useful acidulous and astringent drink or gargle 
in catarrhal pharyngitis, stomatitis, aphthae, etc. An infusion (gj to the 
pint) may be used, or the official fluid extract as a wash and dressing for 
ulcers and wounds. Internally they are useful remedies for mild catarrhal 
affections of the stomach and bowels. 



RHUS TOXICODENDRON, Poison Sumach,— is the fresh 
leaf of Rhus Toxicodendron, the poison Oak, and of Rhus radicans, the 
Poison Ivy, shrubs of the nat. ord. Terebinthacese, indigenous to Canada 
and the greater part of the United States east of the Rocky Mountains. 
The climbing plant (R. radicans) is not a distinct species, but a variety 
of the erect form, both when wounded exuding a poisonous, acrid, milky 
juice which turns dark on exposure. The leaves are trifoliate, on peti- 
oles 4 or 5 inches long, the lateral leaflets sessile, entire and glabrous in 
R. radicans (or variously notched, toothed or lobed, downy beneath, in 
R. Tox.), inodorous, astringent and acrid. They may be confounded 
with the leaves of the hop-tree, Ptelea trifoliata, which are quite similar 
in appearance, but all its leaflets are sessile. The poisonous principle of 
the plant is Toxicodendric Acid, which is volatile, and also exists in Rhus 
venenata or Swamp sumach, Rhus pumila, and Rhus diver siloba, the 



RHUS TOXICODENDRON. 347 

former of which is probably the most poisonous of the four species. Dose 
of the leaves is generally placed at gr. j-iv, but if old and dry they will 
generally prove to be inert. There are no official preparations. 

Preparations. 

Tinctura Rhois Toxicodendri (Unofficial), — may be prepared according to the formula 
of the Pharmacopoeia for Tincturae Herbarum Recentium (Tinctures of Fresh Herbs), one 
part of the fresh leaves to two of Alcohol. Dose, rr^x^-rriij. 

Extractum Rhois Toxicodendri, — has been used in France in large doses. It is prob- 
ably inert. 

Physiological Action. 

The effects of Rhus Toxicodendron upon the skin are familiar to all 
who have suffered from contact with poison-oak or ivy. Some persons 
are so susceptible to the poison that the exhalations from the plant will 
produce on them its characteristic action. Others are apparently insus- 
ceptible to its influence, and can with impunity rub the juice into their 
skin, or even chew its leaves. 

The action of the plant when locally applied is that of a cutaneous 
irritant, causing redness and swelling of the affected parts, with a vesicu- 
lar eruption and intolerable itching, which may spread rapidly over the 
surface of the body and extend to the mucous membranes, producing 
conjunctivitis, redness and tumefaction of the mouth and throat, thirst, 
cough, nausea and vomiting, vertigo, stupefaction, etc. Colicky pains 
are experienced in the abdomen, are worse at night and are aggravated 
by food or drink. Diarrhoea may occur, with tenesmus and bloody 
stools, also diuresis, bloody urine, or even complete retention. Fever 
with delirium is frequently present, and may be typhoid in character, or 
intermittent with profuse perspiration. Pains of rheumatoid type are ex- 
perienced throughout the body, but particularly in the joints and lumbar 
region, apparently intensified by rest and heat. The fibrous structures 
are evidently the seat of its selective action, and a sensation of numb- 
ness in the lower extremities is frequently experienced. Similar phe- 
nomena attend its internal administration, but fatal results have not fol- 
lowed in any case of poisoning recorded. The effects of the poison 
usually last from ten to fifteen days, and are then followed by desquama- 
tion of the epidermis. 

Antidotes. 
Grindelia Robusta is the best local application in cases of Rhus poisoning, but a solu- 
tion of Mercuric Chloride is also a very serviceable lotion, and Lime-water with Linseed- 
oil, solution of Plumbum Acetate, solution of Chlorinated Soda, and Alum-curd are all 
very useful. Rest, low diet and laxatives are appropriate, and Opium or strong black 
coffee to relieve the irritability of the nervous system. 

Therapeutics. 
Rhus Toxicodendron was used medicinally by Dufresnoy in France and 
by Alderson in England about the close of the eighteenth century. The 
attention of the former was attracted to it by the accidental poisoning of 



34-8 RICINI OLEUM. 

a student who was afflicted with chronic eczema, which disappeared on 
the subsidence of the Rhus symptoms. It is a favorite remedy with the 
so-called homceopathists, who ascribe to it extraordinary virtues in acute 
cutaneous affections of vesicular type, subacute and chronic rheumatism, 
vesicular erysipelas and typhoid fever. Among regular authorities it meets 
with very little favor as a remedial agent, but Dr. Phillips recommends it 
strongly in rheumatic affections of the fibrous tissues, erythema and ery- 
sipelas, eczema, herpes zoster and pemphigus. Dr. Piffard corroborates 
these opinions of its therapeutical value, and states that when rheumatic 
pain is " worse at night " prompt relief may be expected from Rhus. It 
was used by Dufresnoy in paralyses with a certain degree of success, and 
Eberle reports a case of paralysis in which it proved curative. It is ad- 
mitted by many observers to be a useful remedy in paralytic affections of 
the lower extremities depending on a rheumatic diathesis, or resulting 
from exposure to cold and wet. As an external application it is efficacious 
in sprains and other affections of ligaments and tendons, also to extensive 
but superficial burns, stings of insects, and chilblains. For these affections 
a lotion of about gss of the strong tincture to a pint of water is usually 
employed. 



RICINI OLEUM, Castor Oil, — is a fixed oil expressed from the 
seeds of Ricinus communis, a tree of the nat. ord. Euphorbiacese, indigen- 
ous to India, but extensively cultivated in the United States, where it is 
an annual plant about 5 or 6 feet high, bearing ovate seeds, smooth and 
shiny, of gray color marbled with brownish spots and stripes, three con- 
tained in a pod. The oil is an almost colorless, transparent, viscid liquid, 
of faint odor, bland or slightly acrid taste, neutral reaction, sp. gr. 0.950 
to 0.970, soluble in an equal weight of alcohol, and congealing at about 
0.4 F. It consists mainly of Ricinoleic Acid, C 18 H 34 3 , combined with 
glycerin, but palmitin, stearin, cholesterin, and probably a resin and an 
alkaloid also occur in small quantities. Dose, 3J-^j. It is contained in 
Collodium Flexile (3 per cent.) and in Linimentum Sinapis Co. (15 per 
cent.). 

Physiological Action. 
Used externally pure Castor Oil is perfectly bland. Internally admin- 
istered it is non-irritant until it reaches the duodenum, where it is decom- 
posed by the pancreatic juice, setting free the Ricinoleic Acid, which pro- 
duces purgation by a mildly irritant action on the bowel, stimulating the 
intestinal glands and muscular coat, but not the liver. It is a simple pur- 
gative, acting in four to six hours, producing one or more liquid stools 
without pain or tenesmus, and followed by a sedative effect on the intes- 
tines. The leaves are believed to possess galactagogue properties when 



ROSA CENTIFOLIA. 349 

locally applied as a poultice to the breasts. Ricinoleic Acid enters the 
blood and the tissues, and is excreted with the various secretions of the 
body, imparting its purgative qualities to the milk of the nursing mother. 

Therapeutics. 

Castor Oil is the best of simple purgatives, and is used where a free 
evacuation of the bowels is alone indicated, or when only a laxative action 
is desired, as in the constipation of typhoid fever, in pregnancy and post- 
partum conditions, (jiarrhcea from the presence of irritating matter in the 
bowels, and after operations on the abdominal or pelvic organs. It is 
often used as a purgative for children, also for the aged and infirm. In- 
fants bear a larger relative dose than adults, probably from their ability to 
digest a larger quantity of what is taken. It is employed with great benefit 
as a laxative in irritation or inflammation of the bowels, in hemorrhoids, 
inflammatory or spasmodic affections of the genito-urinary organs, ne- 
phritis or cystitis, gonorrhoea, calculi, and stricture of the urethra and 
rectum. In cases of dysentery 10 to 20 drops of Laudanum may be added 
to each dose to counteract the pain, tenesmus and exhaustion resulting 
from the frequency of the passages. If much depression exists, as shown 
by lowered arterial tension and a dry, glazed tongue, 5 drops of Turpen- 
tine should also be added. 

Castor Oil is much used in the puerperal state and greatly abused. 
There is considerable evidence in support of the charge that it induces 
hemorrhoids by congesting the rectal vessels. Its purgative action is 
milder in proportion to the purity of the sample employed. Externally, 
the pure oil is employed as a local sedative and protective, as in neutraliz- 
ing the effects of lime upon the conjunctiva. 

The leaves of the castor-oil plant are used to promote the secretion of 
milk. They may be applied to the breast in poultice, and a decoction or 
fluid extract given internally at the same time. 

Administration. 
The nauseous smell is best concealed by the Essential Oil of Bitter Almonds. Emul- 
sions are not a success. Capsules containing the requisite dose are easily obtained. In 
the absence of these the best way to administer a dose of oil is to smear the sides of a 
clean wineglass with very thick cream, then to pour in the oil, covering it with a little 
more cream. A teaspoonful of cream being then taken into the patient's mouth, he is 
directed to bolt the dose at one gulp. Some prefer it floated on orange-juice, strong 
coffee, gruel or wine. One of the best vehicles for it is foaming beer. Glycerin increases 
its purgative power, when given conjointly. 

ROSA CENTIFOLIA, Pale Rose,— the petals of Rosa ceniifolia, 
the Cabbage Rose, a well-known cultivated shrub of the nat. ord. Rosacese. 
They are of pink color, fragrant odor, sweetish taste changing to slightly 
bitter and fairly astringent. The odor is due to a minute quantity of a 
Volatile Oil (Oil of Rose), besides which, the petals contain tannin, fat, 



350 ROSA DAMASCENA ROSA GALLICA. 

resin, sugar, etc. If it is desired to keep Pale Rose fresh for any length 
of time, it should be mixed with half its weight of Sodium Chloride, 
pressed into a jar and kept, well closed, in a cool place. 

Preparations. 

Aqua Roses, Rose-water, — Pale Rose 40, Water 200 parts, mixed and distilled by steam 
to 100 parts. Dose, indefinite. 

Unguentum Aquce Rosce, Qo\& Cream, — has of Expressed Oil of Almond 50 parts, 
Spermaceti 10, White Wax 10, Rose-water 30. If Glycerin and Benzoic Acid were 
added, it would keep better and be much more efficient as an emollient and protective. 

Pale Rose is also an ingredient of the Compound Syrup of S^arsaparilla. 

Pale Rose is only used for odoriferous and flavoring purposes. Rose- 
water has no strictly medicinal properties, but is an agreeable excipient 
for lotions, urethral injections and collyria. The ointment, commonly 
termed " cold cream," is an agreeable emollient and protective in chapped 
hands and other superficial skin affections. 



ROSA DAMASCENA,— is not official, but is the source of the 
official Oil of Rose. It is largely cultivated in Roumelia on the southern 
slope of the Balkan Mountains, from whence almost all of the product is 
supplied to commerce. 

Oleum Roses, Oil of Rose, Attar of Rose, — is a volatile oil distilled from the fresh 
flowers of Rosa damascena. It is a pale-yellowish, transparent liquid, having a strong 
odor of rose, a sweetish taste and a slightly acid reaction, but slightly soluble in alcohol, 
of sp. gr. about 0.860. Slowly cooled to 50 F., it congeals to a transparent solid, inter- 
spersed with slender, iridescent, scale-like crystals. Rapidly cooled to 54 F., it congeals 
to a solid mass of feathery scales or plates. It consists of an aromatic oxygenated elaeop- 
ten and an odorless solid stearopten (rose- camphor). Being very expensive it is much 
adulterated with other volatile oils. It is used chiefly for perfuming cosmetic prepara- 
tions, ointments and lotions. 



ROSA GALLICA, Red Rose,— the petals of Rosa gallica (nat. 

ord. Rosaceae), collected before expanding. They occur in small cones 

of roseate odor, and a bitter, slightly acid and distinctly astringent taste, 

and contain an aromatic oil, tannic and gallic acids, quercitrin, coloring 

matter, salts, etc. 

Preparations. 

Extractum Rosce Fluidum, — Dose, V\y-^ ij. 

Confectio Rosce,— has of Red Rose 8 parts, Sugar 64, Honey 12, Rose-water 16. A 
basis for pills. 

Mel Rosce, Honey of Rose, — has of Red Rose 8, Honey 92, Diluted Alcohol to 100 
parts. For local use. 

Syrupus Rosce, — has of the Fluid Extract of Rose 10 in Syrup 90. Dose, gj-ij, for 
flavoring. 

Red Rose is also an ingredient of Pilulae Aloes et Mastiches. 

Rosa Gallica is classed among the astringents, as it contains an appre- 
ciable amount of Tannic and Gallic Acids. A compound infusion, con- 
taining sugar and dilute Sulphuric Acid, was formerly official, and is used 



ROSMARINUS RUBUS. 35 I 

as an agreeable gargle for the throat and mouth in inflamed and ulcerated 
conditions. The chief uses of the rose preparations, however, are as 
vehicles for other agents, or to impart flavor and odor to extemporaneous 
prescriptions. 



ROSMARINUS, Rosemary, — the leaves of Rosmarinus officinalis, 
a shrub of the nat. ord. Labiatse, cultivated in gardens for the sake of its 
large pale-blue flowers. The leaves are pungently aromatic and some- 
what camphoraceous, containing, besides the official volatile oil, a little 
tannin, resin and a bitter principle. They constitute one per cent, of 
the ingredients of Vinum Aromaticum (see ante, page 87). 

Oleum Rosmarini, — is the volatile oil distilled from Rosemary, a colorless or yellowish 
liquid, of sp. gr. about 0.900, having the characteristic odor of the plant, a camphoraceous 
taste, and is readily soluble in alcohol. It consists of a terpene, isomeric with Turpen- 
tine, C 10 H ]6 , and a body allied to Camphor. It is an ingredient of Linimentum Sapo- 
nis, Spiritus Odoratus and Tinctura Lavandulae Composita. Dose, mj-v. 

Rosemary was formerly considered emmenagogue, galactagogue and 
diuretic, but is now never employed in substance. Its oil is somewhat 
stimulant and carminative, and in excessive quantity has caused death. 
It is chiefly employed as an external stimulant in liniments and lotions, 
especially to the scalp in alopecia, where it is supposed to increase the 
blood-supply to the hair-bulbs, and is usually combined with cantharides. 
Inhaled it reduces the body temperature and gives the urine a violaceous 
odor. 



RUBUS, Blackberry-Bark, — is the bark of the root of Rubus vil- 
losus, the common Blackberry, Rubus canadensis, the Dewberry, and 
Rubus trivialis, the Bush Blackberry of the Southern States, all of the 
nat. ord. Rosacea?. It occurs in thin, tough, flexible bands, blackish- 
gray externally, pale-brown internally, inodorous, strongly astringent and 
of somewhat bitter taste. It contains over 10 per cent, of Tannin. 
Dose, gr. xv-xxx. 

Preparations. 

Extractum Rubi Fluidum, — Dose, TT^x-^j. 

Syrtipus Rubi has of the Fluid Extract 20 parts, Syrup 80. Dose, 5jj- Jj. 
Syrupus Rubi Aromaticus (Unofficial), — contains the root bark, cinnamon, cloves and 
mace. Each flj| has gr. xxx of the drug. 

Blackberry-bark derives its virtues from its tannin. It is strongly 
astringent, and may be used in decoction, wine or the above-named 
official preparations. It is highly esteemed in summer and infantile 
diarrhoeas. 



352 RUBUS IDiEUS — RUMEX — RUTA. 

RUBUS IDiEUS, Raspberry,— is the fruit of Rubus idceus, the 
Raspberry bush, Rubus occidentalis, the Thimbleberry, or Rubus strigosus, 
the wild Red Raspberry, all of the nat. ord. Rosaceae. It contains sugar, 
malic and citric acids, proteids, pectin, etc., also a Volatile Oil consist- 
ing of compound ethers, to which the odor is due. Its sole use in medi- 
cine is to prepare a pleasantly flavored syrup. 

Preparation. 

Syrupus Rubi Idcei, Raspberry Syrup, — has of Raspberries and Sugar any convenient 
quantity, boiled (but not in tinned vessels) and strained. Dose, ad libitum. It has a 
bright-red color, a fruity, agreeable odor, a pleasant, acidulous taste and an acid reaction. 
It has no special medicinal virtues, but forms an agreeable flavoring for mixtures, and 
mixed with water a pleasant drink in febrile conditions. 

The leaves of the wild Red Raspberry {Rubus strigosus) are considerably astringent, 
and in infusion, ^ j to the pint, are a popular domestic remedy for diarrhoeas. 



RUMEX, Yellow Dock, — is the root of Rumex crispus, and of 
other species of Rumex, plants of the nat. ord. Polygonacese, growing 
as common weeds along roadsides. Several species of Rumex have sour 
leaves, and are popularly called Sorrel to distinguish them from the 
others which are called Dock. The official root is 8 to 12 inches long, 
y 2 inch thick, somewhat fusiform and fleshy, annulate above, deeply 
wrinkled below, externally rusty-brown, internally whitish, with fine 
medullary rays ; fracture short, odor slight, taste bitter and astringent. 
It contains tannin, mucilage, starch, calcium oxalate, and two principles 
named Rumicin and LaJ>athin, which are shown to be identical with 
Chrysophanic Acid. (See ante, page 344). Its constituents are nearly 
identical with those of Rhubarb. Dose, gr. xv-^j. 

Preparations. 

Extr actum Rumicis Fluidum, — Dose, n^xv-^j. 

Decoctum Rumicis (Unofficial), — ^ijof the fresh root, or ^j of the dry root to Oj of 
water. Dose, Jj-ij. 

Rumex is astringent, tonic and laxative. It has also been considered 
alterative and anti-scorbutic. It has been employed chiefly in chronic 
cutaneous disorders, glandular swellings, and other symptoms of the stru- 
mous diathesis. It seems to possess a selective action on the mucous 
membrane of the larynx, and in many cases of laryngeal irritation with 
catarrhal symptoms, dry, violent cough, and a sense of soreness behind 
the sternum, it will give prompt relief. The Rumex Acetosa has a popu- 
lar reputation as a local application for cancer. 



RUTA, Rue, — is the source of the official Oil of Rue, which is dis- 
tilled from the leaves of Ruta graveolens, an herbaceous perennial of the 
nat. ord. Rutacese, growing wild throughout Southern Europe, and fre- 



SABINA. 353 

quently cultivated in gardens for its yellowish flowers. The fresh leaves 
only should be used, and as drying impairs their qualities the oil is 
generally employed. 

Oleum Ruice, Oil of Rue, — the volatile oil distilled from Ruta graveolens ; a colorless, 
or greenish-yellow liquid, of disagreeable but aromatic odor, pungent acrid taste and neu- 
tral reaction, sp. gr. about 0.880, soluble in an equal weight of alcohol. Dose, tt\j-v, in 
mucilage. 

Physiological Action and Therapeutics. 

Rue is an active irritant, locally a rubefacient, the oil producing heat, 
inflammation and vesication. In the ordinary dose it causes a sensation 
of heat in the stomach and skin, increases the action of the heart, and 
stimulates the bronchial, cutaneous and renal secretions, the odor of the 
oil being distinctly perceptible in the breath, sweat and urine. After 
toxic doses of the oil violent gastro-enteritis results, with extreme pros- 
tration, convulsions, strangury and suppression of the urine. Abortion 
may be produced by large doses, but with great danger to life. Rue is an 
efficient emmenagogue, and in men aphrodisiac ; it is also considered 
antispasmodic and carminative. 

The Oil of Rue is employed internally in amenorrhcea, menorrhagia and 
metrorrhagia, hysteria, convulsions and flatulence. As an emmenagogue 
it is very efficient when the condition is one of functional inactivity of 
the uterus and ovaries. In small doses it has been well used in metror- 
rhagia from debility and after abortion. A decoction of the fresh leaves 
is often employed by injection against ascarides, and internally to remove 
lumbricoid worms. Externally the same preparation has been applied to 
the chest in chronic bronchitis, also in various scaly eruptions and 
glandular enlargements. Used as an abortifacient it has frequently 
caused death, preceded by symptoms of narcotic and irritant poisoning. 
Even in poisonous doses its abortifacient action is very uncertain, so that 
only the most ignorant criminals employ it with such purpose. 



SABINA, Savine, — the tops of Juniperus Sabina, a small ever- 
green shrub of the nat. ord. Coniferae, growing in Northern Europe, 
Asia and America. It closely resembles Red Cedar {Juniperus virgi?iiana), 
but is distinguished from the latter by its smaller size and by its larger 
fruit. It occurs in short, thin branchlets, having oveo-lanceolate leaves 
in four rows; of peculiar, terebinthinate odor, and nauseous, bitter, 
resinous taste. It contains a Volatile Oil (which is official), also tannin, 
resin, extractive matters, chlorophyll, etc. Dose, gr. v-x. 

Preparations. 

Extractum Sabintz Fluidum, — Dose, IT^v-xv. 

Ceratum Sabina, — has of the Fluid Extract 25, Resin Cerate 90 parts, melted and 
cooled. 

23 



354 SACCHARINA. 

Oleum Sabince, — a volatile oil distilled from Savine existing in the fresh tops in the 
proportion of 2J^ per cent., and in the berries io per cent. It is a colorless, or yellowish 
liquid, isomeric with oil of turpentine, C 10 H 16 , having a peculiar, terebinthinate odor, a 
pungent camphoraceous taste, and neutral reaction, of sp. gr. about 0.910 and soluble in 
an equal weight of alcohol. Dose, TTiJ-v. 

Physiological Action. 
Externally the action of Savine resembles that of Turpentine, except 
that it is more irritant, the oil producing vesication if applied sufficiently 
long. Internally a full medicinal dose causes heat sensations, nauseous 
eructations, flatulence, increased cardiac action, stimulation of the cuta- 
neous, bronchial and renal secretions, irritation of the kidneys, hypere- 
mia of the ovaries and uterus and increased menstrual activity. In large 
doses it produces hematuria, dysuria, and intense gastro-enteritis, with 
violent vomiting and purging. It may originate uterine contractions in 
the pregnant female, but its abortifacient effect can only be produced by 
a quantity sufficient to endanger life. The oil diffuses into the blood 
and is excreted by the various excretory channels. 

Therapeutics. 
As an emmenagogue Savine is highly esteemed by many authorities, 
Dr. Phillips considering it " one of the most certain and powerful " agents 
of this class, "with the additional advantage that it can be given with 
perfect freedom from risk of doing harm." So irritant an agent, however, 
requires the exercise of great caution in its use. It has been found 
extremely efficient in dysmenorrhcea when not due to mechanical causes ; 
also, in menorrhagia and hemorrhage after abortion. In chronic gout 
and the joint affections of chronic rheumatism, it was formerly much em- 
ployed. Externally the cerate is used to prolong the discharge from 
blisters, setons or issues, and to stimulate the healing of indolent ulcers. 
For these purposes it is considered safer than Cantharides, as its prolonged 
employment does not bring on strangury or vesical irritation. As a 
caustic it is efficient for the destruction of warts and other excrescences, 
and the moistened powder is used as a paste on venereal condylomata, in 
combination with burnt alum or cupric subacetate. The oil is the most 
efficient preparation for internal administration. 



SACCHARINA, Saccharine, — is a recently discovered derivative 
of a coal-tar product, Toluene, from which it is prepared by a complicated 
process. It has the chemical title Benzoyl-sulphonic-imide, and the for- 
mula C 6 H 4 (CO)(S0 2 )NH. It occurs as a white amorphous powder, with 
a very sweet taste, and a faint flavor of bitter almonds, soluble in alcohol 
and in ether [Sugar is not soluble in ether], sparingly in cold water, more 
so in hot water. 



SACCHARUM. 355 

Saccharine is 220 times sweeter than sugar to the taste, and is also an 
efficient antiseptic. It is not a food, like sugar ; and has no injurious 
action on man. It may prove of use as a substitute for sugar in cases of 
diabetes, but it has no curative action upon that disease. 

SACCHARUM, Sugar, Cane-sugar, C 12 H 22 O n j — is the refined 
sugar of Saccharum officinarum, or Sugar-cane, a perennial plant of the 
nat. ord. Graminaceas, indigenous to India and adjoining countries, but 
cultivated in tropical regions throughout the world. This sugar is also 
present in several grasses (as Zea Mays, maize, Sorghum saccharatum, etc.), 
in the juice of various trees (maple, birch, palm, etc.), and in many toots, 
particularly Beta vulgaris, the sugar-beet, which contains 12 per cent. 

Cane-sugar occurs in white, dry, hard, crystalline granules, permanent in the air, odor- 
less, of purely sweet taste and neutral reaction, soluble in 0.5 of water and in 175 of 
alcohol at 59 F., in 0.2 of boiling water and in 28 of boiling alcohol, insoluble in ether. 
The aqueous solution, saturated at 59 F., has the sp. gr. 1.345, and is miscible with alco- 
hol in all proportions. Its freedom from Grape-sugar (glucose) and from more than a 
slight quantity of Inverted Sugar (glucose plus levulose) is ascertained by dissolving I 
gram in 10 c.c. of boiling water, then mixing with the solution 4 or 5 drops of test- 
solution of Silver Nitrate and about 2 c.c. of Aqua Ammonias, and quickly heating to 
boiling, when not more than a slight coloration, but no black precipitate should appear 
after standing at rest for 5 minutes. 

Other Sugars. 

Saccharum Lactis, Sugar of Milk, Lactose, C ]2 H 22 O u .H 2 0, — described on next page. 

Glucose, Dextrose, Grape-sugar, Starch-sugar, C 6 H 12 6 , or hydrated C 6 H 12 6 .H 2 
(Unofficial), also known as liver-sugar, diabetic sugar, — forms yellowish nodules or crys- 
tals, very soluble in water and in alcohol, has a sweet taste, less marked than that of cane- 
sugar, may be obtained artificially from cane-sugar or from starch, by boiling with a dilute 
mineral acid, or by the action of Diastase, a vegetable ferment formed during the germi- 
nation of grain. Boiling solutions of the alkalies convert it into a brown substance 
(melassic acid). 

Levulose, Fruit-sugar, C 6 H 12 6 (Unofficial), — frequently found with grape-sugar in 
fruits, also in honey. 

Inosit, Phaseo-mannit, C 6 H 12 6 .2H 2 (Unofficial), — exists in the juice of some meats, 
in asparagus, etc. Is very sweet, but does not undergo alcoholic fermentation. 

Allied Substances. 

Theriaca, Treacle, Sugar-house Molasses (Unofficial), — is the uncrystallizable residue 
of the process for refining sugar, — a thick, brown, fermentable syrup, very sweet and of 
sp. gr. about 1.40. It is official in the B. P., and is used in making up some of the official 
pills of that pharmacopoeia. 

Amylum, Starch, C 6 H 10 O 5 , — when boiled with dilute mineral acids or when subjected 
to the action of diastase, ptyalin or pancreatin, starch is converted into glucose. (See 
ante, article Amylum, page 1 01.) 

Cellulose, C 6 H 10 O 5 (Unofficial), — forms the basis of all vegetable fibre, and is isomeric 
with starch. It exists almost pure in cotton and in Swedish filter paper. Pyroxylin (see 
ante, page 235), or gun-cotton, is dinitro- cellulose. 

Glycogen (Unofficial), — closely resembles starch in its properties, being converted into 
glucose by the same agents which so act on starch. It exists in the liver of all animals. 

Dextrin (Unofficial), — is produced by the action of dilute acids on starch, and is an 
intermediate product in the conversion of starch into glucose. It is a transparent, brittle 
solid, looking like gum, soluble in water and dilute alcohol, is not fermentable, nor is it 
colored by Iodine. 

Preparations. 

Sugar is an ingredient of Pil. Ferri Carbonatis, Pil. Ferri lodidi, Ferri Carbonas Saccha- 
ratus, Mistura Ferri Composita, Pulvis Cretaa Compositus, Pulvis Glycyrrhizae Compositus, 
and the Troches, Syrups, Compound Syrups, etc. 



356 saccharum lactis salix. 

Physiological Action and Therapeutics. 
Sugar is employed in pharmacy and therapeutics chiefly as a vehicle, a 
corrigent, a preservative and an antiseptic. Syrups protect the active 
ingredients against putrefaction, but not always against fermentation. 
They also protect certain ferruginous preparations against oxidation. As 
an ingredient in troches, powders and extemporaneous mixtures sugar is 
used to cover the taste or to make insoluble substances more easily mis- 
cible with water. It increases the solubility of Lime in water. As a food 
it possesses well-known properties, being a nutrient to adipose tissue and 
a respiratory fuel, and is decidedly diuretic in its action upon healthy 
kidneys. 

SACCHARUM LACTIS, Sugar of Milk, Lactose,— 

C 12 H 22 O n .H 2 0, — is one of the constituents of the milk of mammals, and 
is officially described as a peculiar, crystalline sugar obtained from the 
whey of cow's milk by evaporation and purified by re-crystallization. 
Occurs in white, hard, crystalline masses, yielding a gritty, white powder, 
odorless, permanent in the air, of faintly sweet taste and neutral reaction, 
soluble in 7 of water at 59 F. and in 1 of boiling water, insoluble in alco- 
hol, ether or chloroform. On adding to a solution of sugar of milk in an 
equal weight of boiling water some solution of soda, the liquid turns 
brownish, and on further addition of test-solution of Cupric Sulphate a 
brick-red precipitate separates. 

Sugar of Milk is the least soluble of all sugars in water and is insoluble in alcohol. It 
enters into alcoholic fermentation with difficulty. In the presence of decomposing albu- 
minous matter and under certain other influences, it undergoes the lactic fermentation, 
which results in the formation of Lactic Acid, Carbon Dioxide and Alcohol. It readily 
reacts with the reduction tests. 

Lactose has been shown to act as a powerful diuretic, especially in cardiac dropsy, in 
which Dr. See considers it "the best and most certain diuretic we possess, the excretion 
of urine caused by it being greater than that due to any other drug." He found that it 
acts similarly to, though more powerfully than, Caffeine, while possessing none of the 
disadvantages of the latter. Its diutetic action is but very little in cases where extensive 
renal disease exists, and it has no power over dyspnoea. 

Sugar of milk is used in the Triturations, also in the Abstracts, Dover's 
Powder, Denarcotized Opium, etc., as a diluent. Being much harder 
than cane-sugar it is considered a valuable excipient for powders requir- 
ing fine trituration and the minute subdivision of their medicinal consti- 
tuent. It is less sweet than cane-sugar, and being less apt to ferment in 
the stomach and bowels is better than the latter for use with infants' food. 



SALIX, Willow, — is the bark of Salix alba, the common White 
Willow, and of other species of Salix, trees of the nat. ord. Salicaceae. 
It occurs in fragments or quills, inodorous, bitter or astringent, and con- 



salix. 357 

tains a large proportion of tannin, besides resin, gum, wax, lignin, etc., 
and the characteristic constituent Salicin, which is official. Dose of the 
bark, gr. x-^j, or more, in infusion. 

Salix Nigra, the Pussy Willow, grows along streams in the Southern 
States. A fluid extract is on the market, and may be used in doses of £ss 
thrice daily, as a sexual sedative. 

Salicin, C 13 H 18 7 , is a crystalline glucoside, consisting of Saligenin and 
glucose ; found in Gaultheriaprocumbens (Wintergreen), and in the bark 
of several species of Salix (willow). Salicylic Acid, HC 7 H 5 3 , is a deriv- 
ative of Salicin, probably by double oxidation ; but may also be consid- 
ered as a substitution-derivative of Benzene, formed by replacing 2 atoms 
of its hydrogen, the one by hydroxyl, and the other by carboxyl. (See 
page 183, ante.*) It is obtained, therefore, either synthetically by com- 
bining the elements of Carbolic Acid with those of Carbonic Acid, and 
subsequent purification, — or from natural salicylates as the oils of winter- 
green and sweet-birch, — or from salicin, by heating with caustic potash 
and treating the mass with hydrochloric acid. The acid prepared from 
natural sources is purer and more efficient than that prepared artificially, 
and will often be tolerated by a patient who cannot bear the latter. 

Preparations. 

Salicinum, Salicin, C 13 H 18 7 , — a neutral principle prepared from the bark of Salix 
Helix and of other species of Salix. White, shiny, silky crystals, odorless, of very bitter 
taste and neutral reaction; — soluble in 28 of water and in 30 of alcohol at 50 F., in 0.7 
of boiling water and in 2 of boiling alcohol; insoluble in ether or chloroform. Dose, 
gr. x-gij. 

Acidum Sahcylicum, Salicylic Acid, HC 7 H 5 3 , — occurs in fine, white, needle-shaped 
crystals, of sweetish acrid taste and acid reaction, soluble in 450 of water and in 2)/ 2 of 
alcohol at 59 F.; 100 parts may be dissolved in 100 of water by the aid of 8 parts of 
Borax. Dose, gr. v-^j. 

Sodii Salicylas, Salicylate of Sodium, 2NaC 7 H 5 3 .H 2 0, — is soluble in 1^ parts of 
water. Dose, gr. v-^j. 

Lithii Salicylas, Salicylate of Lithium, 2LiC 7 H 5 3 .H 2 0, — is very soluble in water or 
alcohol. Dose, gr. v-^j. 

Physostigmince Salicylas, — is described under Physostigma, ante, page 315. Dose, 

or 1.1 
& 1, 100 60' 

Oleum Gaultheria, Oil of Wintergreen. Dose, tt^v-xv. (See ante, page 229.) 

Unofficial Preparations. 

Salol, Salicylate of Phenol,— -consists of 60 parts by weight of Salicylic Acid and 40 of 
Carbolic Acid. Is insoluble in water, almost tasteless and odorless. Dose, gr. v-^j, in 
compressed tablet. 

Salipyrin. C 18 H 18 N 2 4 , — is a combination of Salicylic Acid 57.7 parts, and Antipyrine 
42.3 parts; a white, odorless powder, very soluble in alcohol, insoluble in water. Thera- 
peutically, it is an antipyretic and antirheumatic of considerable value, according to Dr. 
Guttmann. Dose, gr, x-xxx, every two hours. (See ante, page 106.) 

Physiological Actions. 

Willow-bark is highly astringent and antiperiodic and feebly tonic, 
but is never employed medicinally, owing to its bulk. Salicin is a bitter 
tonic, an antiferment, antiseptic, and is highly destructive to low organ- 



358 salix. 

isms. It has slight antiperiodic power and is feebly antipyretic. It pre- 
vents the reaction between Amygdalin and Emulsin (see page 68), and 
also that of Ptyalin, etc., on Starch (see page 101). It seems to be devoid 
of toxic power on man, and is mainly excreted as Salicylic, Salicyluric 
and Salicylous acids, being first changed in the bowel into Saligenin and 
Glucose. Salicin is well borne by the stomach. 

Salicylic Acid has properties similar to the above, but is much more 
energetic in its action, being a powerful antipyretic and antiseptic. It is 
also anhydrotic, checking local perspiration when locally applied. Inhaled 
it causes irritation of the respiratory passages, producing sneezing and 
cough. In small doses it stimulates the stomach, heart and respiration, 
but moderate quantities derange the stomach, causing nausea and vomit- 
ing, while large doses depress the heart's action and the respiration after 
a primary excitation of both, lower the arterial tension, relax the vessels, 
produce free perspiration, and reduce the temperature in fever. It causes 
vertigo, dilated pupils, tinnitus aurium, a sensation of tension in the 
frontal cerebrum, delirium, and may produce bed-sores from depression 
of the circulation, but does not affect the peripheral nerves as to either 
motion or sensation. In the blood it is first changed to Salicylate of 
Sodium, but a portion is again set free and uniting with glycocoll forms 
Salicyluric Acid (HC 9 H 8 N0 4 ), coloring the urine green. It is slowly 
excreted through the secretions generally, especially in the urine, sweat, 
saliva and bile. It stimulates the kidneys, at the same time disinfecting 
them and increasing the acidity of the urine, but may so irritate the 
kidneys as to produce albuminuria and hematuria. 

Salicylic Acid is destructive to the torula, prevents alcoholic fermenta- 
tion, also that caused by the organic ferments (pepsin, ptyalin, etc.). In 
solutions containing bacteria, it will prevent their development, if in the 
proportion of i per cent. ; and in that of i in 60 it will destroy them when 
in full activity. 

Salicylate of Sodium is remarkably antipyretic in doses of gr. xv, 
given 4 or 5 times in 24 hours. It is a powerful diaphoretic, and an effi- 
cient cholagogue, and it is supposed to possess the curious property of 
increasing the fluidity of the bile, at the same time that it promotes its 
secretion, — other cholagogues increasing the proportion of solids therein. 
(Brunton.) It has no antiseptic power unless in association with a strong 
mineral acid, which will liberate the salicylic acid. 

Salol is antiseptic, antipyretic, and germicide, in a higher degree than 
either of its constituents. As an antipyretic in fever it stands next after 
Antipyrine, and it acts with such force as to frequently depress the tem- 
perature a degree or two below normal. It is sedative to the cerebro- 
spinal system, and somewhat analgesic. It causes profuse sweating, and 
in a few cases considerable depression has accompanied its antipyretic 



salvia. 359 

employment ; but it is not toxic, and may be used freely in its proper 
dosage, which ranges from 5 to 60 grains, up to 2 or 3 drachms in the 24 
hours. 

Therapeutics. 

Salicin and its derivatives are chiefly used in acute rheumatism, to 
lower temperature, relieve pain, and reduce articular swelling. They 
are most suitable to strong, vigorous patients, and if not promptly effi- 
cient they should be abandoned. The acid is much used as an antipy- 
retic in fevers, especially those of septicaemic character. It is a useful 
local application in gangrenous wounds, eczema of the hands or feet, 
cancer, burns, and in fetid perspirations, in the last affection being 
used in solution with borax. 

Salicylate of Sodium is more soluble than the acid and less irritant 
to the stomach, while in doses about 50 per cent, larger it is equally effi- 
cient. It is employed in 3- to 5-grain doses internally after meals, to 
arrest gastric fermentation, and to prevent acidity and flatulence. It is 
used instead of the acid in acute and chronic rheumatism, to relieve 
headaches, and for phlegmasia alba, in which it is considered very effi- 
cient, — also in cases where there is a tendency to the formation of 
gall-stones. It is considered a very efficient remedy to cut short an 
attack of tonsillitis, a "bad cold," and also other acute affections of 
the respiratory mucous membrane. 

Salicylate of Lithium is also non-irritant and is supposed to act towards 
uric acid in the same manner as the other salts of this metal. It is expected 
to be of especial value in acute rheumatism and rheumatic gout. 

Salol is the most efficient remedy for duodenal catarrh, catarrh of the 
bile-ducts and catarrhal jaundice ; also in the bilious form of sick-head- 
ache, and in some forms of neuralgia. Its greatest power is manifested 
over acute rheumatism, in which disease many clinicians maintain that it 
has no superior, if given in 15- to 30-grain doses, up to 2 drachms, in the 
24 hours, and continued for some time after the acute symptoms have 
subsided. It should prove an efficient disinfectant in catarrh of the blad- 
der, as its constituents are excreted with the urine, and come in contact 
with the vesical mucous membrane for a considerable period of time. 



SALVIA, Sage, — the leaves of Salvia officinalis, the common gar- 
den sage, a perennial plant of the nat. ord. Labiatae, native in Southern 
Europe, but cultivated in our gardens for its strong, fragrant odor. The 
leaves are about 2 inches long, finely crenulate, grayish-green, thick and 
wrinkled ; soft, hairy and glandular beneath, of aromatic odor and bitter- 
ish, astringent taste. They contain tannin, resin, etc., and a volatile oil 
which consists of Salviol (C 10 H 16 O), camphor and terpenes. Sage is a con- 



360 SAMBUCUS — SANGUINARIA. 

stituent of Vinum Aromaticum. There are no official preparations. Dose 
of the powdered leaves, gr. xx-xxx, in infusion. » 

Sage is aromatic, stimulant, tonic, astringent, and a vulnerary. It was 
highly esteemed in ancient times, and even yet is popular as a domestic 
cure-all with many people. In an infusion it may be used as a beverage 
in febrile conditions and to check sweating, also for the night-sweats of 
phthisis. Like other members of the same class it has a slight influence 
over enteralgia and flatulence. It makes a good astringent and stimu- 
lating gargle. 

SAMBUCUS, Elder, — the flowers of Sambucus canadensis, the 
common elder, a shrub of the nat. ord. Caprifoliaceae, from 6 to 10 feet 
high, having small white flowers disposed in loose cymes of five divisions, 
the cream-colored corolla being whorl-shaped with five stamens on the 
tube. The berries are small, globular, and when ripe of a deep purple 
color. The plant contains a small quantity of a volatile oil, also a resin 
and valerianic acid. The common elder of Europe (S. nigra) is more of 
a tree, and is official in the B. P. There are no official preparations. 
Dose, gr. xxx-^j, in hot infusion. 

Elder-flowers are stimulant and diaphoretic, also perhaps diuretic in 
some degree. The berries are diaphoretic and laxative, while the inner 
bark is a hydragogue cathartic and in large doses emetic. Formerly the 
inspissated juice of the berries was employed as an alterative in rheuma- 
tism and syphilis, but at present the flower's are used only for flavoring 
purposes. Elder-flower Water (Aqua Sambuci, B. P.) is a nice vehicle 
for collyria and lotions. 

SANGUINARIA, Blood-root, — is the rhizome, collected in 
autumn, of Sanguinaria canadensis, a perennial plant of the nat. ord. 
Papaveracese, which grows abundantly throughout the U. S., being one of 
the earliest and most beautiful of the spring flowers. It has a single white 
flower on an erect stalk, the petals often tinged with rose or purple. Leaf 
reniform, smooth, deeply lobed, yellow-greenish above, paler beneath, 
and strongly marked with orange-colored veins. The rhizome is about 
2 inches long and -fths inch thick, cylindrical, horizontal, wrinkled, 
reddish-brown, fracture short, waxy, with numerous small red resin -cells, 
bark thin, odor slight, taste very bitter and acrid. It contains 3 alkaloids, 
— Sanguinarine, C 17 H 15 N0 4 , which is probably identical with Chelery- 
thrine (see Chelidonium), Porphyroxine, and Puccine, combined with 
Chelidonic and Sanguinarinic Acids, — also resin, gum, albumen, sugar, 
etc. The salts of its alkaloids are of brilliant red and orange colors and 
are all soluble in water. Dose of the powdered root as expectorant, gr. 
j-v ; as emetic, gr. x-xx, best given in pill. 



SANGUINARIA. 36 1 

Preparations. 

Extractum Sanguinaria Fluidum, — Dose, fflj-v as expectorant and stimulant ; TT^x-lx 
as emetic, cautiously. 

Tinctura Sanguinaria > — strength 15 per cent. Dose, as expectorant, Tt\v-gj, as 
emetic gj-iij. 

Acetum Sanguinarice, — has of Sanguinaria 10, in Diluted Acetic Acid 90. Dose, 
TT^x-xxx; as an emetic, ^ij-^ss. 

Sangirinarina, Sanguinarine, C llr H 15 N0 4 (Unofficial), — is the chief alkaloid and prob- 
ably the active principle of the plant. Dose, as an expectorant, gr. T V"i ; as an emetic, 
gr. ^ repeated in 10 minutes will produce vomiting after the second or third dose. 

Physiological Action. 
Sanguinaria is sternutatory, sialagogue, expectorant and emmenagogue, 
a systemic emetic, a cardiac paralyzer, a violent irritant, an acro-narcotic 
and an alterative. Its taste is bitter and acrid. It causes violent sneez- 
ing when inhaled, increases secretion by irritating the secretory organs as 
it is eliminated, and in full doses produces salivation, catharsis and vomit- 
ing with great depression. Overdoses are violently irritant, the heart's 
action being at first increased, together with the arterial tension, then 
markedly depressed, and finally paralyzed by stimulation of its inhibition. 
The reflexes are lowered by paralysis of the spinal centres, muscular con- 
tractility impaired, the pupils dilated, temperature lowered, cold sweats, 
great thirst and collapse supervene, and death occurs by paralysis of the 
cardiac and respiratory centres, often preceded by convulsions. Locally 
used, Sanguinaria is a feeble escharotic. 

Antagonists and Incompatibles. 

Opium, Amyl Nitrite, Atropine, etc., to antagonize the depression of the circulation and 
the local irritant action. Incompatibles are alkalies, tannin, and most of the metallic 
salts. 

Therapeutics. 
As a tonic to the stomach and a stimulant to the liver Sanguinaria or 
its active principle is well employed in small doses (gtt. iij of the tinc- 
ture or gr. T L of the alkaloid) for atonic dyspepsia, duodenal catarrh and 
catarrh of the biliary ducts with jaundice. Respiratory affections are 
often remarkably amenable to its influence, particularly chronic nasal 
catarrh, asthma and acute bronchitis. In these affections expectorant 
doses are the best, namely, gtt. x of the tincture, and in the former the 
powder locally as a sternutatory. A decoction is a very efficient gargle 
in the sore-throat of scarlet fever. Sanguinaria is a very serviceable 
remedy in chronic bronchitis and in amenorrhcea of functional charac- 
ter, also in functional impotence from irritability of the organs, with 
daily losses and relaxation of the genitalia. By many practitioners it is 
considered a specific emetic in croup, but others look upon it with dis- 
favor as too uncertain and harsh in its action. It has been thought to 
have alterative properties, and hence is frequently used with Stillingia and 
other plants in the treatment of strumous and syphilitic affections. In 



362 SANTALUM ALBUM — SANTALUM RUBRUM. 

pneumonia of typhoid type and in pleuro-pneumonia it has undoubtedly 
been of great service in many cases. 

Locally, the powdered root is well employed as an application to foul 
ulcers and fungous granulations, and by insufflation to nasal polypi, and 
for chronic hypertrophy of the nasal mucous membrane. 

Sanguinarine has been used with good results in pneumonia, bronchitis 
and atonic dyspepsia. Doses of gr. -^ to -§- are expectorant without irri- 
tating the stomach ; and still smaller doses (gr. -^ to -^) are stimulating 
to the gastric and intestinal secretions. 

SANTALUM ALBUM, White Sandalwood,— is the source 
of the official Oil of Santal (see below), but is not itself official. It is a 
tree of the nat. ord. Santalacese, having its habitat in India but now nearly 
exterminated there ; — Santalum citrinum, the yellow sandalwood, from 
the Sandwich and Feejee Islands, is more commonly met with in commerce. 

Preparations. 

Oleum Santali, Oil of Santal, Oil of Sandalwood, — a volatile oil distilled from the 
wood of Santalum album; a pale-yellow liquid, of sp. gr. about 0.945, soluble in al- 
cohol, of peculiar and aromatic odor, pungent taste and acid reaction. Dose, TT^x-xxx, 
in emulsion or capsule. 

Extr actum Santali Fluidum (Unofficial), — made with alcohol as a menstruum. Dose, 

Physiological Action and Therapeutics. 
Sandalwood is a very agreeable perfume. The Oil is astringent to 
mucous membranes, producing dryness of the fauces, thirst, colic, and a 
sense of fulness in the renal regions. In concentrated form it is a local 
irritant, but the effects of large doses have not been studied. It is exten- 
sively used in chronic bronchitis and in gonorrhoea, forming the contents 
of proprietary capsules which are sold for the cure of the latter disease in 
all drug stores. As found in the shops it is extensively adulterated with 
Oil of Cedar, and hence is a very unreliable remedy. 

SANTALUM RUBRUM, Red Saunders,— is the wood of 
Pterocarpus santalinus, a tree of the. nat. ord. Leguminosae, native in 
India. It comes as a dark reddish-brown, heavy, coarse wood, in chips 
or as a coarse powder, nearly inodorous and tasteless, not imparting any 
red color to water when macerated in it, but coloring alcohol, ether and 
alkaline solutions a bright red. The wood has no medicinal properties 
and is employed solely for the purpose of coloring alcoholic preparations. 
It is a constituent of Tinctura Lavandulae Compositus. 

SANTONICA, Levant Wormseed, — the unexpanded flower- 
heads of Artemisia maritima, var. Stechmanniana, small, perennial plant 



SANTONICA. 363 

of the nat. ord. Compositae, which grows in Asia Minor, Turkestan, etc., 
and contains a volatile oil and the peculiar, crystalline principle, Santonin 
(see below). 

Flower heads about -^ inch long, pale greenish-brown, smooth, resem- 
bling seeds in appearance, but consisting of imbricated involucral scales 
with a green midrib, enclosing 4 or 5 tubular florets ; odor strong and 
peculiar, somewhat camphoraceous, taste aromatic and bitter. Dose, gr. 

x-lx. 

Preparations. 

Santoninum, Santonin, C 15 H 18 3 , — the neutral principle prepared from Santonica. 
Occurs in colorless, prismatic crystals, turning yellow on exposure to light, odorless, of 
bitter after-taste, and neutral reaction, nearly insoluble in cold water, but soluble in 250 
of boiling water, in 40 of alcohol, 3 of boiling alcohol, 160 of ether, 4 of chloroform, also 
in solutions of the alkalies. Dose, gr. *^-j for a child, gr. j-v for an adult, not repeated 
too soon, as the action of the drug is slow. 

Sodii Santoninas, Santoninate of Sodium, 2NaC 15 H 19 4 .7H 2 0, — colorless, rhombic 
crystals, turning yellow on exposure to light, slightly efflorescent, of saline taste and 
slightly alkaline reaction, soluble in 3 of water and in 12 of alcohol at 59 F., in 0.5 of 
boiling water and in 3.4 of boiling alcohol. Dose, gr. ij-x, as per age. 

Trochisci Sodii Santoninatis, — each troche contains of the preceding gr. j, with sugar, 
tragacanth and orange-flower water. Dose, ij-x, as per age. 

Trochisci Santonini (Unofficial), — each troche contains gr. ss of Santonin. Dose, j-v, 
as per age. 

Santonin and its preparations are sensitive to light and should be kept in amber colored 
bottles tightly corked. 

Physiological Action. 

Santonin is anthelmintic to the round worm (Ascaris lumbricoides), 
also but in less degree to the thread- worm (Oxyuris vermicularis). It is 
taken into the blood as Santoninate of Sodium, and affects the cerebral 
faculties and the vision, objects appearing at first blue, green or red, then 
yellow (chromatopsia), often succeeded by blindness for a week or more. 
Large doses disturb the consciousness of the patient, produce a sort of 
intoxication, tremors, weakness, with enfeebled respiration and slowing 
of the pulse, coldness of the surface, vomiting, sweating, mydriasis, con- 
vulsions and death from failure of respiration. A dose of 2 grains is said 
to have proved fatal to a feeble child of five years old. It is excreted by 
the kidneys, coloring the urine if acid a greenish-yellow, if alkaline a 
reddish-purple, and produces considerable enuresis. 

Santoninate of Sodium acts similarly, but being more soluble it is 
more rapidly absorbed and eliminated, and does not produce the consti- 
tutional symptoms of the drug in so marked a degree. 

Therapeutics. 
As an anthelmintic Santonin is the most certain agent against the round- 
worm, and is best administered in powder with Calomel at bedtime after 
a day of fasting, a Senna-draught or a dose of Castor Oil being used the 
following morning. It also acts fairly well in suppository against the 
thread-worm, but is inoperative against tape-worm. Some observers con- 



364 SAPO. 

sider that it is more promptly efficient when given in Castor Oil, and that 
the oil lessens the risk of evil after-effects. It has also been prescribed 
with great benefit for nocturnal incontinence of urine, and for certain eye 
affections, particularly amaurosis from atrophic or inflammatory changes 
in the retina and optic nerve. It should never be given to children during 
a fever, nor when the bowels are constipated, for fear of toxic results. 



SAPO, Soap, — is soap prepared from Soda and Olive Oil; a white 
solid, hard yet easily cut when fresh, of slight, peculiar odor, free from 
rancidity, a disagreeable, alkaline taste, and an alkaline reaction, readily 
soluble in water and in alcohol. It is well represented by the best 
"white Castile Soap." 

Sapo Viridis, Green Soap, — is soap prepared from Potassa and fixed 
oils ; a soft, greenish -yellow unctuous jelly, having a peculiar odor and 
an alkaline reaction, soluble in water and in alcohol, does not impart an 
oily stain to paper. Incinerated it yields an ash which is very deliques- 
cent. Green soap is a bad name for it, as its color is usually brown. 

Saponification is a process of double decomposition between a fat (stearate, palmi- 
tate or oleate of glyceryl) and an alkali, in which glycerin and the metallic salt of the 
fatty acid are formed. The glycerin, not being saponifiable, is set free, but the fatty acid 
(stearic, palmitic or oleic) unites with the salifiable base to form soaps, which are there- 
fore mixed stearates, oleates and palmitates of various bases. Nearly all soaps are oleates 
or palmitates (or both) of sodium or potassium (or both). Hard soaps are soda soaps, 
soft soaps are potassium soaps. [Compare the articles Oleum Olivse, Adeps, Acidum 
Oleicum, Glycerinum, etc.] 

Insoluble Soaps are combinations of the oily acids with earths and 
metallic oxides. Two of them are official, viz., — the Soap of the Mon- 
oxide of Lead (Emplastrum Plumbi) and the Soap of Lime (Linimentum 

Calcis). 

Unofficial Soaps. 

Sapo Mollis, Soft Soap, — official in the Br. Phar., is made with Olive Oil and Potash, 
the solution of the alkali being present in excess. It is often adulterated with starch. 

Sapo Animalis, Curd Soap, — official in the Br. Phar., — is made with Soda and a puri- 
fied animal fat, consisting chiefly of Stearin. Used in pills and suppositories. 

Sapo Medicalus, — official in the Fr. Codex, — is a Soda soap prepared from expressed 
Almond Oil. 

Preparations. 

Emplastrum Saponis, Soap Plaster, — has of Soap 10 parts, Lead Plaster 90, Water q. s. 

Linimentum Saponis, Soap Liniment, — has of Soap 10 parts, Camphor 5, Oil of Rose- 
mary 1, Alcohol 70, Water q. s. ad 100 parts. Opodeldoc is a similar preparation. 

Tinctura Saponis Viridis, — has of Green Soap 65 parts, Oil of Lavender 2, Alcohol 
q. s. ad 100 parts. For external use. 

Soap is also an ingredient of Chloroform Liniment and several of the official pills. 

Physiological Action and Therapeutics. 
Soap is a laxative, antacid and antilithic ; externally it is a stimulating 
discutient, and is used for cleansing the skin, removing fatty substances 



SARSAPARILLA. 365 

and softening the epidermis, but if too long applied it may prove de- 
cidedly irritant. It is a good antidote in poisoning by acids, and should 
be administered freely in such cases until more energetic alkalies can be 
obtained. In aqueous solution it makes a useful enema for constipation, 
or a plug of soap may be inserted into the rectum. 

Green Soap is a powerful detergent stimulant and is much employed 
in skin diseases, especially eczema rubrum, in which the tincture is well 
rubbed on, the diseased skin well washed and then covered with a bland 
ointment. The tincture is the most elegant form for use, and may be 
diluted with three parts of alcohol for shampooing the scalp. 

The Liniment is used with friction in sprains, bruises and stiff joints, 
being a little more stimulating than Camphor-liniment. It makes a good 
basis for extemporaneous liniment prescriptions. 

SARSAPARILLA, — is the root of Smilax officinalis, Smilax 
medica, and of other undetermined species of Smilax, plants of the 
nat. ord. Smilaceae, growing in Mexico, Central America, Brazil, etc. 
There are six commercial varieties on the market, which are generally 
put up in differently formed bundles. The roots are about as thick as a 
goose-quill, reddish-brown, several feet in length, covered with rootlets 
and folded in bundles about 18 inches long, taste mucilaginous, bitter 
and acrid. It contains starch, resin, oxalate of calcium, an essential oil, 
and an acrid neutral principle named Parillin or Smilacin, which when 
acted on by dilute sulphuric acid affords another principle, Parigenin. 

Preparations. 

Extr actum Sarsaparillce Fluidum, — Dose, ^ss-gj. 

Ext. Sarsaparillce Compositum Fluidum, — contains Sarsaparilla 75, Glycyrrhiza 12, 
Sassafras bark 10, Mezereum 3, Glycerin 10, Water and Alcohol up to 100. Dose, 
3SS-3J. 

Syrupus Sarsaparillce Compositus, — Sarsaparilla 1 50, Guaiacum Wood 20, Pale Rose 
12, Glycyrrhiza 12, Senna 12, Sassafras 6, Anise 6, Gaultheria 6, Sugar 600, Alcohol 
and Water up to 1000 parts. Dose, 3J-^ss. A good vehicle for Potassium Iodide. 

Decoctum Sarsaparilla Compositum, — Sarsaparilla 10, Sassafras 2, Guaiacum Wood 2, 
Glycyrrhiza 2, Mezereum 1, Water q. s. ad 100 parts. Dose, % j-iv. 

Syrup of Sarsaparilla (Unofficial), — so much used in flavoring soda-water, is a mixture 
of the oils of sassafras and gaultheria. 

Physiological Action and Therapeutics. 
Those who believe that Sarsaparilla has any action ascribe to it prop- 
erties as a diuretic, diaphoretic, tonic and alterative. So far careful 
physiological experiments with the drug and its principle have given 
negative results. It has been used as a so-called ''blood-purifier" in 
scrofula, chronic abscesses, necrosis, old ulcers, many cutaneous dis- 
eases, etc., but is generally combined with other agents of undoubted 
activity. The compound decoction is considered a good agent in 
tertiary syphilis, especially in debilitated subjects ; while the other pre- 



366 SASSAFRAS SCAMMONIUM. 

parations are commonly employed as vehicles for Iodide of Potassium 
and Bichloride of Mercury in syphilis of any form. Whenever used, the 
compound decoction will give the best results, the hot water and its other 
constituents being each of medicinal value. 

SASSAFRAS, — is the root-bark of Sassafras officinalis, a tree of 
the nat. ord. Lauracese, growing throughout the U. S., and occurs in 
irregular fragments of a bright, rust-brown color, strongly fragrant, taste 
sweetish, aromatic and somewhat astringent. The volatile oil is official. 

Sassafras Medulla, Sassafras Pith, — is the pith of the tree described 
above. Occurs in slender cylindrical pieces, often curved or coiled, 
light, spongy, white, inodorous, insipid. Macerated in water it forms a 
mucilaginous liquid which is not precipitated on the addition of alcohol. 

Preparations. 

Mucilago Sassafras Medulla, — has of the pith 2 parts in 100 of water. Dose, indefinite. 

Oleum Sassafras, — is a volatile oil distilled from Sassafras, — a colorless or yellowish 
liquid, having the odor of Sassafras, a warm, aromatic taste and a neutral reaction, readily 
soluble in alcohol. Sp. gr. about 1.090. Treated with cold nitric acid it becomes of a 
dark-red color, and is finally converted into a red resin. Dose, mj-iv. 

Infusum Sassafras (Unofficial), — a popular "tea" which may be drunk ad libitum. 

Sassafras is a constituent of the three compound Sarsaparilla preparations. 

Physiological Action and Therapeutics. 
Sassafras is a stimulant diaphoretic when used in quantity of the hot 
infusion. It enjoys a popular reputation asa " blood-purifier," and has 
a destructive influence on infusoria. It is employed chiefly in combina- 
tion with Sarsaparilla and Guaiacum in cutaneous disorders and rheu- 
matic and syphilitic affections. The mucilage of the pith is an excellent 
demulcent drink in acute gastritis or enteritis, or in poisoning by irritant 
or corrosive agents. It may also be used in extemporaneous prescriptions 
to hold insoluble substances in suspension and for flavoring purposes. 
The oil is chiefly used for flavoring in mixtures and confectionery. The 
syrup popularly known as " Sarsaparilla" is composed of Oil of Sassafras 
and Oil of Gaultheria. 



SCAMMONIUM, Scammony, — is a resinous exudation from the 
root of Convolvulus Scammonia, a plant of the nat. ord. Convolvulacese, 
growing chiefly in Syria and Asia Minor. It occurs in irregular, angular 
pieces or circular cakes, of a greenish-gray or blackish color, a peculiar, 
cheese-like odor, and a slightly acrid taste; easily triturated into a dirty- 
gray powder, and with water yields a smooth, greenish emulsion. It 
contains about 80 per cent, of Resin, with gum, sugar, starch, etc. The 
active principle, Jalapin, is probably identical with the Convolvulin of 
Jalap, and is contained in the root, the resin, etc. Dose, gr. v-x. 



SCILLA. 367 

Preparations. 

Resina Scammonii, Resin of Scammony, — is wholly soluble in ether. Dose, gr. iij-viij. 
Exlradum Colocynthidis Composilum, — (see ante, page 190) contains 14 per cent, of 
Resin of Scammony, and is an ingredient of the Compound Cathartic Pill. 

Physiological Action and Therapeutics. 

Scammony is an active cathartic, stimulating the liver and the intesti- 
nal glands, and causing free purgation in a few hours, with considerable 
griping. Its solution in the bile is necessary to its action, and it combines 
with the soda in that secretion. Though quite drastic in action it is 
somewhat uncertain as a purgative and is generally employed in combina- 
tion with similarly acting agents. It is anthelmintic against the tapeworm, 
and in overdoses produces a high degree of irritation. 

It is used as a drastic purgative for children with Calomel or Potassium 
Sulphate, when an active cathartic is indicated. In the same way it is 
the appropriate agent on the principle of derivation in dropsies and 
cerebral affections, also in torpid states of the intestines with much slimy 
intestinal mucus; but it is contraindicated in cases attended by irritabil- 
ity of the stomach and bowels. 



SCILLA, Squill, — is the sliced bulb of Urginea Scilla, or Scilla 
maritima, a perennial plant of the nat. ord. Liliaceas, growing on the 
shores of the Mediterranean. It comes in narrow segments about two 
inches long, of yellowish-white or reddish color, slightly translucent, 
inodorous, mucilaginous, bitter and acrid to the taste. Its active prin- 
ciple has not yet been definitely isolated, but it is probably the acrid, 
bitter glucoside Scillitoxin. Other principles have been obtained and 
named Scillipicrin, Scillitin and Scillin, also Sinistrin, a peculiar carbo- 
hydrate or mucilage, and the usual constituents of plants. Dose, in 
powder, gr. j-iij. 

Preparations. 

Extractum Scilla Fluidum, — Dose, rnj-v. 

Tinctura Scilla, — 15 per cent. Dose, TT^v-xxx. 

Acetum Scilla, — 10 per cent. Dose, W[x-g]. 

Syrupus Scilla, — has of the Acetum 40 parts with Sugar 60 and Water. Dose, 
3 ss— ij. 

Syrupus Scillce Composilus, — has of Squill 120, Senega 1 20, Tartar Emetic 3, Sugar 
1200, Calcium Phosphate 9, Diluted Alcohol and Water up to 2000 parts. Is known as 
Coxe's Hive Mixture, and each fluid ounce contains about gr. }( of Tartar Emetic. 
Dose, tt\v-3;j, for children, the latter being an emetic dose ; as an expectorant for adults 
TTLxx-xxx. 

Physiological Action. 

In small doses Squill is expectorant, in larger doses emetic and diuretic, 

and in overdoses it is a violent irritant poison, producing nausea, vomiting, 

purging, gastro-enteritis, strangury, bloody urine, perhaps suppression 

of urine, paralysis and convulsions, with death by paralysis of the heart in 



368 SCOPARIUS. 

systole. Medicinal doses slow the heart, making the pulse stronger and 
slower, raising the arterial tension, and increasing the flow of urine (like 
Digitalis). Its active constituents diffuse into the blood, and its systemic 
effects follow on its application to the skin and seem to be exerted upon 
the mucous membrane of the secretory organs, especially affecting the 
bronchial, gastro-intestinal and genito-urinary. 

Therapeutics. 

Squill is employed in medicine for its expectorant and diuretic effects. 
It is especially applicable in cardiac dropsy, combined with Digitalis or 
the saline diuretics, and in chronic bronchitis associated with Ipecac or 
Ammonia, Asafcetida, Benzoin, etc. It is also used in croup, but is 
usually combined in this affection with some other emetic, as Tartar 
Emetic in the Compound Syrup, a mixture which may produce very 
depressing effects and should be used with caution. In whooping-cough 
and other irritant coughs with tickling sensations in the throat the Syrup 
or Vinegar of Squill is often of great service. 

The actions and uses of Squill should be studied in connection with 
those of Digitalis and Ipecacuanha. 



SCOPARIUS, Broom, — the tops of Sarothamnus Scoparius, or 
Broom-plant, a common garden shrub of the nat. ord. Leguminosse, 
having small, downy leaves and numerous large golden-yellow flowers. 
It occurs in thin, flexible twigs, usually free from leaves, nearly smooth, 
tough, of a peculiar odor when bruised and a disagreeably bitter taste. 
It contains Scoparin, C 2 iH 22 O 10 , a neutral, crystallizable principle; and 
Sparteine, Ci 5 H 26 .N 2 , a volatile, liquid alkaloid, having no oxygen, but 
possessing very decided basic qualities and being highly poisonous. 
There are no official preparations, but a decoction maybe prepared in the 
proportion of gj to the pint, and administered in doses of % every three 
hours until its diuretic effect is produced. 

Sparteine Sulphas, Sulphate of Sparteine, Dose, gr. T V-§-» hypo- 
dermically ; — gr. ^-ij per orem. Small doses,, gr. •£$-%, every 5 hours, 
for cardiac action ; — larger, gr. j-ij, for diuresis^ (Clarke.) Larger 
doses are necessary, say gr. iss-iij, ter die. (Prior.) 

Physiological Action. 

Broom-tops are diuretic and laxative, also emetic and cathartic in large 
doses. In the form of decoction they have long been a favorite diuretic 
and vehicle for other diuretics, in the treatment of dropsies, both cardiac 
and renal, but are considered most reliable in the dropsy of renal origin. 

Sparteine has been thought to resemble Coniine in its- action, paraly- 
zing the end-organs of the motor nerves and vagi, lowering the reflex 



SCOPARIUS. 369 

excitability of the cord, and causing death by paralyzing the respiratory 
centre in the medulla. Recent observations, however, place it in the 
Digitalis group, and in the front rank among the members thereof. 

In small doses Sparteine slows and strengthens the heart-beats, and 
raises arterial tension, at the same time increasing the cutaneous and renal 
circulation, so that the surface becomes flushed and moist, and in some 
cases marked diuresis and diaphoresis occur. The respiration, at first 
quickened, is soon slowed and deepened, — the patient having a sense of 
increased warmth and well-being, and if suffering from irregular cardiac 
action, precordial distress and dyspnoea, these symptoms are promptly 
relieved. If the pulse has been abnormally slow Sparteine will quicken 
it, though its general action is to slow the cardiac rate. An overdose 
brings on marked palpitation, a small and rapid pulse of very high tension, 
prsecordial pain and a sense of " tightness " about the chest, with anxiety, 
and a feeling of intense debility, perhaps even muscular tremor. Death 
occurs by asphyxia from depression of both the centre and the muscles 
of respiration. 

The action of Sparteine upon the circulation is manifested quickly as 
compared with that of other similarly-acting drugs. In y 2 hour after its 
ingestion the pulse is markedly slower, — in another y^ hour the arterial 
tension rises, and both effects last from 5 to 6 hours. When taken regu- 
larly for several days or weeks its influence remains for nearly a week after 
its discontinuance. There is, however, no danger of cumulative action, 
and though the dosage employed has varied from gr. -jL every 4 hours, to 
gr. xij in 24 hours, no toxic action was observed, nor was there any evi- 
dence of accumulation, even when given continuously for 3 to 4 months. 
(Clarke.) Only from a dose of gr. xxxj were evil effects observed. (Prior.) 

Its diuretic power on healthy persons is denied by some observers and 
affirmed by others, though all acknowledge it in disease. It is accompa- 
nied by increased excretion of urea, — is due to the increase of blood- 
pressure both behind and in front of the renal circulation, — and is 
produced only by large doses, gr. %-gr. ij. 

Sparteine acts directly on the cardiac muscle, as well as upon the inhib- 
itory apparatus, thus giving greater force to the cardiac contractions, and 
regulating (generally slowing) the pulse-rate. It also stimulates the vaso- 
motor centre to contract the vessels throughout the splanchnic area, thus 
increasing the circulation in the skin and kidneys, and raising arterial 
tension generally. 

Therapeutics. 
Broom-tops are a favorite remedy for dropsies of cardiac origin, and 
for the general anasarca of chronic kidney disease, but are inadmissible 
in acute renal affections or where there is pulmonary congestion or in- 
flammation. 
24 



370 SCUTELLARIA SENEGA. 

Sparteine has been employed with very great benefit in cardiac affec- 
tions requiring stimulation of the heart's action with the smallest possible 
increase of arterial tension, relief of dyspnoea, praecordial pain, palpita- 
tion and oedema. In such cases small doses, gr. -£$ \, are best, and as 
the influence of the drug is remarkably sustained, they need not be re- 
peated oftener than once m 5 or 6 hours. It has given the most marked 
satisfaction in mitral regurgitation, in which it relieves all the symptoms; 
also in mitral stenosis, when the pulse is small, weak and irregular. In 
aortic regurgitation, it quiets excited action of the heart, without unduly 
prolonging the systole, and is of great value. Used in -chronic Bright's 
disease, with hypertrophy and high arterial tension, it stimulates the 
heart without increasing the tension. In exophthalmos, it gives remark- 
able relief to all the symptoms. For cardiac palpitation and arhythmia, 
small doses are of great service. In asthma it is of signal benefit, cutting 
short the paroxysms, and rendering their recurrence much less frequent. 
In the opium-habit it is used at periods of depression during the treat- 
ment, to overcome the "plateau" shown in the sphygmograph trace, by 
stimulating the cardiac action. (Jennings.) For this purpose, doses of 
gr. iss-iij three or four times daily are necessary. (Prior.) 



SCUTELLARIA, Skull-cap, — is the plant Scutellaria lateriflora, 
an indigenous, perennial herb of the nat. ord. Labiatse, growing in moist 
places and along ditches ; having small, pale-blue flowers disposed in long, 
leafy racemes, of slight odor and bitterish taste. It contains a little vola- 
tile oil, traces of a bitter principle, besides fat, tannin, sugar, etc. 

Preparation. 
Extractum Scutellaria Fluidum, — Dose, ^ss-ij. 

Physiological Action and Therapeutics. 
Scutellaria produces no very obvious effects when taken internally. By 
some practitioners it is said to have tonic, nervine and antispasmodic 
powers, and it has been used in domestic practice to calm the nervous 
system in diseases characterized by restlessness, tremors, spasms, twitch- 
ing of the muscles, hypersesthesia, etc., as chorea, delirium tremens, nerv- 
ous exhaustion from fatigue or over-excitement, hydrophobia, hysteria and 
epilepsy. The Scutellarin of the Eclectics is not a proximate principle, 
but an extract precipitated by alum from a concentrated aqueous tincture. 
It is given in dose of from one to four grains. 

SENEGA, — is the root of Polygala Senega, an indigenous, perennial 
plant of the nat. ord. Polygalacese, having small, white flowers in a close 
spike at the summit of the stem. The root is about 4 inches long, with a 



SKNNA. 371 

knotty crown and tortuous, spreading branches, thick bark inclosing a 
porous, yellowish wood ; odor slight but unpleasant, taste at first sweetish, 
afterwards acrid. Its principal constituent is the glucoside Senegin^ 
C 32 H 54 18 , which is identical with Saponin, and closely allied to Digitonin. 
It is a white, amorphous powder, readily soluble in alcohol and hot water, 
forming a soapy emulsion when mixed with boiling water, and decom- 
posed by HC1 into sugar and Sapogenin, C u H 22 2 . 

Preparations. 

Abstractum Senega, — Dose, gr. v-x. 

Extractum Senegce Fluidum, — Dose, TT^x-xx. 

Syrupus Senegce, — has of the fluid extract 160, Aqua Ammonise 4, Sugar 600, Water 
to 1000 parts. Dose, gj-ij. 

Syrupus Scillce Compositus, — contains 6 per cent, of Senega. (See page 367.) Dose for 
children, V(\v-g] ; for adults as an expectorant, m^xx-s^ss. 

Physiological Action. 
Senega is a stimulating expectorant, a diuretic and a diaphoretic. It 
causes irritation of the throat, with some salivation and gastro-intestinal 
irritation, an inclination to cough, increased bronchial secretion, and 
perhaps some diuresis and diaphoresis. Inhaled as a snuff it is very irri- 
tant to the mucous membrane of the nose, causing cough, sneezing and 
nasal catarrh. Senegin is violently irritant and a powerful depressant to 
the heart, vessels, nervous and muscular systems. It is excreted by the 
bronchial mucous membrane, the kidneys and the skin, all of which it 
stimulates and in large quantity irritates. 

Therapeutics. 
The use of Senega is chiefly that of a stimulating expectorant in chronic 
bronchitis, the second stage of acute bronchitis, typhoid pneumonia, 
asthma, croup, and as a diuretic in dropsy due to renal disease. It re- 
moves the. tightness and oppression experienced in subacute chest affec- 
tions, relieves the cough and rapidly promotes expectoration. When the 
mucus is tough and scanty this remedy is of no value. It has been used" 
with great benefit in amenorrhcea, given in saturated decoction for two 
weeks before the expected period. In chronic rheumatism and in rheu- 
matic paralysis its stimulating and diaphoretic powers have been of great 
value. Senegin has been successfully used in 2 -grain doses as a remedy 
for uterine hemorrhage. 



SENNA, — the leaflets of Cassia acutifolia (Alexandria Senna), and of 
Cassia elongata (Indian Senna), shrubs of the nat. ord. Leguminosae, 
growing in Egypt and India. The leaflets are from 1 to 2 inches long, 
lanceolate, brittle, dull green, of peculiar odor, and nauseous, bitter taste. 
They contain an amorphous glucoside, Cathartic Acid, C 180 H 192 N 2 SO 8 2, 
which forms salts with bases and may be decomposed into glucose and 



372 SENNA. 

Cathartogenic Acid. Other constituents are Sennapicrin and Sennacrol, 
both glucosides ; — Catharto-mannite, a peculiar unfermentable sugar ; also 
a coloring matter allied to Chrysarobin (see page 178), and various vege- 
table salts. 

Preparations. 

Extractum Senna Fluidum, — Dose, ^j. An excellent preparation. 

Syrupus Senna, — has of Senna 23 parts, Sugar 60, Alcohol 4, Oil of Coriander and 
Water to 100 parts. Dose, g.ss-ij. 

Confectio Senna, — has of Senna 10, Coriander 6, Cassia Fistula 16, Tamarind 10, 
Prune 7, Fig 12, Sugar 50, Water 60 parts. Is sold under the titles " Tamar-Indien, " 
" Tropical Fruit Laxative, " etc. Dose, gj-ij. 

Infusum Senna Compositum, Black Draught, — has of Senna 6, Manna 12, Magnesium 
Sulphate 12, Fennel 2, Water 100 parts. Dose, J j-iij. 

Pulvis Glycyrrhiza Compositus, (see ante, page 234), — contains 18 per cent, of Senna. 
Dose, gr. xx-gj. 

Syrupus Sarsaparilla Compositus (see ante, page 365), — contains 12 per 1000 of Senna. 
Dose, ^j-iv. 

Physiological Action. 
Senna is a very efficient and safe cathartic, producing, when taken in- 
ternally, copious yellow stools in about 4 hours, with considerable griping 
and flatulence, which may, however, be lessened by combining it with 
carminatives. Its action is chiefly expended on the small intestine, and 
it increases both peristalsis and secretion. It has no irritant qualities in 
ordinary medicinal doses, and does not produce hypercatharsis, nor leave 
constipation as an after-result. Its infusion injected into the veins causes 
both vomiting and purging ; and in large doses per orem it produces nau- 
sea, vomiting, flatulence, excited pulse, drastic purgation with severe tenes- 
mus, but its effects are never poisonous. It may produce hemorrhoids 
and increase the menstrual flow in women. Given to a nursing mother 
her milk will acquire purgative powers. In some very susceptible per- 
sons the odor of the leaves or of the infusion will cause an evacuation of 
the bowels. Its odor and taste are particularly disagreeable,, especially 
when administered in infusion. 



Therapeutics. 
Senna would probably take rank as our best and safest cathartic but for 
the nauseousness of its smell and taste. It is a favorite laxative in Eng- 
land for children, and is used with great benefit in habitual constipation 
or where prompt evacuation of the bowels is required. In hemorrhoids 
and anal fissures it is employed to produce soft and easy motions ; but if 
a tendency to hemorrhoids exists, the use of this drug in cathartic doses 
will cause irritation of the part and induce an acute attack. For the 
same reason it is contraindicated in any such conditions as hemorrhage 
or inflammation of the intestinal mucous membrane, hemorrhoids, menor- 
rhagia, abortion, etc. The least disagreeable of its preparations are the 
Confection of Senna and the Compound Liquorice Powder. 



SERPENTARIA SESAMI OLEUM. 373 

SERPENTARIA, Virginia Snake-root,— is the rhizome and 
rootlets of Aristolochia Serpentaria and of Aristolochia reticulata, indi- 
genous herbaceous plants of the nat. ord. Aristolochiaceae, growing in 
rich, shady woods, with purple flowers arising from joints near the root. 
The rhizome is about an inch long, thin and bent, having on the upper 
side short stem-remnants, on the lower side numerous thin, branching 
rootlets; odor and taste are aromatic and camphoraceous. It contains a 
volatile oil, a camphor-resin and a bitter principle named Aristolochine, 
which is soluble in both alcohol and water. All its preparations should 
be made from the fresh root, as it deteriorates by keeping. 

Preparations. 
Extra ctu m Serpent a rice Flu idu m , — D o se , TT^x-xx x . 
Tinctura Serpentaria, — IO per cent. Dose, gss-ij. 

Tinctura Cinchona Composita, — has 2 parts of Serpentaria in 100. (See ante, page 
181.) Dose,3J-ij. 

Physiological Action. 

Serpentaria is a stimulant expectorant and tonic, also a cardiac stimu- 
lant, a diaphoretic, diuretic, emmenagogue, aphrodisiac, and somewhat 
of an antiperiodic. Its taste is warm and pungent, its odor characteris- 
tic. Small doses promote appetite and digestion, increase the bronchial 
and intestinal secretions, the action of the heart, the cutaneous circula- 
tion and the surface temperature, and produce considerable mental exhila- 
ration. Large doses are irritant, causing nausea and vomiting, vertigo 
and headache, colic, borborygmi, rectal tenesmus, flatulent distention and 
frequent but not watery stools. The irritant action seems to produce gas 
rather than fluid. Pruritus ani and hemorrhoids are occasionally caused 
by its use. 

Therapeutics. 

Serpentaria is chiefly employed as a vehicle for other stimulant drugs, 
but has many uses of its own. In bronchial affections it is extremely 
valuable as a stimulating expectorant. In typhoid pneumonia it is a good 
vehicle for carbonate of ammonium, and in the exanthemata is extremely 
useful when much depression exists. It is indicated in typhoid condi- 
tions generally, and in the amenorrhoea of anaemia and chlorosis it is an 
efficient emmenagogue in many cases. It will often restore the waning 
sexual power in functional impotence, while in bilious vomiting it fre- 
quently checks the nausea and settles the stomach. It is used as a 
vehicle for Cinchona in remittent fever. In diphtheria, scarlatina, etc., 
the infusion forms an excellent gargle. Its diaphoretic and diuretic prop- 
erties, though slight, are sometimes of avail in chronic rheumatism. 

SESAMI OLEUM, Oil of Sesamum, Benne Oil,— is a fixed 
oil expressed from the seeds of Sesamum indicum, or Benne plant (nat. 
ord. Pedaliaceae), which is a native of India, but is cultivated in the 



374 SEVUM — SILICATES SINAPIS. 

southern portion of the U. S. It is a yellowish or yellow, oily liquid, 
inodorous or nearly so, having a bland, nut-like taste and a neutral reac- 
tion. It is a bland fixed oil, very similar in its properties to olive oil, 
and may be used for the same purposes. It is rich in Olein (76 per cent.) 
and keeps better than olive oil. It is chiefly employed as a hair-oil. 



SEVUM, Suet, — is the internal fat of the abdomen of Ovis Aries 
(the Sheep), purified by melting and straining. It should be kept in 
well-closed vessels and not used after it has become rancid, as it will on 
exposure to air. It is a white, smooth, solid fat, of bland taste and neu- 
tral reaction, soluble in 24 of boiling alcohol, 60 of ether, and slowly in 
2 of benzin. It consists chiefly of Stearin, but also has Palmitin and 
Olein, and is a constituent of Unguentum Hydrargyri and Unguentum 
Picis Liquidae. It is a harder fat than lard and more liable to turn rancid. 
It is used in ointments and liniments to give them greater consistency, 
but may be applied alone as a dressing to ulcers. In physiological 
action and therapeutics it follows the other oils and fats (see ante, pages 
288, 296). 

SILICATES of Sodium (Na 2 Si0 3 ) of Potassium (K 2 Si0 3 ), and of 
Magnesium (2Mg03Si0 2 ) are used in medicine and surgery, a solution of 
the Silicate of Sodium being official. 

Liquor Sodii Silicatis, Soluble Glass Solution, — is a semi-trans- 
parent, colorless or yellowish, viscid liquid, odorless, of sharp saline and 
alkaline taste and alkaline reaction, of sp. gr. 1.300 to 1.400. A small 
quantity should not produce any caustic effect when applied to the skin. 
It usually contains about 20 per cent, of Silica and 10 per cent, of Soda, 
and is used on bandages to make immovable dressings, being lighter than 
plaster-of- Paris and stronger than starch. 

Liquor Potassii Silicatis (Unofficial), — also known as Soluble Glass Solution, — is used 
for immovable dressings in the same manner as the preceding. A mixture of 2 parts of 
this solution with one of the soda salt solution is said to set more quickly and firmly than 
either solution separately. Diluted ( 1 to 4) the solution of the Potassium Silicate has been 
applied locally in erysipelas, gonorrhoea, cystitis, vaginitis, etc., as an antiseptic, and 
with good results. 

Magnesii Silicas Hydrattis, Hydrated Silicate of Magnesium, Meerschaum, 2MgO, 
3Si0 2 + 2 H 2 (Unofficial), — a mineral used for the manufacture of smoking-pipes, and 
employed in France as a substitute for Bismuth Subnitrate in obstinate choleraic diarrhoea, 
to protect the intestinal mucous membrane or as an absorbent. It is given in fine powder 
and in doses of 3 j— iv per diem. 

SINAPIS, Mustard, — is official under the two following titles, 
but all the pharmacopceial preparations are made from Black Mustard 
only. 



sinapis. 375 

Sinapis Alba, White Mustard, — the seed of Sinapis Alba, an annual 
plant of the nat. ord. Cruciferae, cultivated in our gardens. It has yellow 
flowers in racemes, and ribbed pods with a long, ensiform beak. The 
seeds are about -^ inch in diameter, yellowish, hard, almost globular with 
a circular hilum ; embryo oily, with a curved radicle and two cotyledons, 
one folded over the other ; inodorous, taste pungent and acrid. 

White Mustard contains Myrosin, a ferment, and Sinalbin, a crystalline substance, 
which reacting on each other in the presence of water produce Sidpho-cyanate of Acrinyl, 
a rubefacient principle allied to the volatile oil of black mustard. It also contains Sin- 
apine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil, all three contained also 
in Black Mustard. 

Sinapis Nigra, Black Mustard, — is the seed of Sinapis nigra, an 
annual plant of the nat. ord. Cruciferae, native of Europe but naturalized 
in the U. S. It has small, yellow flowers standing closely together on 
peduncles at the end of the branches, also smooth, erect pods with a 
short beak. The seeds are about one-half the size of those from white 
mustard, black and hard, almost globular with a circular hilum ; embryo 
as in Sinapis Alba ; inodorous when dry, but when moist of a pungent, 
irritating odor ; taste pungent and acrid. 

Black Mustard contains Myrosin, a ferment, and Sinigrin (Potassium Myronate), 
which reacting on each other in the presence of water produce the Sulpho- cyanide of 
Allyl, or Volatile Oil of Mustard. It also contains Sinapine, an alkaloid, Erucic or 
Brassic Acid, and a bland, fixed oil ; all three of which are contained also in While 
Mustard. 

Commercial Flour of Mustard (Unofficial), — is a mixture of white 
and black mustard seeds ground to a fine powder. It may be employed 
in lieu of either variety. Dose, as emetic, gij-iv. 

Preparations. 

Oleum Sinapis Volatile, Sulpho-cyanide of Allyl, C 4 H 3 NS, — a colorless or pale yellow 
liquid, of very pungent and acrid odor and taste 'and neutral reaction, sp. gr. 1.017 to 
1.021, almost insoluble in water but freely soluble in alcohol and ether. Dose, V(\ J %-}i. 

Charta Sinapis, Mustard Paper, — consists of Black Mustard, the fixed oil removed by 
percolation with Benzin, mixed with Solution of Gutta-Percha and spread on paper. 
Each square inch should contain about gr. vj of Mustard. For local use. 

Linimentum Sinapis Compositum, — has of the Volatile Oil 3, Extract of Mezereum 2, 
Camphor 6, Castor Oil 15, Alcohol to 100 parts. For local use. 



Physiological Action. 
Locally used, Mustard is rubefacient, counter-irritant, and a nervous 
stimulant, causing heat, redness and severe burning pain. Its prolonged 
application produces vesication by inducing local inflammation. Inter- 
nally it is a local emetic in full doses, in smaller a condiment and carmi- 
native. Its irritant effect on the gastric mucous membrane is much less 
powerful than on the skin. 



376 SODIUM. 

Therapeutics. 

Mustard is commonly used as a local application to relieve local pain, 
to stimulate the viscera, and to produce counter-irritation. These objects 
find their application in muscular rheumatism, neuralgia, colic, gastralgia, 
inflammation of the throat, larynx, bronchi, lungs, pleurae and peri- 
cardium, also as a derivative in headache, cerebral congestion, and sup- 
pressed menstruation. It may also be used as a stimulant to the heart, 
vascular system and respiratory apparatus. When action of a mild cha- 
racter is desired it may be diluted with flaxseed or flour. 

Internally it may be employed as an emetic in indigestion or narcotic 
poisoning. Its use as a condiment is familiar, acting by stimulation of 
the gastric mucous membrane. In overdoses it may excite severe gastritis. 
White Mustard seed, unground, has been used as a laxative, as it pro- 
duces no irritation. 

The Oil is one of the most irritant of the volatile oils, producing severe 
gastro-enteritis. It is used chiefly as an ingredient of stimulating lini- 
ments, but may be employed internally in small doses. 

SODIUM, Natrium, Na. — This metal is not official, but is repre- 
sented by a number of official salts, which are generally colorless or white, 
and with very few exceptions are readily soluble in water. Some of them 
are found native, as the Chloride (in sea-water, salt lakes, salt mines), — 
the Nitrate (in Peruvian deserts, etc.) and the Borate (in lakes of Persia, 
California, etc.). The Carbonate is found in the ashes of marine plants. 
From the Chloride is prepared the Sulphate, from this the Carbonate, and 
from the latter most of the other salts are prepared. All sodium salts 
impart a yellow color to flame, which should not appear more than tran- 
siently red when observed through a blue glass, which cuts off the yellow 
rays but allows the violet ones of Potassium to be seen. 

Sodium Compounds and their Preparations. 

Soda, Sodium Hydrate, Caustic Soda, NaHO, — a white, hard, opaque solid, deliques- 
cent in moist air, efflorescent in dry air, odorless, of intensely acrid and caustic taste and 
strongly alkaline reaction, soluble in 1.7 of water at 59 F., and in 0.8 of boiling water, 
very soluble in alcohol. Is a powerful caustic but milder than Potassa, and should be 
kept in well-stoppered bottles made of hard glass. 

Liquor Sodce, Solution of Soda, — contains about 5 per cent, of the hydrate, and is pre- 
pared by dissolving 180 parts of Sodium Carbonate in 400 of boiling Distilled Water, 
also 60 of Lime in the same quantity of Distilled Water, boiling, mixing the solutions 
gradually, again boiling and when cold adding water up to 1000 parts, straining, settling, 
and then removing the clear solution. Or, by dissolving 56 of Soda in 944 of Distilled 
Water. It is a clear, colorless liquid, odorless, of acrid and caustic taste and strongly 
alkaline. Dose, rr\v-gss, well diluted with water 

Sodii Acetas, Acetate of Sodium, NaC 2 H 3 2 .3H 2 0, — large, transparent prisms, efflo- 
rescent in dry air, odorless, of saline, bitter taste and a neutral or faintly alkaline reaction, 
soluble in 3 of water and in 30 of alcohol at 59 F., in I of boiling water and in 2 of 
boiling alcohol. Dose, gr. xx-£j. 

Sodii Carbonas, Carbonate of" Sodium, Na 2 CG 3 ioH 2 0, — large, colorless crystals, 
rapidly efflorescent, with a harsh alkaline taste and strongly alkaline reaction ; very solu- 



sodium. 377 

ble in water, insoluble in alcohol. By heat it undergoes aqueous fusion and then dries 
up, losing 63 per cent, of its weight. Of it 20 grains will neutralize 9.7 grains of Citric 
Acid, or 10 *4 grains of Tartaric Acid. Dose, gr. v-xxx. 

Sodii Carbonas Exsiccalus, Dried Carbonate of Sodium, — is the Carbonate 200 parts 
dried at a heat of 113 F., until it is converted into a white powder weighing 100 parts. 
Is chiefly used for pharmaceutical purposes. 

Sodii Bicarbonas, Bicarbonate of Sodium, NaHC0 3 , — an opaque, white powder, 
permanent in the air, odorless, of cooling, saline taste, and a slightly alkaline reaction ; 
soluble in 12 of water at 59 F., insoluble in alcohol, decomposed by hot water. It is 
distinguished from the Carbonate by its solution in cold water giving a white and not a 
colored precipitate with solution of perchloride of mercury. Of it 20 grains neutralize 
16.7 grains of Citric Acid, or 17.8 grains of Tartaric Acid. It is a constituent of Mis- 
tura Rbei et Sodae (see page 344) and of Pulvis Effervescens Compositus (see page 331). 
Dose, gr. x-gj. 

Sodii Bicarbonas Venalis, Commercial Bicarbonate of Sodium, — should contain 95 
per cent, of pure bicarbonate, which it resembles in appearance and properties. It is 
employed solely for external applications. 

Trochisci Sodii Bicarbonatis, — each troche contains of the Bicarbonate 3 grains, with 
Sugar, Nutmeg and Mucilage of Tragacanth. Dose, as of the bicarbonate. 

Sodii Chloras, Chlorate of Sodium, NaC10 3 , — colorless, transparent tetrahedrons of the 
regular system, permanent in dry air, odorless ; of cooling, saline taste and neutral reaction, 
soluble in 1.1 of water and in 40 of alcohol at 59 F., also in 0.5 of boiling water and in 
43 of boiling alcohol. When heated it melts and then gives off a portion of its oxygen, 
leaving a residue of sodium chloride. Should be kept in well-stoppered bottles, and 
should not be triturated with readily oxidizable or combustible substances. Dose, gr. v-xx. 

Sodii Chloridum, Chloride of Sodium, Common Salt, NaCl, — white, hard, cubical 
crystals or a crystalline powder, permanent in the air, odorless, of a purely saline taste 
and neutral reaction ; soluble in 2.8 of water at 59 F., and in 2.5 of boiling water. Al- 
most insoluble in alcohol. Dose, gr. x-^j. 

Sodii JVitras, Nitrate of Sodium, Cubic Nitre, Chili Nitre, Chili Saltpetre, NaN0 3 , — 
colorless, transparent crystals, slightly deliquescent, odorless, of cooling, saline and bitter 
taste, and neutral reaction; soluble in 1. 3 of water at 59 F., and in 0.6 of boiling water, 
scarcely soluble in cold alcohol. Dose, ^j-ij. 

Sodii Sulphas, Sulphate of Sodium, Glauber's Salt, Na 2 S0 4 .ioH 2 0, — large, colorless, 
transparent, monoclinic prisms, rapidly efflorescent in air; of cooling, saline taste and 
neutral reaction; soluble in 2.8 of water at 59 F., in 0.25 of water at9l.4° F., and in 
0.4 of boiling water, insoluble in alcohol. Dose, gr. v-xx; as purgative ^ss-j or a 
third of a teaspoonful in a large glass of water. 

Sodii Ethylas, Ethylate of Sodium, Caustic Alcohol, C 2 H 5 NaO (Unofficial), — is a 
white powder, often having a brownish tinge, dissolving in water with a hissing sound. 
Upon contact with the smallest quantity of water or moist living tissue it splits into alco- 
hol and caustic soda. An alcoholic solution is made by dissolving sodium in absolute 
alcohol, and is used as a caustic. Chloroform decomposes it at once into ether and chlo- 
ride of sodium. It should be kept in a cool place as it is liable to explode. 

The Arseniate of Sodium is described under Arsenic, page 119 ; — the Benzoate under 
BenzoIiN, page 132;— the Borate under Ac. Boricum, page 60; — the Bromide under 
Bromum, page 136; — the Solution of Chlorinated Soda under Chlorum, page 177; — 
the Iodide under Iodum, page 258; — the Hypophosphite, Phosphate and Pyrophosphate 
under Phosphorus, page 312; — the Salicylate under Salicin, page 357;— the Santoni- 
nate and its Troches under Santonica, page 363 ; — the Sulphite, Bisulphite and Hypo- 
sulphite under Acidum Sulphurosum, page 74; and the Sulpho- car bolate under Car- 
bolic Acid, page 61. 

Physiological Action. 
The action of the Sodium salts is similar to that of the Potassium salts, 
except that the former are feebler as alkalies, are not so depressant, and 
are not so poisonous to the cardiac muscle or the nerves. They are dif- 
fused more slowly, are neither absorbed nor excreted so readily, and have 
not so marked a diuretic action. Locally applied in large doses to mus- 
cular and nervous tissue they are paralyzant, but not so powerfully as 



378 sodium. 

potassium salts. Urate of Sodium is not soluble like the urates of 
lithium or potassium, being therefore much less readily excreted, and 
forming the masses called "chalk-stones" in gouty subjects. Soda is a 
less active escharotic than potash, having less affinity for water. Liquor 
Sod^e renders the blood and secretions more alkaline, but does not alter 
nutrition to the extent that liquor potassse does. The Acetate is con- 
verted into the Carbonate in the blood, and is a less active diuretic than 
the corresponding potassium salts. The Carbonate is chiefly used in 
the preparation of the other salts. The Bicarbonate is slightly irri- 
tant, stimulates the secretion of gastric juice, acts as an antacid and will 
increase the alkalinity of the blood. The Chloride is a most important 
food. It exists normally in the blood, where it keeps the fibrin and albu- 
men in solution, and plays an important part in tissue change. In in- 
flammation, being thus needed, it accumulates at the seat of the morbid 
action, disappearing from the urine ; its reappearance therein being a 
sign of improvement. A solution of 0.65 parts to 100 of water does not 
destroy animal tissue like water alone, and may be mixed with blood 
without destroying the corpuscles, though strong solutions are intensely 
irritating. Internally used in quantity it is emetic and hemostatic. As 
an enema it is destructive to ascarides. 

Nitrate of Sodium is a mild cathartic, and in solution is a solvent of 
false membranes. The Sulphate is generally cathartic in action, though 
in small doses and with little water it may be passed off by the kidneys. 
It is mixed with the Bicarbonate to imitate the salts obtained by evapora- 
tion of Carlsbad water. The Ethylate is antiseptic, and a powerful 
but almost painless caustic. 

[The actions of the other Sodium salts are respectively described under 
the titles of their other constituents, to which their effects are mainly 
referable.] 

Antagonists and Incompatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable acids, as vinegar, cider, 
lemon-juice; then demulcent drinks and oils to protect the mucous membrane, and the 
usual vital supporters. The alkalies and their carbonates are incompatible with the acids 
and also with metallic salts, and the caustic alkalies decompose most alkaloids. 

Therapeutics. 
The sodium salts treated of in this article are not much used internally, 
the corresponding Potassium salts being preferred, especially when it is 
desired to alkalinize the urine or to promote oxidation. In the alkaline 
treatment of stomach affections the Sodium salts are the most efficient, 
especially the Bicarbonate before meals or on an empty stomach to 
increase the secretion of the gastric juice. This same salt is used in 
diabetes to lessen the amount of sugar, in frontal headache with consti- 
pation, the pain being seated at the junction of the forehead with the 



SOMNAL. 379 

hairy scalp, — also as a wash (gr. ij ad §j) in itching skin affections and as 
a lotion in burns and eczema. The Chloride is used internally as an 
antidote in poisoning by Nitrate of Silver and as an emetic, and will 
often relieve hemoptysis and migraine. In bilious diarrhoea it is em- 
ployed in doses of gr. x-^j, thrice daily. Locally in baths it is a good 
stimulant to the skin, and in solution (}4 to i per cent.) to wash 
wounds in place of water, to cleanse the nasal cavities, or to destroy 
ascarides, in which case it is given by enema of the strength of two 
tablespoon fuls to the pint. The Carbonate may be used in dilute solu- 
tion locally to prevent itching, but is chiefly employed in the preparation 
of the other salts. The Sulphate is a good purgative, either alone or 
with the Bicarbonate in imitation of Carlsbad Salts, for bilious disorders, 
gouty affections, chronic constipation, obesity and diabetes mellitus. The 
Chlorate has similar uses to those of the Potassium Chlorate, but being 
more soluble can be used in stronger solutions, but this is of doubtful 
benefit for internal use, as it has all of the irritating power on the kidneys 
and destructive action on the blood possessed by the other salt. (See 
ante, page 332.) The Nitrate is employed as a mild cathartic, and in 
solution by atomization to destroy the false membrane in croup. The 
Ethylate has been of service as a caustic in cancer, lupus and nsevi, 
for the latter affection being painted over the growth with a glass rod. 
Caustic Soda is a better caustic than Potassa, as it has less affinity for 
water and hence does not destroy the tissues so deeply, nor has it the 
same tendency to run over adjacent parts. 

[The therapeutics of the other Sodium Compounds are described as 
noted on page 378.] 



SOMNAL, C 7 H 12 C1 3 3 N, — is a new hypnotic, introduced by a German 
manufacturer, and formed by the union of Chloral, Alcohol and Urethan, 
the result being a complex body, and not a simple mixture. It is a color- 
less liquid, resembling chloroform in its behavior with cold water, with 
which it forms globules and refuses to mix or dissolve. It is soluble in 
hot water in alcoholic solutions and in alcohol, 3 parts in 1. The ad- 
vantage claimed for Somnal is that when administered in 20-grain doses 
it induces within half an hour a quiet sleep lasting from six to eight hours 
without any inconvenient after- or by-effects. 

Doses of 45 and even 60 minims produced no depression of the circulation or respira- 
tion. In doses of ^ss its action is usually very prompt, the dose is well borne always, 
easily taken (in a little syrup of tolu or whiskey), and entirely without deleterious effect. 
The effects are much more striking and certain than those of urethane, and far less de- 
pressing than those of chloral ; and there is no vertigo or depression, as may follow the 
use of Sulphonal. In drachm-dose>, this drug is not powerful enough to decidedly con- 
trol delirium tremens, maniacal delirium or severe pain. (Dr. Gilman Thompson.) 



380 SPIGELIA STAPHISAGRIA. 

SPIGELIA, Pink-root, — is the rhizome and rootlets of Spigelia 
?narilandica, the Carolina Pink, an herbaceous perennial of the nat. ord. 
Loganiaceae, native of the southern states ; having large, showy flowers, 
scarlet or crimson externally, yellow within. The rhizome is 2 inches 
long, y% inch thick, horizontal, bent and branched ; having cup-shaped 
scars above and numerous thin rootlets below. It contains a bitter prin- 
ciple and a volatile oil, also tannin, wax, resin, lignin and salts. Dose, 
3j-ij for an adult, gr. x-xx for a child of 3 years. 

Preparations. 
Extractum Spigelia Fluidum, — Dose for an adult, 3 j-ij ; for a child of 3 years, mjc-xx- 
Infusum Spigelice Compositum, Worm Tea (Unofficial), — has of Spigelia 15, Senna 
10, Fennel 10, Manna 30, Water 500. Dose, ^ iss-v. 

Spigelia is anthelmintic against the round worm (Ascaris lumbricoides), 
and is in popular use as a vermifuge, administered usually with Senna. In 
large doses it is an uncertain cathartic, and may produce quite serious 
symptoms, as vertigo, dimness of vision, dilated pupils, spasms and even 
convulsions. These effects are most apt to occur when the drug fails to 
produce purgation, hence it is usually administered with an active 
cathartic. 

Spigelia Anthelmia, the Demarara Pink-root, or Worm -grass, pro- 
duces vomiting, dilated pupils, dyspnoea, convulsions, and death. If 
eaten by cattle they perish in great agony. It has been used with real 
benefit in cardiac affections of rheumatic origin, also in rheumatic fever, 
and in cardiac palpitation with dyspnoea, due to mitral and aortic 
disease. A tincture (1 to 8) may be used in doses of n^v-xx. 



STAPHISAGRIA, Stavesacre,— is the seed of Delphinium Sta- 
phisagria, an annual or biennial plant of the nat. ord. Ranunculaceae, a 
native of Europe, having bluish or purple flowers, in terminal racemes ; 
and seeds in straight, oblong capsules. The seeds contain an alkaloid 
Delphinine, probably 3 other alkaloids, a bitter principle, a volatile oil 
and a fixed oil, etc. There are no official preparations. 

Preparations. 

Unguentum Staphisagricz (Unofficial), — contains of the powdered seeds I part with 2 
each of olive oil and lard. 

Delphinina, Delphinine, C 22 H 35 N0 6 (Unofficial), — is the active alkaloid, and exists in 
the fatty oil which is extracted by ether. Dose, gr. T ^- \. 

Stavesacre is a violent emetic and cathartic, also parasiticide. The 
alkaloid is irritant to the skin if locally used, producing tingling, burn- 
ing, and inflammation. Internally, it lowers the activity of the heart 
and respiration and produces a most profound adynamia, and may prove 
fatal from paralysis of the spinal cord and asphyxia. In many respects 
its alkaloid resembles Aconitine and Veratrine. 



STILLINGIA — STRAMONIUM. 38 1 

The ointment is often employed as a parasiticide against pediculi and 
the acarus scabies. The fixed oil is probably equally defective. Delphi- 
nine has been used internally in asthma, rheumatism and neuralgia, and 
in the latter affection is well employed as an ointment (gr. xx to gj), 
applied over the course of painful superficial nerves. It has been sug- 
gested as an antipyretic and for dropsy. A tincture or fluid extract is a 
very efficient application against pediculi. 



STILLINGIA, Queen's Root, — is the root of Stillingia sylvatica, 

or Queen's Delight, an indigenous, perennial plant of the nat. ord. 

Euphorbiaceae, with yellow flowers on a spike, and a large, thick and 

woody root, of peculiar and unpleasant odor, and an acrid, pungent, 

bitter taste. It contains a resin and a volatile oil, but its active principle 

has not yet been isolated. The fresh root should be used in making the 

preparations, as those from the dried root are almost inactive. Dose of 

the powdered root, gr. x-^j. 

Preparations. 

Extraction Stillingia Fluidum, — Dose, WLx-gj. 

Tinctura Stillingice (Unofficial), Dose, .^ss-ij. 

Decoctum Stillingice (Unofficial), — ^j ad Oj. Dose, ^j-ij. 

Syrupus Stillingice Compositus (Unofficial), — is composed of Stillingia, Corydalis, Iris, 
Chimaphila, Coriander, Xanthoxylum, Sambucus, Sugar, Water and Alcohol. For the 
formula, see U. S. Disp., page 1363. 

Physiological Action. 
Stillingia in large doses is emetic and cathartic, in smaller doses it is 
expectorant, diaphoretic, diuretic, sialagogue and cholagogue, possessing 
the various properties which are considered "alterative." Its taste is 
acrid and pungent, and it increases the action of the heart, skin, kidneys, 
and bronchial mucous membrane ; and the gastric, hepatic, intestinal 
and salivary excretions. Full doses often excite epigastric pain, nausea 
and vomiting. 

Therapeutics. 
Stillingia is much employed with Sarsaparilla and similar acting drugs 
as an alterative in syphilitic affections, particularly in chronic cases of 
the tertiary form, in which the system is greatly reduced by the abuse of 
mercurials and iodides. In these cases it possesses considerable power 
and frequently cures. It is also valuable in strumous affections, in ascites 
due to hepatic changes, portal congestions with jaundice following mala- 
ria, habitual constipation, hemorrhoids from hepatic obstruction, and 
intermittents. In the latter affection the fluid extract with Quinine or 
Arsenic is a very useful combination. A strong decoction is used to ward 
off an impending paroxysm of ague. 



382 STRAMONIUM. 

STRAMONIUM, Thornapple.— The plant Datura Stramonium, 
Jamestown Weed or Thornapple (nat. ord. Solanacese), is official in two 
forms, the leaves and the seed. It is an annual, of rank and vigorous 
growth, having a green stem with large white flowers, and numerous seeds 
in a large, fleshy, four-celled capsule, open at the summit. It grows wild 
in Southern Russia and the middle United States, and contains an alka- 
loid, Daturine, which is generally considered identical with Atropine 
both physiologically and chemically, — also malic acid, albumen, gum, 
resin, etc. 

Stramonii Folia, — the leaves of Datura Stramonium, are about 6 
inches long, smooth, petiolate, ovate, pointed, unequal at the base, coarsely 
toothed, of bitter and nauseous taste. Dose, gr. ij-xx. 

Stramonii Semen, — the seed of Datura Stramonium, is about }& 
inch long, reniform, flattened, pitted and wrinkled, the testa blackish 
and hard, enclosing a curved embryo embedded in whitish, oily albumen ; 
of unpleasant odor when bruised and an oily, bitter taste. Dose, gr. j. 
The official preparations are all made from the seed. 

Preparations. 

Ext r actum Stramonii, — Dose, gr. ]/(,- l /2. 

Extractum Stramonii Fluidum, — Dose, rt\, j-v. 

Tinctura Stramonii, — 10 per cent. Dose, ir^v-xxx. 

Unguentum Stramonii, — has of the Extract 10, Water 5, Benzoinated Lard 85 parts. 

Daturina, Daturine, C 1T H 23 N0 3 (Unofficial), — is the alkaloid found in all parts of the 
plant, also in Datura Tatula. It is a Tropate of Tropin, isomeric and identical with 
Atropine. Dose, gr. j^-^u- 

Physiological Action. 

The action of Stramonium is similar to that of Belladonna in almost 
every particular, except that Stramonium is more powerful and chiefly 
influences the sympathetic nervous system, not affecting the motor or 
sensory nerves. It excites a greater degree of cardiac irregularity and a 
more furious delirium, and seems to have a special affinity for the gen- 
erative apparatus, being decidedly aphrodisiac in full doses. [Compare 
Belladonna, ante, page 129.] 

As previously stated the alkaloids, Atropine, Daturine, Hyoscyamine, 
and Duboisine are chemically alike and almost identical physiologically. 
They all produce dilatation of the pupil, increase the cardiac action, the 
pulse and respiration rate, and cause delirium. Poisoning by one of 
them is indistinguishable from that by another. 

Antagonists and Incompatibles. 

These are the same as for Belladonna. Poisoning by Stramonium is not uncommon, as 
children may eat the seeds, which should be evacuated by an emetic. If physiological 
symptoms follow Opium must be exhibited as the antagonist, but cautiously, lest opium- 
narcosis be substituted. 



STROPHANTHUS. 383 

Therapeutics. 
Stramonium is chiefly used as an antispasmodic and to relieve pain. In 
asthma the leaves are smoked with advantage at the commencement of a 
paroxysm, the smoke being drawn into the lungs. In other spasmodic 
affections, as hepatic colic, laryngeal cough, chorea and stammering, it is 
very beneficial. In dysmenorrhcea and neuralgia it is used in combina- 
tion with Opium and Hyoscyamus, and in tic douloureux and sciatica "it 
is often very efficient. In nymphomania with great mental depression it 
is often very effective, and in mania of furious character, particularly the 
puerperal form with suicidal tendency, it is highly serviceable in 10-20 
minim doses of the tincture every 3 or 4 hours. The ointment is much 
used in irritable ulcers, and as an anodyne application in painful hemor- 
rhoids and certain cutaneous diseases. 

STROPHANTHUS,— is the seed of Strophantus hispidus, an Af- 
rican climbing plant (nat. ord. Apocynaceae), from which the natives 
extract a toxic preparation known as the Kombe arrow-poison. It con- 
tains a crystalline glucoside, named Strophanthin, the active principle, 
which is bitter, slightly acid, soluble in water and in alcohol, but almost 
insoluble in ether, chloroform, benzin, etc. It is very plentiful in the 
seeds (8 to 10 per cent.), and is an agent of great energy, the frog being 
killed by a solution of i in 10,000,000. (Denian.) 

Preparations. 

Professor Frazer recommends the tincture. 

Tinctura Strophanthi (i in 20), — Dose, TT^ v-x, or TT^^-ij frequently repeated. A 
stronger tincture (i in 8) is on the market. 

Strophanthinum, Strophanthin, — Dose, gr. T |o - "sV hypodermically. gr. -fa has been 
used, the influence of the one injection upon the circulation lasting at least 8 days. 

Physiological Action. 

Strophanthus acts primarily upon muscular tissue, by direct contact 
through the blood, and with great energy. It increases the contractile 
power of all striped muscle, and in poisonous quantity it fixes the muscu- 
lar contraction into a condition of tetanic permanence, the muscle being 
unable to resume its normal condition of partial flexibility. As the heart 
receives much more blood in a given time than any other muscle in the 
body, it is quickly and markedly affected by the strophanthus-charged 
fluid, and by regulating the dosage, the cardiac muscle may alone be 
affected, by a quantity which would not influence the other muscles. 

Small doses stimulate the cardiac contractions, increasing the force of 
the ventricular systole, and lowering the rate of the heart-beats. At the 
same time the general blood-pressure is raised, and diuresis produced, 
both being due to the vis a tergo, — the direct stimulation of the circula- 
tion from behind. Large doses paralyze the heart in systole, and leave 



384 STYRAX. 

the cardiac muscle in a state of contraction resembling cadaveric rigidity. 
It does not act through the nervous system, but paralyzes the muscular tissue, 
striated and non-striated, by direct contact; — and when contractility has 
been once destroyed thereby, no stimulus will re-excite it. It does not 
affect the vascular system directly. 

Compared with Digitalis, then, we have in Strophanthus a powerful 
cardiac stimulant, differing from Digitalis in not producing vaso-motor 
constriction of the arterioles. It reduces the pulse, lowers body-temper- 
ature somewhat, is not cumulative in action, and does not cause any 
gastro-intestinal disturbance. It is diuretic, by direct stimulation of the 
renal circulation ; and has power over rigors, by its rapid cardiac action, 
stopping them, and preventing their recurrence. 

Therapeutics. 

Strophanthus is undoubtedly a valuable cardiac stimulant, from the 
rapidity and permanence of its action, as well as its non-interference with 
the calibre of the peripheral vessels. It promptly relieves cardiac 
dyspnoea, often modifies the pulse-rate in less than an hour, while the 
influence of a single dose upon the circulation persists for a long time. 
It may well replace Digitalis in the treatment of chronic Bright's disease 
and valvular lesions of the heart, when it is important that the work of 
the heart should not be increased by any additional resistance in the 
arterial system. 

Strophanthus has been exceedingly useful in the treatment of Bright's 
disease, for the dyspnoea, orthopncea, dropsy and uraemia; also in mitral 
insufficiency, with great anasarca and dyspnoea ; in palpitation, exagge- 
rated cardiac action, and in weak heart, and for exophthalmos, with 
tumultuous action of the heart ; also in pulmonary oedema, due to valvular 
lesions, or to pneumonia. It is useful in endocarditis, also in atheroma 
of the arteries ; in reflex palpitation of neurasthenia, hysteria and chlo- 
rosis, and for rigors due to catheterization, or operations on the urethra. 
These high claims, made by enthusiastic therapeutists, have not been 
maintained by the experience of the general profession, so that this drug 
is gradually falling into disuse. 

STYRAX, Storax, — is a balsam prepared from the inner bark of 
Liquidambar orientalis, the Oriental Sweet-gum, a tree of the nat. ord. 
Hamamelaceae, growing in Asia Minor. It is semi-liquid, sticky, opaque 
and gray-colored, of agreeable odor and balsamic taste, completely 
soluble (except accidental impurities) in an equal weight of warm alcohol. 
It consists of a volatile oil named Styrol, C 8 H 8 , — a crystalline solid 
Styracin, which is a cinnamate of cinnamic ether, — two peculiar resins, 
one hard, the other soft, — and Cinnamic Acid, C 9 H 9 2 , a colorless, odor- 






SUCCINUM SULPHUR AND SULPHIDES. 385 

less, crystalline body, closely allied to Benzoic Acid, excreted in the 
urine partly as Hippuric Acid, and occurs also in the Balsams of Peru and 
Tolu. Dose of Storax, gr. v-xx. 

Preparation. 
Tinctura Benzoini Composita, Friar's Balsam, — contains 8 per cent, of Storax. (See 
ante, page 132.) Dose ^ss-ij. 

Storax is a stimulant expectorant, an antiseptic and a disinfectant, 
acting both locally and remotely, like Benzoin and the Balsams of Tolu 
and Peru. It is used with benefit in chronic bronchitis and other affec- 
tions of the respiratory organs, also in chronic catarrhs of the genito- 
urinary passages, in gonorrhoea and in amenorrhcea. Externally it is 
employed in ointment as a detergent for foul ulcers, and as a parasiticide 
for scabies and phthiriasis. 



SUCCINUM, Amber, — the source of the official Oil of Amber, is 
a fossil resin, occurring in alluvial deposits, chiefly in Prussia, Bohemia, 
and Courland. It is usually associated with lignite, sometimes encloses 
insects and parts of vegetables, and consists of a volatile oil, a yellow 
resin, another resin, succinic acid and a bituminous principle. Its 
source is thought to be an extinct coniferous tree, the Pinites succi?iifer, 
of which amber represents the exudation. 

Preparation. 
Oleum Succini t Oil of Amber, — is a volatile oil obtained by the destructive distillation 
of Amber, and purified by subsequent rectification ; — a colorless or pale yellow, thin 
liquid, of sp. gr. about 0.920, of empyreumatic and balsamic odor, a warm, acrid taste, 
and a neutral or faintly acrid reaction, and readily soluble in alcohol. Dose, gtt. v-x. 

Oil of Amber is stimulant, antispasmodic and diuretic, when used 
internally. Externally it is irritant and rubefacient. It has been em- 
ployed with benefit in epilepsy, hysteria, convulsions, amenorrhcea, 
whooping-cough, etc. As a liniment it is often used in chronic rheuma- 
tism, and has been applied along the spine in infantile convulsions, mixed 
with an equal part of laudanum and diluted with olive oil or brandy. 



SULPHUR, and SULPHIDES.— The non-metallic element Sul- 
phur, S, is a brittle solid of a pale yellow color, permanent in the air, of 
crystalline texture and susceptible of several allotropic states, which are 
for the most part induced by heat. It is obtained native in several vol- 
canic districts, or from the native Sulphides of Iron and Copper (iron 
and copper pyrites) by roasting, as it sublimes at about 238 F. It is 
official in three forms, viz.: — 

Sulphur Sublimatum, Sublimed Sulphur, S, — is prepared from 
crude Sulphur by sublimation and condensation. It is a fine citron-yel- 
2=; 



386 SULPHUR AND SULPHIDES. 

low powder, of faintly acrid taste and acid reaction, insoluble in water or 
alcohol. Ignited it burns with a blue flame, forming sulphurous acid gas, 
and leaving no residue or only a trace. Dose, gr. x-xx-lx. 

Sulphur Lotum, Washed Sulphur, S, — prepared by digesting sub- 
limed Sulphur with dilute Water of Ammonia, thoroughly washing with 
water and passing through a No. 30 sieve. In this process the Ammonia 
dissolves out any Sulphide of Arsenic which may be present and neutral- 
izes any Sulphurous or Sulphuric Acid. [For solubility and dose see S. 
Pr^ecipitatum, below.] 

Sulphur Prsecipitatum, Precipitated Sulphur, Lac Sulphuris, Milk 
of Sulphur, S, — prepared by boiling sublimed Sulphur with slaked lime 
and water, thus forming the Sulphide and Hyposulphite of Calcium. 
These are then decomposed by HC1, and Sulphur is precipitated as a very 
fine powder which is next washed until the washings are tasteless, and it 
is dried with a gentle heat. The result is a very fine, yellowish-white, 
amorphous powder, odorless and almost tasteless, insoluble in water or 
alcohol, but completely soluble in disulphide of carbon or a boiling solu- 
tion of soda. By heat it is completely volatilized. Dose, gr. x~3j. 

Preparations of Sulphur. 

Unguentum Sulphuris, — has of Sublimed Sulphur 30, Benzoinated Lard 70 parts, 
rubbed together. 

Unguentum Sulphuris Alkalinum, — has of Washed Sulphur 20, Potassium Carbonate 
10, Water 5, Benzoinated Lard 65 parts, thoroughly rubbed together. 

Pulvis Glycyrrhiz(E Compositus (see ante, page 234) contains 8 per cent, of Sulphur 
Lotum ; and Emplastrum Ammoniaci cum Hydrargyro (see ante, page 94) contains I 
per 1000 of Sulphur Sublimatum. 

Sulphuric Acid is described under Acidum Sulphuricum, ante, page 73 ; Sulphurous 
Acid and the Sulphites under Acidum Sulphurosum, ante, page 74. The Sulphates are 
noted under the titles of their respective bases. 

Ichthyol, — is a preparation obtained from a bitumen found in the Tyrol, and regarded as 
the residue of extinct fishes. It contains Sulphur in the proportion of about 10 per cent., 
is soluble in a mixture of Ether and Alcohol, mixes with vaseline, oils and lard, and is 
non-irritant to the skin. For local use, in a 10 to 20 per cent, ointment. 

Sulphides and their Preparations. 

Calcii Sulphidum, Sulphide of Calcium, CaS (Unofficial), — is the preparation named 
"Hepar Sulphuris, Liver of Sulphur," by the homceopathists, who prepare it by mixing 
equal parts of powdered oyster-shell and sublimed sulphur, and heating at a white heat 
in a crucible hermetically sealed. It is a constituent of the following official compound, 
viz. : — 

Calx Stilphurata, Sulphurated Lime, — is commonly misnamed Sulphide of Calcium. 
It is a mixture of Calcium Sulphide and Calcium Sulphate, CaS -f- CaS0 4 , in varying pro- 
portions, but containing not less than 36 per cent, of the former, and is prepared by heat- 
ing together in a closed crucible Powdered Lime 100 parts and Precipitated Sulphur 90 
parts, at a low red heat for one hour. The result, rubbed to powder, is grayish-white, of 
offensive taste and alkaline reaction, very slightly soluble in water, insoluble in alcohol. 
Dose, gr. fo\. 

Potassa Stdphurata, Sulphurated Potassa, — formerly called Hepar Sulphuris, — is a 
mixture of Potassium Trisulphide with small quantities of Potassium Hyposulphite and 
Sulphate, formed by heating together 1 part of Sublimed Sulphur with 2 of Potassium 
Carbonate, until melted. Of a liver brown color gradually changing with age to a greenish- 
or brownish yellow, of disagreeable odor, alkaline and repulsive taste and alkaline reaction. 
Soluble in 2 of water, excepting a small residue, partly soluble in alcohol. Dose, gr. 
ij-x, in pill or solution. 



SULPHUR AND SULPHIDES. 387 

Sulphuris Iodidum, Iodide of Sulphur, Iodine Disulphide, I 2 S 2 , — is prepared by fusing 
together Washed Sulphur I part, and Iodine 4. It is a grayish-black crystalline solid, 
having the odor of iodine, an acrid taste and a faintly acid reaction, insoluble in water, 
but very soluble in disulphide of carbon and in about 60 of glycerin. Alcohol and ether 
dissolve out the iodine, leaving the sulphur. Only used as ointment, gr. xxx to the £ . 

Hydrogen Sulphide, Sulphuretted Hydrogen, H 2 S (Unofficial), — is used only as a 
test. It is a colorless gas having the smell of rotten eggs, prepared by the action of dilute 
Sulphuric Acid on Sulphide of Iron ; the gas being passed into water a solution is obtained. 
It precipitates most of the metals from acid solutions as sulphides, that with Arsenic 
being yellow ; with Antimony, orange ; with Cadmium, yellow ; with Copper, Lead, 
Mercury and Silver, black; with Bismuth, brown ; with Gold and Platinum, brownish- 
black. 

Bisulphide of Carbon is described under Carbo, ante, -page 158; Sulphide of Antimony 
and Sulphurated Antimony under Antitnonium, ante, page 103. 

Physiological Action. 

Sulphur is a mild laxative and a diaphoretic. In contact with living 
protoplasm it enters into combination and produces either sulphuretted 
hydrogen or sulphurous acid ; taken into the intestinal canal a large por- 
tion passes out unchanged, some of it being converted by the alkaline bile 
into sulphuretted hydrogen and sulphides. The former is excreted by 
the lungs, giving to the breath the smell of rotten eggs, and by the skin, 
discoloring silver articles carried#about the person by forming a sulphide 
of silver. The Sulphides are partly absorbed into the blood, and are 
excreted in the urine, chiefly as sulphates, and in the faeces, which they 
blacken and render soft. Given in full doses they are irritant to the 
stomach and intestines, extremely nauseous to the taste and smell, increase 
the secretions of the intestinal glands, and peristaltic action, and if used 
for any length of time they impair the blood, causing anaemia, emacia- 
tion, tremor and great debility. 

Sulphuretted Hydrogen is very destructive to plant life, and in ani- 
mals it destroys the tissue functions, decomposing the blood and para- 
lyzing the nervous and the muscular systems. The symptoms of poisoning 
are those of asphyxia ; muscular tremors occur and are followed by con- 
vulsions and death. This gas is often found in cesspools in large quantities, 
but in one case poisoning occurred from its excessive formation in the 
intestines and subsequent absorption into the blood. 

Calx Sulphurata and Potassa Sulphurata act like the sulphides as 
local irritants and in large doses as irritant poisons, producing narcotic 
symptoms and convulsions. In small doses they act like sulphur and are 
supposed by many observers to have a peculiar influence on suppuration, 
to limit or prevent it if given in small doses frequently repeated. 

The Iodide is believed to possess some of the properties of both its 
elements. It is doubtful whether it is a distinct chemical compound or 
merely a physical mixture. As a parasiticide it is very efficient, and has 
been found remarkably alterative in many local affections of chronic char- 
acter, but may prove very irritant to the skin if improperly prepared. 

[The actions of Sulphuric Acid, Sulphurous Acid and the Sulphites 
are respectively described on pages 73 and 74, ante. ] 






388 SUMBUL. 

Antagonists and Incompatibles. 
Solutions of the Sulphides are decomposed by the mineral acids and by solutions or 
metallic salts. Antidotes are Chlorine-water, Chlorides of Sodium and Potassium, Sul- 
phate of Iron, etc. Poisoning by Sulphuretted Hydrogen is best treated by artificial 
respiration. 

Therapeutics. 

Sulphur is chiefly used as a laxative when pultaceous rather than liquid 
stools are required, as in hemorrhoids, anal fissure, or constipation. 
Scabies has long been treated by its local and internal use, but sulphur 
alone does not kill the itch insect. The older sulphur ointments were 
made with sublimed sulphur, and probably contained a considerable 
amount of sulphurous acid on which their parasiticide property depended. 
The recent ointments, made with purified sulphur, all contain an alkaline 
ingredient and develop sulphides which are powerful insect poisons. 
Sulphur fumigations are practically applications of volatile sulphurous 
acid, while most of the sulphur baths and mineral waters are solutions of 
sulphuretted hydrogen or of the alkaline sulphides. They are of value in 
lead poisoning to favor the elimination of that metal, in chronic consti- 
pation, chronic rheumatism and sciatica, and many skin diseases, especially 
chronic psoriasis, eczema, pityriasis and prurigo. The Ointment and the 
Alkaline Ointment are both used in scabies. 

The Iodide has been used internally in scrofula, glanders and cutaneous 
disorders, but it is chiefly employed as an ointment in lupus and parasitic 
skin diseases, especially herpes circinatus. 

Calx Sulphurata is extremely efficient as an internal remedy in crops 
of boils, scrofulous sores, glandular enlargements, acne, etc., and will 
prevent or limit suppuration. For these purposes it must be used in small 
doses (gr. 1 L J ) frequently repeated. 

Potassa Sulphurata is only used externally as baths or ointment in 
skin diseases and mucous discharges, also in chronic rheumatism. 

Ichthyol has been introduced by Dr. Unna, of Hamburg, the cele- 
brated dermatologist, as a promptly efficient remedy in certain chronic 
skin diseases, particularly eczema and psoriasis. It mixes with vaseline, 
lard and oils, is soluble in a mixture of ether and alcohol, and is not irri- 
tant locally, even if covered with oiled silk. 

In one case of eczema infantile, an ointment was applied containing i 
part of Ichthyol to 5 of Vaseline, resulting in the child's sinking into a 
stupor which lasted for 12 hours. Though recovery was complete, the 
result of the application shows that care must be used in the employment 
of the remedy, as it is not devoid of danger (Sinclair). 

SUMBUL, — is the root of Ferula Sumbul, a very large plant of the 
nat. ord. Umbelliferse, which grows to the height of 8 feet in the mountains 
of Northern Asia. The root occurs in transverse segments of a strong and 



TABACUM. 389 

musk-like odor and a bitter, balsamic taste, and contains Angelic Acid, 
C 5 H 8 2 , Valerianic Acid, C 5 H 10 O 2 , also a volatile oil, two balsamic resins, a 
bitter substance, etc. Dose, gr. xxx-^j or more in infusion, decoction, etc. 

Preparation. 
Tinctura Sunibul, 10 per cent. Dose, gj-iv. 

Sumbul is an efficient nerve tonic, having qualities closely resembling 
musk and valerian. It is used by the Russian physicians in very many 
morbid conditions, and seems to be a favorite remedy in that country for 
almost any disease. It is probably of some value in hysteria and other 
nervous derangements of delicate females, and may be used as a substitute 
for musk in typhoid conditions and fevers, asthma, delirium tremens and 
perhaps in epilepsy. 



TABACUM, Tobacco, — the commercial, dried leaves of Nicotiana 
Tabacum, an annual plant of the nat. ord. Solanaceas, native of tropical 
America, but cultivated in several parts of the world, especially in Cuba 
and Virginia. The leaves are large, as long as 20 inches,' mottled-brown, 
ovate or lanceolate, glandular-hairy ; having a heavy, peculiar odor, and 
a nauseous, bitter and acrid taste. It contains a very powerful and poi- 
sonous fluid alkaloid named Nicoti?ie, C 10 H U N 2 , also a concrete, campho- 
raceous, volatile oil, Nicotianin, besides alkaline salts (nitrates, phos- 
phates), and other less important substances. Its combustion gives rise 
to several empyreumatic products, of which Pyridine, C 5 H 5 N, and its com- 
pounds are the chief, having somewhat the same action as Nicotine, but of 
less severity. Besides these products, tobacco-smoke contains Creasote, 
Hydrocyanic and Hydrosulphurous acids, etc., but little or no Nicotine. 

Unofficial Preparations. 

Enema Tabaci, — gr. xx infused in 3 viij Boiling Water, and administered as one 
enema. 

Vinum Tabaci, — ^j to the pint. Dose, TlVv-^j. 

Oleum Tabaci, — is an empyreumatic product, obtained by distillation at a temperature 
above that of boiling water, and a most virulent poison. 

Nicotina, Nicotine, C ]0 H U N 2 , — the alkaloid and active principle ; a colorless, oily- 
looking fluid, having the odor of tobacco and an acrid taste ; readily soluble in water, and 
forming soluble salts with acids. Dose, r^V-jo xn strychnine-poisoning, up to Tl\ij in 2 
hours. 

[Other Liquid Alkaloids besides Nicotine are — Coniine, Muscarine, Sparteine, Lobe- 
line, Lupuline, and Pyridine.] 

Physiological Action. 
Tobacco is a very depressant nauseant, an emetic by irritant as well as 
systemic action, and an antispasmodic ; also sternutatory, diuretic, dia- 
phoretic, cathartic, sedative and narcotic. It paralyzes the motor nerv- 
ous system, its action commencing at the periphery and extending to the 
spinal cord. It increases the salivary and intestinal secretions, and pro- 



390 TABACUM. 

duces diuresis, tremor, clonic spasms and a tetanic stage followed by- 
paresis. It contracts the pupils, depresses the heart, lowers arterial 
tension, reduces body-temperature, and causes profuse sweating, cold 
and clammy skin, collapse and death usually by paralysis of respiration, 
sometimes by paralysis of the heart. It does not impair the muscular 
irritability, nor does it act upon the cerebrum directly. Its empyreumatic 
products act similarly but less powerfully. Fatal results have followed on 
the inhalation of its vapor into the lungs. 

Nicotine is almost as rapidly fatal as Prussic Acid, death having oc- 
curred from a toxic dose in three minutes, with no symptoms except a 
wild stare and a deep sigh. 

The continued use of Tobacco in excess by smoking or chewing pro- 
duces granular inflammation of the fauces and pharynx, atrophy of the 
retina, dyspepsia, lowered sexual power, nervous depression, and occa- 
sionally angina pectoris. Used by the young it hinders the development 
of the higher nerve centres, and impairs the body nutrition by interfering 
with the processes of digestion and assimilation. 

Strychnine is the true physiological antagonist to Nicotine (or Tobacco) and vice versd. 
Alcohol, Ammonia, Ergot, Digitalis, Belladonna, etc., antagonize its action on the circu- 
lation. In poisoning by Tobacco the means resorted to are evacuation of the stomach, 
Tannin, Iodides, and artificial respiration. A curious synergism has been observed by the 
author between Opium and Tobacco. If a person, habituated to the use of the latter, 
either by smoking or chewing, begins to use Morphine, the smallest quantity of Tobacco 
will make him sick, the symptoms being those experienced by a novice' in its use. 



Therapeutics. 

Tobacco is now but little used in medicine ; the dangers attending its 
employment either internally or externally have caused it to be super- 
seded by less violently acting agents. The chief indications for its use 
are to relax spasm and to relieve local pain. It may be employed with 
advantage in habitual constipation, for the dyspnoea of spasmodic asthma 
and emphysema, and in nymphomania and chordee. Intestinal affections 
like impaction of the caecum, intussusception and strangulated hernia may 
be overcome by a tobacco-enema to relax spasm, but it is a dangerous ex- 
pedient. In dropsy, especially the renal form, it makes a very efficient 
diuretic. In tetanus there is no more effective remedy than minim doses 
of the alkaloid every two hours by the stomach, or n^ij by the rectum, 
or better still the wine in io-minim doses repeated for effect. Strych- 
nine-poisoning is best met by minute doses of Nicotine (gr. -^) hypoder- 
mically, as a physiological antagonist. 

The use of Tobacco in moderation, when under excessive exertion, aids 
in supporting the system and lessening the sense of fatigue. Smokers 
rarely suffer from constipation, but generally experience an immediate 
laxative result from their morning cigar. 



TAMARINDUS TANACETUM TARAXACUM. 39 1 

TAMARINDUS, Tamarind, — is the preserved pulp of the fruit of 
Tamarindus indica, a large tree of the nat. ord. Leguminosse, native in 
the East and West Indies. It occurs as a reddish-brown, sweet-acid and 
pulpy mass, containing strong, branching fibres and brown, quadrangular 
seeds, each enclosed in a tough membrane. It contains citric, tartaric 
and malic acids, sugar, gum, potassium bitartrate, etc. 

Preparation. 
Confectio Sennce (see ante, page 372), — contains Tamarind to the amount of 10 per 
cent. Dose, gj-ij. 

Tamarind is a laxative and refrigerant fruit. In infusion it may be 
used by convalescents as a pleasant acidulous drink, or the pulp may be 
boiled with milk as a whey for the same purpose. As a laxative it is 
usually prescribed in connection with other agents having the same 
action. 



TANACETUM, Tansy, — the leaves and tops of Tanacetum vul- 
gare, a perennial, herbaceous plant of the nat. ord. Compositse, having 
yellow flowers in dense terminal corymbs, indigenous in Europe, but 
cultivated in our gardens, and growing wild in roads and old fields. It 
contains a volatile oil, a bitter principle named Tanacetin, a tannic acid, 
etc. There are no official preparations, but a fluid extract may be pre- 
pared according to the general rule and administered in doses of ^x-^j. 
The dose of the volatile oil (Oleum Tanaceti) is i to 3 drops. An infu- 
sion (Tansy Tea) may be made in the proportion of gj to the pint, and 
used in doses of §j-ij. 

Tansy is emmenagogue, diuretic and anthelmintic, an aromatic bitter 
and an irritant narcotic. Fatal results have frequently followed upon 
overdoses of the oil (§ss— j), or strong decoctions, preceded by clonic 
spasms, disturbed respiration and cessation of the heart's action. It is a 
useful remedy in amenorrhcea, but is in popular repute as an abortifacient, 
a virtue which it does not possess except in quantity dangerous to life. 



TARAXACUM, Dandelion, — is the root, gathered in autumn, of 
Taraxacum Dens-leonis, an herbaceous plant of the nat. ord. Compositae, 
with a perennial fusiform root, long, sinuate-toothed or runcinate leaves, 
and slender peduncles, each bearing a single head of yellow flowers. All 
parts of the plant contain a bitter, milky juice, exuding from any break 
or wound. Its constituents are a bitter amorphous principle named 
Taraxactn, a. crystalline principle Taraxacerin, with potassium and cal- 
cium salts, inulin, and resinoid bodies, etc. The French name for the 
plant is " Pissenlit." 



392 TEREBINTHINA. 

Preparations. 
Extra ctum Taraxaci, — Dose, gr. v-xxx. 
Extra ctum Taraxaci Fluid um, — Dose, 3J-^j. 

Physiological Action and Therapeutics. 
Taraxacum is a bitter tonic, a diuretic and an aperient. It has been 
supposed to act especially on the liver, and is chiefly used in dyspepsia 
with hepatic torpor. As found in the shops it is usually inert. The ex- 
tract is probably only of value as an excipient for pills. 

TEREBINTHINA, Turpentine,— means a vegetable exudation, 
liquid or concrete, which consists of resin combined with a peculiar 
essential oil named Oil of Turpentine (C 10 H 16 ), and generally procured 
from various species of the nat. ord. Coniferse (cone-bearers). Of the 
many turpentines two only are official, viz. : — 

Terebinthina, Turpentine, — a concrete oleoresin obtained from Pinus 
australis, the Yellow Pine, and from other species of Pinus, nat. ord. 
Coniferse. Occurs in tough, yellowish masses, brittle when cold, crummy- 
crystalline interiorly, of terebinthinate odor and taste. Dose, gr. v-xxx 
as a stimulant, antispasmodic or diuretic ; 3ij-iv as an anthelmintic. 

Terebinthina Canadensis, Canada Turpentine, Balsam of Fir, — a 
liquid oleoresin obtained from Abies balsamea, the Silver Fir, or Balm of 
Gilead, a tree of the nat. ord. Coniferae. A yellowish, transparent, viscid 
liquid, of agreeable, terebinthinate odor, and a bitterish and slightly acrid 
taste, slowly drying on exposure, forming a transparent mass ; completely 
soluble in ether, chloroform or benzol. Dose, gr. x-xxx. 

[For Pitch and its preparations, see ante, page 323.] 

Preparations. 

Oleum Terebintkince, Oil of Turpentine, Spirits of Turpentine, — is a volatile oil distilled 
from Turpentine, any variety furnishing it. Dose, as a stimulant or diuretic, HVv-xv, in 
emulsion, 3 to 6 times daily ; — as a cathartic or anthelmintic J ss or more, combined with 
other cathartics. A little glycerin and oil of gaultheria will disguise the taste. 

A thin, colorless liquid, of characteristic odor and taste, having the sp. gr. 0.855 to 
0.870, soluble in 6 of alcohol, mixes with other volatile and fixed oils, and dissolves resins, 
wax, sulphur, phosphorus and iodine. Bromine and powdered Iodine act violently on it, 
and when brought into contact with a mixture of Nitric and Sulphuric Acids it takes fire. 
It is isomeric with a number of volatile oils, has the formula C 10 H 16 — but constantly 
absorbs oxygen from the ,air when exposed, becoming thicker and less active, from forma- 
tion of resin. It is a mixture of several hydrocarbons, each having the same formula as 
itself, viz. :— Ci H 16 . 

Linimentum Terebintkince, Turpentine Liniment, — has 35 parts of the oil with 65 of 
Resin Cerate. 

Linimentum Cantharidis, contains the oil in the proportion of 85 per cent., the other 
15 being Cantharides; making a very powerful and unmanageable application unless 
closely watched. See ante, page 155. 

Unofficial Turpentines. 
Chian Turpentine, — from the Pistacece Terebinthus, a small larch tree growing in the 
islands of Chio and Cyprus, a thick, tenacious, greenish-yellow liquid, concreting on 
exposure to the air into a translucent solid. Dose, gr. iij-v in emulsion. 



TEREBINTHINA. 393 

Venice Turpentine, — procured in Switzerland from the Larix Europcea or European 
Larch ; — a viscid liquid of the consistence of honey, does not concrete on exposure, and 
is entirely soluble in alcohol. The Venice Turpentine of commerce is usually prepared 
by dissolving Resin in Oil of Turpentine. 

Thus Americanum, Common Frankincense, (B. P.), — the concrete turpentine which 
is scraped off the trunks of Pinus australis and Pinus Tceda, Southern States of N. 
America. An ingredient of the Emplastrum Picis of the B. P. 

Analogues of Turpentine. 

Oleum Succini, Oil of Amber, — a volatile oil obtained by the 

destructive distillation of Amber (Succinum), a fossil resin, occurring in 

alluvial deposits in Bohemia, etc., and thought to be the exudation of 

Pinites succinifer, an extinct coniferous tree. Dose, gtt. v-x. See ante, 

Page 385- 

Oleum Thuj^e, — a volatile oil, which is given in doses of tthj-v. A 
saturated tincture may be used in drachm-doses. Obtained from Thuja 
occidentalis, the Arbor Vitse, a coniferous tree. See infra, page 396. 

Derivatives of Turpentine. 

Resina, Resin, Colophon y,— is the residue left after distilling off the 
volatile oil from turpentine; the portion of turpentine which is fixed by 
oxidation ; consisting in greater part of Abietic anhydride (C 44 H 62 4 ). 
See ante, page 341. 

Terebene, C a0 H 16 , — is a hydrocarbon obtained by the oxidation of oil 
of turpentine by means of sulphuric acid. A colorless liquid, of hot 
taste, soluble in alcohol. Dose, itlv-xx on sugar, or suspended in gss of 
water by the aid of gr. xx of light carbonate of magnesium. 

Terebinthene, C 10 H 16 , — another isomeric hydrocarbon, obtained by 
distilling oil of turpentine with an alkali. This by hydration, is con- 
verted into Terpine, commonly called " Hydrate of Terpine," instead of 
Hydrate of Terebinthene, a solid, crystalline body, soluble in glycerin. 
Acting on this by an acid, we get an oily body, named Terpinol, the dose 
of which is gr. ij-v, while that of Terpine is gr. v-x. None of these 
bodies are soluble in water, but all are in alcohol. 

Sanitas, — is a disinfecting solution obtained by the action of water 
upon oxidized turpentine, its active principle being Peroxide of Hydrogen. 
It is not poisonous, and does not stain the linen, — two qualities which 
strongly recommend it. 

Physiological Action. 

Turpentines are stimulant, diuretic, anthelmintic, and hemostatic ; 
in large doses laxative and irritant, and externally used are rubefacient 
and antiseptic. Their virtues depend entirely on the volatile oil. 

Oil of Turpentine in small doses causes a sense of heat at the epigas- 
trium, burning in the mouth, and by reflex action salivation. In moderate 



394 TEREBINTHINA. 

doses it at first stimulates the vaso-motor nervous system, afterwards 
paralyzing these centres, thus causing a rise and then a fall of the arterial 
tension. It lowers the functions of the brain, spinal cord and medulla 
in the order stated, causing diminution of voluntary movement and reflex 
action, dilatation of the vessels, lowered blood-pressure, and slowed re- 
spiration, the latter often becoming spasmodic. The pulse is sometimes 
slowed, sometimes quickened. Large doses produce gatro-enteritis, with 
vomiting and diarrhoea, suppression of urine, pain in the lumbar regions, 
burning in the urethra, hematuria, and strangury. The muscular power 
is diminished, coordination impaired, and a state of intoxication induced. 
Toxic doses cause complete muscular relaxation, profound insensibility, 
with abolished reflexes, dilated pupils, cyanosed face, labored and ster- 
torous breathing and death by paralysis of respiration. It is excreted by 
the various organs of excretion, all of which are highly irritated, the 
kidneys suffering particularly. Its vapor inhaled produces nasal and 
renal irritation, frontal headache, and frequently strangury and hematuria. 
Locally to the skin it is rubefacient, and even vesicant if applied for any 
length of time or if evaporation be prevented. 

Turpentine-oil when exposed to the air readily absorbs oxygen in the 
form of ozone, which it retains tenaciously. This Ozonized Oil of Tur- 
pentine is an antidote to Phosphorus, preventing the formation of phos- 
phoric acid, and converting the phosphorus into an insoluble substance 
resembling spermaceti. Worn about the neck in an open vial it is believed 
to prevent necrosis of the jaw and steatosis of the organs in workmen 
exposed to phosphorus-fumes. It is also supposed to dissolve gall-stones. 

Antagonists . 
In cases of poisoning the stomach should be emptied, anodynes and demulcents admin- 
istered, elimination favored, and special symptoms met as they arise. 

Therapeutics. 

The Oil of Turpentine is employed externally as a rubefacient and 
counter-irritant in many conditions producing pain and inflammation. 
Cloths wrung out of hot water and then sprinkled with the oil (turpen- 
tine stupes), are useful applications in sciatica and other neuralgias, lum- 
bago, chronic rheumatism, chronic bronchitis, peritonitis with tympanites, 
pleurisy, renal colic, etc. It is one of the most efficient agents in hos- 
pital gangrene applied in full strength to the part affected. The liniment 
is in constant use for sprains, neuralgia, and other slight local affections. 

Internally it is best employed in ulceration and hemorrhage of the 
intestines and in hemorrhages of a passive character from other organs. 
Active bleeding with a plethoric condition and hematuria are states in 
which it is contraindicated. It is often used with Ether (i to 3) in 
biliary and flatulent colic, as an anodyne and antispasmodic. As a ver- 



THEOBROMA OLEUM. 395 

mifuge, against tape-worm it must be employed in large doses (Sss-ij), 
with Castor oil to promote its rapid passage through the intestinal canal. 
The French acid oil, which is old and contains ozone, is used in phos- 
phorus poisoning. It is well employed as a stimulant to the heart and 
vasomotor system in puerperal fever, yellow fever, traumatic erysipelas, 
pneumonia, capillary bronchitis, etc. It is also useful in chronic bron- 
chial catarrh, chronic cystitis, subacute gonorrhoea and similar affections 
of the mucous surfaces generally. 

Inhalations of the vapor or atomized oil are extremely beneficial in 
chronic affections of the larynx and bronchi. The pure vapor is too irri- 
tating for inhalation, but it may be diluted with steam from a steam atom- 
izer. 

Chian Turpentine is one of the many remedies which have been used 
for cancer. 

Terebene has been extensively used by Dr. Murrell, with excellent 
results, as a remedy for obstinate winter-cough and emphysema of the 
lungs, in flatulence, and flatulent dyspepsia, also in cystitis and in gleet. 
He has employed it with benefit as a spray in phthisis and post-nasal 
catarrh, also with Cocaine in solution as a spray for coryza and hay-fever. 
Other observers, of several years' experience with this remedy in England, 
praise it highly as an inhalant remedy in phthisis, bronchiectasis, chronic 
bronchitis, and other pulmonary affections characterized by profuse, puru- 
lent expectoration. Dr. Rieu employs it extensively in bronchitis and 
bronchorrhcea, in doses internally of gr. xv-xxx per diem, — but says that 
it does not affect the muco-purulent expectoration of phthisis {Bull. Gen. 
de Therapy April 30, 1886). It probably has no superior efficacy to 
Creasote, Venice Turpentine, etc., except. that it is without much odor, 
and has no taste. 

Terpine Hydrate is praised very highly in chronic and recurrent 
bronchitis, night-cough from habit, cold, catarrhs and kindred affections. 
In fact, all acute and many chronic affections of the respiratory passages 
form the field for the therapeutical action of this preparation. 

THEOBROM^ OLEUM, Oil of Theobroma, Cacao-but- 
ter, — is a fixed oil expressed from the seed of Theobroma Cacao, the 
Chocolate-tree, nat. ord. Sterculiaceae, growing in Mexico, the West 
Indies and South America. The oil is a yellowish-white solid, of faint 
odor, bland taste and neutral reaction, and melting at 86° to 95 F. 

The seeds are oval, about the size of almonds, and consist of shells and kernels, in 
both of which is found the alkaloid Theobromine C 7 H 8 N 4 2 , which closely resembles 
Caffeine, the latter being its methyl derivative. Chocolate is prepared by roasting the 
seeds, removing the shells, then crushing or grinding the kernels to a smooth paste, 
which is cast in molds. 

Cacao-butter consists chiefly of Stearin with a little Olein. Its action 



39^ THUJA. 

is demulcent, and it does not become rancid on exposure to the air. Its 
chief use is as a basis for making suppositories. A cerate is prepared by- 
melting together Cacao-butter 35, White Wax 35, Oil of Almond 30, 
adding a drop of Oil of Rose and coloring with a minute quantity of 
Carmine previously triturated with a drop of Water of Ammonia. This 
is known as Red Lip-salve. 

Theobromine has the same action and uses as Caffeine. (See ante, 
page 143, for this principle and Diuretin.) 



THUJA, Arbor Vitse, — the fresh tops of Thuja occidentalis, a tree 
of the nat. ord. Coniferge, commonly though incorrectly called W T hite 
Cedar, and growing in swampy ground in Canada and the northern U. S. 
Its twigs are flattish and two-edged, with scale-like leaves appressed and 
closely imbricate in four rows, rhombic-ovate, obtusely pointed, having a 
roundish gland upon the back; of a balsamic, somewhat terebinthinate 
odor, and a pungently aromatic, camphoraceous and bitter taste. They 
contain a volatile oil, tannin, wax, resin, etc.; also Pinipicrin, C 22 H 18 O n , 
a bitter principle, and Thujin, C 20 H 22 O 12 , a yellow, astringent and crystal- 
lizable coloring principle, which is separable into glucose and Thujetin 
C M H u 8 . 

Preparations. 

There are none official. The dose of a saturated, fresh tincture or fluid extract is 
3 j 3-6 times daily. The Volatile Oil may be given in doses of rr\j-v. 

Physiological Action. 
Thuja reiembles Savine in action very closely. It is stimulant, irritant, 
astringent, also aromatic, diuretic and emmenagogue. The oil is a 
gastro-intestinal irritant, and produces epileptiform convulsions in warm- 
blooded animals, and paralysis in cold-blooded ones. It causes rhythmi- 
cal contraction and dilatation of the vessels, lowers the temperature, and 
is anthelmintic. Thuja is indirectly an abortifacient when given in doses 
sufficient to cause violent gastro-enteritis, and is reported to have pro- 
duced an acute urethritis resembling gonorrhoea. 

Therapeutics. 
Thuja in decoction has been usefully employed in coughs, rheumatic 
and arthritic pains, dropsy and amenorrhcea. It has also been given 
with benefit in intermittent fever and as an alterative blennorrhetic in 
chronic catarrh and bronchorrhcea. It is highly praised by Dr. Phillips 
for the cure of warts with narrow base and pendulous body, a strong 
tincture being applied locally and given internally at the same time in 
5 -minim doses twice daily. Dr. Piffard speaks strongly in its favor as a 
valuable agent for non-syphilitic warts (condylomata acuminata) of the 



THYMI OLEUM. 397 

penis and vulva, for papillomatous growths in general, and for gleets 
dependent on granular urethritis. It has been used in chronic gonorrhoea 
and prostatitis with asserted success, and is said to have cured epithe- 
lioma. The oil has been employed as a vermifuge. 



THYMI OLEUM, Oil of Thyme,— is a volatile oil distilled 
from Thymus vulgaris, Garden Thyme, a common shrub of the nat. ord. 
Labiatas, indigenous in France but cultivated in our gardens. The soil is 
a pale yellow or colorless, thin liquid, having a strong odor of thyme, a 
warm, pungent and afterward cooling taste, and a neutral reaction, of sp. 
gr. about 0.880, and readily soluble in alcohol. It consists of two por- 
tions, the more volatile being a mixture of the hydrocarbons Cymene and 
Thymene, the less volatile being chiefly Thymol, which is official. 

Thymol, C 10 H 13 HO, — is a stearoptene contained in Oil of Thyme and 
in the volatile oils of several other plants. It occurs in large, colorless, 
hexagonal crystals, of aromatic odor, pungent taste and neutral reaction ; 
soluble in 1200 of water, 900 of boiling water, and in i of alcohol at 59 
F., freely in fats and oils, solutions of chloral and alkalies, ether, chloro- 
form, etc. It liquefies with camphor. Dose, gr. ss-ij. 

Unofficial Preparations. 

Thymol Solution, — for antiseptic spray, I in 1000. 

Thymol Gauze, — contains I per cent, of Thymol. 

Thymol Ointments, — vary from 5 to 30 grains to the ^ . 

Thymol Inhalation, — Thymol gr. xx, Alcoholis 3 iij, Magnesium Carbonate gr. x, 
Water to ^iij. A teaspoonful to a pint of water 150 F. for each inhalation. 

Volkmann's Antiseptic Fluid, — has of Thymol I, Alcohol 10, Glycerin 20, and Water 
100 parts. 

Physiological Action. 

Oil of Thyme has the same properties as the oils of other mints, and 
containing a large quantity of Thymol it is similar to the latter in action. 

Thymol in its action stands between Carbolic Acid and Oil of Tur- 
pentine. Like the former it is a powerful antiseptic and disinfectant. It 
is a local irritant and anaesthetic to the skin and mucous membranes, 
paralyzing the end-organs of the sensory nerves. When absorbed it para- 
lyzes the nerve-centres in the spinal cord and in the medulla, lessening 
reflex action, slowing respiration, lowering the temperature and the 
arterial tension, and in poisonous doses causing weakness, coma and 
death. Internally administered in doses of 20 to 30 grains per diem it 
produces a sensation of epigastric heat, sweating, singing in the ears, 
deafness, a sense of constriction in the forehead, and increase of the 
urinary discharge, which assumes a dark, greenish hue. It is eliminated 
by the respiratory and urinary organs which it irritates considerably dur- 
ing the process of its excretion. As an antiseptic it is much more power- 
ful and permanent than Carbolic Acid and much less poisonous. 



39§ tiglii oleum. 

Therapeutics. 
Thymol is chiefly employed in lieu of Carbolic Acid as an antiseptic 
for dressing wounds; as a gargle, spray or inhalation in laryngitis and 
diphtheria; as an ointment in ringworm, eczema and psoriasis, and as an 
injection in ozsena. A solution of 1 part in 1000 is the strength usually 
employed. Internally it has been used with success in diphtheria, typhoid 
fever, and other intestinal affections, diabetes, phthisis and vesical catarrh. 
Its fragrant odor renders it a very agreeable antiseptic application for 
ulcerated conditions of the mouth and fauces, but makes it very attrac- 
tive to flies; which fact, together with its high price, will prevent it 
becoming a favorite in hospital practice. A solution, used as a mouth- 
wash, is very efficient in removing the odor of tobacco from the breath. 



TIGLII OLEUM, Croton Oil, — is a fixed oil expressed from the 
seed of Croton Tiglium, a small tree of the nat. ord. Euphorbiacese, a 
native of India. The oil is of a pale or brownish-yellow color, somewhat 
viscid and slightly fluorescent, of fatty odor, acrid taste and slightly acid 
reaction ; sp. gr. 0.940 to 0.955, soluble in 60 of alcohol, freely in ether, 
chloroform, or carbon disulphide. Its composition is very complex and 
has not been thoroughly made out, but it is known to contain, the gly- 
cerides of several fatty acids, also a peculiar acid named Tiglinic Acid, 
C 5 H 8 2 , which is isomeric with Angelic Acid. Dose of the oil, fit^-ij, 
in pill, emulsion or tincture. 

Physiological Action. 

Externally Croton Oil is highly irritant, producing a pustular eruption 
which heals by scabbing and may leave unsightly cicatrices. Internally 
it is a powerful drastic cathartic, producing in one or two hours copious 
watery stools, in overdoses causing great congestion of the intestinal canal 
and perhaps death from gastro-enteritis. Vomiting usually occurs after 
large doses, so that the irritant hyper-catharsis is not always observed. It 
is absorbed into the blood, and produces glandular hypersemia as well as 
direct inflammation of the intestinal mucous membrane, together with 
increased peristaltic action. Its cathartic power is increased by the addi- 
tion of an alkali, and is manifested, though in less degree, when applied 
to the integument. 

Therapeutics. 

Croton Oil is used as a hydragogue cathartic when a speedy and com- 
plete evacuation of the bowels, diminution of arterial pressure and prompt 
derivative action are desired, as in apoplexy, impaction of the intestines, 
dropsy, lead constipation, paralysis, etc. It is contraindicated where 
there is debility, organic obstruction, and inflammatory conditions of the 



TONGA TRAGACANTHA. 399 

stomach and bowels. The smallness of the dose makes it a very easily- 
administered and manageable purgative. A considerable fraction of a 
drop is absorbed by a pellet of sugar, and may be given thus in repeated 
doses until the desired effect is obtained. It has been used as a vermi- 
fuge against tapeworm. 

Externally it is used as a counter-irritant in ovaritis, bronchitis, pleu- 
risy, rheumatism, neuralgia, glandular swellings, and in laryngeal and 
pulmonary diseases. The Linimentum Crotonis of the British Pharma- 
copoeia contains 1 part of the oil in 3^ each |of Alcohol and Oil of 
Cajuput, and is a useful pustulant preparation, being more manageable 
than the oil itself. 

TONGA (Unofficial), — is a mixed drug said to be obtained from the 
Fiji Islands, consisting of thin barks, root-fibres and leaves tied into long 
bundles. The fibrous material is believed to be derived from Rhaphido- 
phora vitiensis, a creeping plant of the nat. ord. Aracese, containing 
starch, potassium chloride and a volatile alkaloid Tongine. The barky 
portion is referred to Premna tatiensis, a shrub or tree of the nat. ord. 
Verbenacese, and contains a little volatile oil, sugar, pectin, etc. A fluid 
extract is prepared by Parke, Davis & Co., of Detroit, and may be given 
in doses of n^xxx-^j thrice daily. 

Tonga was introduced by Drs. Ringer and Murrell as a remedy for 
neuralgia in 1880, stating that they had used it with gratifying results. 
Since then reports have differed considerably in regard to its efficacy, 
and from the fact that Dr. Ringer does not mention it in the last edition 
of his Handbook of Therapeutics, it may be inferred that his further 
experience with it has not borne out the claims first made. 

TRAGACANTHA, Tragacanth, — is a gummy exudation from 
Astragalus gummifer and from other species of Astragalus, shrubs of the 
nat. ord. Leguminosae, growing chiefly in the mountainous regions of 
Asia Minor and Persia. It occurs in shell-like, curved or contorted 
bands, translucent, faintly yellowish, horn-like, tough, swelling with 
water to a gelatinous mass, which is tinged blue by test-solution of 
iodine, and consists of a mixture of Arabin, or gum-arabic, which is 
soluble in water, and Bassorin, a gum which is insoluble in water but 
swells up in it, also a little starch. 

Preparation. 
Mucilago Tragacanthce, — Tragacanth 6, Glycerin 18, Water to 100 parts. Dose, ^ j 
or more. 

Physiological Action and Therapeutics. 
Tragacanth is demulcent, but in large quantities it may cause indiges- 
tion. It is chiefly employed to suspend resins and heavy powders in 



400 TRITICUM — ULMUS — UVA URSI. 

emulsion. The mucilage may be used as a vehicle for active agents in 
gargles for pharyngitis, and to cause cohesion in the preparation of pills, 
troches, etc. It is a constituent of 13 of the 16 official troches, and is a 
better agent than acacia for making emulsions of cod-liver oil. 



TRITICUM, Couch-grass, — is the rhizome, gathered in the spring 
and deprived of its rootlets, of Triticum repens, the Couch-grass, a peren- 
nial plant of the nat. ord. Graminaceae, abounding in meadows and cul- 
tivated grounds, where it ranks as a weed, though of the same genus as 
wheat. The rhizome is very long, but as met with in the shops is cut 
into two sections about J-ths inch in length and -^ inch thick, creeping, 
smooth, hollow in the centre, of straw color, and sweet taste. It contains 
much sugar and a gum-like principle Triticin. Dose, 3J-^j, in infusion 
or decoction. 

Preparation. 

Extractwn Tritici Fluidum, — Dose, gj-^j, well diluted. 

Couch-grass is demulcent, emollient and a feeble diuretic. It is chiefly 
used in cystitis and irritable bladder. The infusion is a popular fever- 
drink in Europe, and has had of old a considerable reputation in dysuria. 



ULMUS, Elm, Slippery Elm, — is the inner bark of Ulmus fulva, 

an indigenous tree of the nat. ord. Urticaceae, and occurs in flat pieces 

of various sizes, having a slight, peculiar odor and a mucilaginous, insipid 

taste. It contains a large quantity of mucilage which it readily parts with 

to water. 

Preparation. 

Mucilago Ulmi, — Elm 6, Boiling Water 100 parts, macerated for two hours and 
strained. Dose, ad libitum. 

Slippery-elm bark is demulcent, slightly astringent and somewhat tonic. 
It is used internally in diarrhoea, dysentery and affections of the urinary 
passages, and externally in the form of poultice as an emollient applica- 
tion in cases of inflammation. It is also employed in the dilatation of 
fistulae, strictures and the os uteri. 



UVA URSI, Bearberry, — the leaves of Arctostaphylos Uva-ursi, a 
low, evergreen shrub, of the nat. ord. Ericaceae, inhabiting the northern 
latitudes and high mountains of Europe, Asia and America. The leaves 
are small, obovate, nearly sessile, shining, reticulated beneath, of a faint 
but hay-like odor, and a strongly astringent taste. They contain Tannic 



VALERIANA. 4OI 

and Gallic Acids and 3 principles, viz., — Arbutin, C 24 H 32 O u , a bitter 
glucoside, neutral, crystalline, soluble in warm water and resolvable into 
glucose and Hydroquinone, C 6 H 6 2 ; — Ericolin, C 34 H 56 2 , bitter and 
amorphous; — Ursone, C 2 oH 54 2 , resinous, neutral, crystalline and taste- 
less. The Californian Manzanita (Arctostaphylos glauca) is an allied plant 
and also contains Arbutin and Tannin. Dose of the powdered leaves, 
gr.x-^j in infusion or decoction. 

Preparations. 
Extractum Uv<z-ursi Fluidum, — Dose, TT^x— gj. 
Infusum Uvce-ursi (Unofficial), — ^j-Oj. Dose, ^j-ij. 
Arbntinum, Arbutin (Unofficial), — Dose, gr. iij-v. 

Physiological Action and Therapeutics. 

Uva-ursi is astringent, tonic and feebly diuretic. Used in large quan- 
tity it produces vomiting and purging, and is alleged ' to have oxytocic 
power. Arbutin is an efficient diuretic, and is decomposed in the body, 
yielding Hydroquinone which is excreted by the kidneys as Hydroqui- 
none-sulphuric Acid. This is non-toxic, imparts a brown color with 
antiseptic and slightly irritant qualities to the urine. 

Bear-berry was formerly used in all calculous affections and chronic 
disorders of the urinary passages. It has some reputation as an antilithic, 
and is no doubt useful in gravel, chronic nephritis, cystitis, urethritis, and 
kindred diseases. It relieves incontinence of urine, dysuria and strang- 
ury, and has proved serviceable even in uterine hemorrhages. Arbutin 
has been successfully employed in cardiac dropsy as a diuretic, also in 
urethritis. 



VALERIANA, Valerian, — is the rhizome and rootlets of Valeri- 
ana officinalis, a large, herbaceous plant of the nat. ord. Valerianaceae, 
having small, white, or rose-colored flowers, and opposite pinnate leaves 
on an erect, round and channeled stem. The plant is a native of Europe, 
but is cultivated in Vermont and New York. The root is perennial, its 
rhizome about an inch long, upright, truncate at both ends, internally 
whitish or pale-brownish with a narrow circle of white wood under the 
thin bark. Odor peculiar, taste camphoraceous and bitter. It contains 
a complex Volatile Oil, from which are developed by oxidation Valerene 
C 10 H 16 , which is a terpene, Valerol or Baldrian Camphor, C 12 H 20 O, and 
Valerianic Acid, C 5 H 10 O 2 , which occurs also in many other plants and in 
cod-liver oil. The Valerianic Acid of pharmacy is obtained as a product 
of oxidation of Amylic Alcohol, and from it are formed the various 
Valerianates. It is, however, not identical with the natural acid. Dose 
of the powdered root, gr. x-xxx. 
26 



402 VALERIANA. 

Preparations of Valerian. 

Abstradum Valeriana, — Dose, gr. v-xx. 

Extradum Valeriana Fluidum, — Dose, TTLx-xxx. 

Tindura Valeriana, — Strength 20 per cent. Dose, Zss-ij. 

Tindura Valeriana Ammoniata, — Valerian 20, Aromatic Spirit of Ammonia to 100 
parts. Dose, ^ss-ij. 

Oleum Valeriana, — the volatile oil, sp. gr. about 0.950, a greenish or yellowish, thin 
liquid, having the odor of valerian, an aromatic taste and a slightly acid reaction, readily 
soluble in alcohol. Dose, TTLij-v. 

The Oil is by far the best preparation for use, as the tinctures are extremely nauseous 
and the fluid extract is too bulky. The taste is best covered by Cinnamon. 

Preparations of Valerianic Acid. 
Ammonii Valerianas, Valerianate of Ammonium, NH 4 C 5 H 9 2 , — described on page 
95. Dose, gr. ij-x. 
Ferri Valerianas, Valerianate of Iron, Fe 2 (C 5 H 9 2 ) 6 , — described on page 222. Dose, 

gr- J-»J- 

Quinines Valerianas, Valerianate of Quinine, C 20 H 24 N 2 O 2 C 5 H 10 O 2 .H 2 O, — described on 
page 1 82. Dose, gr. j-iij. 

Zinci Valerianas, Valerianate of Zinc, Zn(C 5 H 9 2 ) 2 .H 2 0, — described on page 41 1. 
Dose, gr. j£-iij. 

The Valerianates are made with the acid produced from Amylic Alcohol, and do not 
represent the action of the plant, but rather that of the bases from which they are pre- 
pared. 

Physiological Action. 

Valerian is antispasmodic, and a gentle stimulant to the nervous and 
circulatory systems. It is sedative to reflex excitability, antagonizing the 
action of Strychnine, Brucine, Thebaine, etc., and is laxative, diapho- 
retic and anthelmintic. 

Its taste and odor are very disagreeable, but cats are extravagantly 
fond of it. In these animals it greatly excites the sexual appetite, prob- 
ably from a resemblance between its odor and theirs when under vene- 
real excitement. After a time it produces in them violent spasms and 
convulsions. 

In full doses it increases the action of the heart and raises the tempera- 
ture, in most persons producing exhilaration (in some, slight mental dis- 
turbance), with formication of the hands and feet. Long used it induces 
a condition of low melancholy and hysterical depression. Large doses 
cause hiccough, diarrhoea, nausea and vomiting, frequent micturition 
with tenesmus of the bladder and lithates in the urine, mental disturb- 
ance even to delirium, reduced motility and sensibility, and lessened 
reflex excitability. The oil in large doses is paralyzant to the brain and 
the spinal cord, lowers the blood-pressure and slows the pulse. 

The Valerianates follow their bases in general action, but are sup- 
posed to combine therewith some of the sedative qualities of the acid. 

Therapeutics. 
Valerian was formerly much used in epilepsy, but it was probably only 
useful in the hysterical form of that disease (hystero-epilepsy). It is a 
valuable remedy in all forms of hysteria, especially when occurring in 



VANILLA VERATRUM VIRIDE. 4O3 

young and delicate women. It is also useful in flatulence of infants 
and in that of hypochondriacal and hysterical subjects, and in coughs of 
nervous type, whooping-cough, diabetes insipidus, convulsions due to 
worms and in delirium with vital depression. In the coma of typhus 
fever the oil proved remarkably efficient in a series of 135 cases out of 
172 cases treated by it. 

Valerianate of Ammonium is used in the same class of disorders as is 
Valerian. It is often a good remedy for nervous headache, administered 
in 10-grain doses and in an elixir. 

Valerianate of Zinc has been supposed to combine the antispasmodic 
power of valerian with the nerve-tonic effect of a zinc salt. It has been 
used in cholera, epilepsy and neuralgia, frequently with considerable 
success. 

The Valerianates of Iron and Quinine are used as the salts of their 
respective bases. 



VANILLA, — is the fruit of Vanilla planifolia, a perennial, climbing 
plant of the nat. ord. Orchidaceae, a native of the West Indies and trop- 
ical America, but cultivated in Java, etc. It has dark green, tough leaves, 
pale greenish-yellow sessile flowers, and long pods (6 to 10 inches), 
wrinkled, warty, one-celled, containing a blackish-brown pulp with 
numerous small seeds and acicular crystals, of peculiar and fragrant odor 
and taste. Its characteristic odorous principle is Vanillin, or the methyl- 
ether of protocatechuic aldehyd, which oxidizes slowly in damp air to 
Vanillic Acid, and may be resolved into methyl chloride and proto- 
catechuic acid. Vanillin may be made synthetically from Coniferin 
or from Eugenol. Dose, indefinite. 

Preparations. 
Tinctura Vanilla, — 10 per cent. Dose, a few drops, according to the strength of flavor 
desired. 

Trochisci Ferri, — contain about -^ per cent, of Vanilla. 

Vanilla is an aromatic stimulant, with considerable influence on the 
nervous system. It is chiefly employed as a perfume and for flavoring 
purposes, but has been used in hysteria and low fevers. 



VERATRUM VIRIDE, American Hellebore,— is the rhizome 
and rootlets of Veratrum viride, or Indian Poke, Poke-root, Swamp 
Hellebore, an indigenous plant of* the nat. ord. Melanthacese, having 
a solid, round stem, furnished with bright green leaves, and terminating 
in a panicle of greenish-yellow flowers. The root is perennial, upright, 



4O4 VERATRUM VIRIDE. 

externally blackish-gray, internally grayish-white, 2 to 3 inches long, with 
numerous, shriveled rootlets, inodorous but sternutatory when powdered, 
taste bitter and very acrid. It contains several alkaloids, Jervine, 
C 26 H 43 N0 2 , Pseudo-jervine, C 29 H 43 N0 7 , Cevadine, C 32 H 49 N0 9 , a very little 
Rubijervine, C 26 H 43 N0 2 , and traces of Veratrine, C 37 H 53 NO n , and Vera- 
tralbine, C 28 H 43 N0 5 . Veratroidine ', formerly regarded as one of its alka- 
loids, is now thought to be Rubijervine and Resin. Veratrum Viride 
also contains Gallic Acid and Sugar. 

Allied Plants. 

Veratrum Album, White Hellebore, — is a native of the mountainous 
regions of continental Europe, and so closely resembles V. Viride in 
appearance and characteristics that it may be considered a variety of 
the same plant. The rhizome was official in the U. S. P. 1870. It con- 
tains the alkaloids Jervine, Pseudo-jervine, Rubijervine, traces of Ceva- 
dine, and another powerful alkaloid Veratralbine, C 28 H 43 N0 5 . 

Veratrum Sabadilla, Cevadilla, Asagraea officinalis, — is a bulbous 
plant of the nat. ord. Melanthacese, indigenous in Mexico and Central 
America. It contains the alkaloids Cevadine (formerly called Veratrine), 
Cevadilline and Veratrine, with Veratric and Sabadillic or Cevadic Acids. 
It is the source of the official Veratrine (see below). The seeds are 
official in the Br. Phar. under the title Sabadilla. 

Preparations. 

Extractum Veratri Viridis Fluidum, — Dose, rt\j-iv. 

Tinctura Veratri Viridis, — 50 per cent. Dose, TT\Jj-x. 

Norwood's Tincture of Veratrum Viride,ha.s a very high reputation for efficiency, — 
Dose, rr\v, increased by n\j every 3 hours, until pulse is down to 65, when the original 
dose will hold it there. 

Veratrina, Veratrine, — is an alkaloid or mixture of alkaloids prepared from the seeds 
of Asagrcea officinalis (see above). A white, or grayish-white, amorphous powder, highly 
irritant to the nostrils, of very acrid taste, producing tingling and numbness of the tongue 
and constriction of the fauces ; slightly soluble in cold water, soluble in 3 of alcohol at 
59 F., in 6 of ether, 2 of chloroform, 96 of glycerin and in 56 parts of olive oil. Dose, 

err 1 - 1 
& r - 5 TO" 

Unguentum Veratrina, — Veratrine 4, Alcohol 6, Benzoinated Lard 96 parts. For 
local use. 

Olealum Veratrince, — Veratrine 2, Oleic Acid 98 parts. For local use. 

Physiological Action. 
Veratrum Viride is in action closely allied to Aconite, being a power- 
ful cardiac depressant and spinal paralyzant. It differs from Aconite in 
affecting the respiration to a much less degree, — in being a systemic 
emeto-cathartic — in paralyzing the motor system centrally, impairing the 
reflexes, but leaving sensation unimpaired, — and in having little or 
no diaphoretic or diuretic action. • It causes great depression, but is 
seldom fatal ; whe*n death does result from its use it usually occurs by 
paralysis of the heart. 



VERATRUM VJRIDE. 4O5 

In small doses Veratrum reduces the force of the pulse, but does not at 
first affect its rate. If continued for some time, the pulse becomes very 
slow, soft and compressible ; rising, on the least exertion, to be very 
rapid and feeble. At the same time there is great muscular weakness, 
and frequently nausea and vomiting. Large doses increase these symp- 
toms very much, the pulse becoming very rapid and so small as to be 
almost imperceptible ; the skin is cold and clammy, and constant vomit- 
ing, extreme debility, giddiness, impaired vision, and partial unconscious- 
ness ensue. 

Jervine represents in part the depressant action on the circulation and 
on the central nervous system. It does not, however, affect the vagus, 
and but very slightly the voluntary muscles or the motor nerves. It irri- 
tates the motor centres in the brain, causing convulsions ; and lowers the 
functions of the cord, of the centres in the medulla, especially the vaso- 
motor, and those of the cardiac ganglia, — slowing the heart by direct 
depression either of the cardiac muscle or its motor apparatus. It always 
causes salivation, but never vomiting or purging ; and kills by asphyxia, 
the heart beating after respiration has ceased. 

Veratroidine, on the contrary, always causes emeto-catharsis, and 
produces less violent convulsions. It stimulates the vagus centre and 
paralyzes the vagus ends, depresses the cord, and paralyzes the respiratory 
centre, — but at the same time increases the excitability of the vaso-motor 
centre. The result is great slowing of the pulse-rate and of respiration, 
and lowering of blood-pressure, until the carbonized blood irritates the 
vaso-motor centre, when the blood-pressure rises greatly. It probably 
consists of Rubijervine and a toxic resin. 

Veratrum Album contains a very powerful alkaloid, Veratralbine ', and 
also an irritant poisonous resin (?). Its general action is similar to that 
of its congener, but it is much more irritant to the gastro-intestinal 
mucous membrane, causing violent vomiting and purging, intense abdom- 
inal and oesophageal pain, greatly reduced temperature and pulse, col- 
lapse, and death from cardiac and respiratory paralysis. 

Veratrine is an acrid, intensely irritant powder, probably consisting 
of a mixture of alkaloids. It causes violent sneezing, a burning sensa- 
tion, and free salivation. It affects the heart and circulation similarly to 
the other Veratriae, and in addition seems to be a direct poison to muscular 
tissue, and to cause violent convulsions before the muscular paralysis sets 
in. The alkaloids Jervine and Rubijervine both depress the circulation, 
while the latter produces the emeto-catharsis. 

Antagonists and Incompatibles. 
Alcohol, Opium, Belladonna and Ammonia counteract the cardiac depression. Mor- 
phine and Atropine should be administered hypodermically, or Laudanum internally with 
alcoholic stimulants, the recumbent position should be enforced, and dry heat applied to 
the body. Caustic alkalies are incompatible, as they decompose the alkaloids. 



406 VERBASCUM. 

Therapeutics. 

Veratrum Viride is inferior to Aconite in most of the fevers and 
inflammations, by reason of its lacking power over excretion. It renders 
good service, however, in the early stages of many parenchymatous and 
serous inflammations when occurring in sthenic subjects, especially in 
pneumonia. It is highly esteemed in puerperal fever and in many cardiac 
disorders, as simple hypertrophy, irritable heart, etc. It has been used 
with remarkably good results in many cases of acute mania and puerperal 
convulsions, and it is of service in aneurism to depress the circulation to 
the lowest point, but in this case the recumbent position must be strictly 
observed in order to secure safety. It should always be administered in 
small doses and its effects carefully watched. 

In puerperal eclampsia large doses have been administered without 
danger and with decided benefit, as much as 20 drops of Norwood's 
tincture having been administered every hour for 5 consecutive days and 
nights in one case, the patient making a good recovery. The same pre- 
paration may be given hypodermically, in doses of n^ij-iv. 

Veratrum Album is the "Hellebore" of the ancient physicians, and 
was much used by them as a derivative in insanity. It is rarely used at 
present except by the homceopathists, who give it in the cold stage of 
cholera, in colic, in the vomiting and purging of summer diarrhoea, in 
whooping-cough and asthma. 

Veratrine is chiefly used externally. The ointment or oleate may be 
used with benefit in many cases of superficial neuralgia, myalgia and 
headaches, a small quantity being rubbed in over the seat of the pain. It 
may be absorbed through an abrasion of the cuticle and give rise to dan- 
gerous symptoms. Internally it has been employed as a cardiac sedative 
in fevers and inflammation, also in acute articular rheumatism, dropsies, 
dysmenorrhcea and various nervous affections, but its uncertainty of action 
and the dangerous depression which it may produce have caused it to lose 
favor as an internal remedy. 

VERBASCUM, Mullein (Unofficial), the leaves of Verbascum 
Thaspus, the Mullein-weed, a common plant of the nat. ord. Scrophu- 
lariaceae, having large woolly leaves and yellow flowers in dense spikes. 
Its chief constituent is mucilage, though the flowers contain an essential 
oil in very small proportion. An infusion of ^iv of fresh leaves to the 
pint of milk is the form in which it has generally been given ; this quan- 
tity to be taken thrice daily. 

Mullein is emollient and demulcent, perhaps also slightly anodyne. 
It has long been a popular Irish remedy in pulmonary affections, as under 
its use the weight steadily increases in phthisis and other wasting dis- 
orders, while expectoration is rendered more easy, cough is palliated and 



VIBURNUM — VIOLA TRICOLOR. 407 

the general condition improved. It is also recommended in cystitis, 
irritable bladder, and diarrhoea, and is employed as an enema in dysen- 
tery and as a poultice for hemorrhoids. The dried leaves may be smoked 
with benefit in aphonia from laryngeal irritation. 



VIBURNUM, Black Haw, — is the bark of Viburnum prunifo Hum, 
an indigenous shrub or small tree of the nat. ord. Caprifoliaceae, having 
sharply serrulate leaves, and small, white flowers in terminal cymes. The 
bark occurs in glossy, purplish-brown, thin pieces or quills covered with 
scattered warts and minute black dots; inner surface whitish and smooth, 
inodorous, somewhat astringent and bitter. It contains tannic, oxalic, 
citric and malic acids, sulphates and chlorides ; also two resins, one of 
which is named Viburnin, and Viburnic Acid, which is identical with 
Valerianic Acid. 

Preparation. 

Extractum Viburni Fluidum, — Dose, ^ss-ij. 

Viburnum is considered to possess nervine, antispasmodic, astringent, 
diuretic and tonic properties, and to be especially useful in preventing 
abortion in the nervous diseases of pregnancy, and in dysmenorrhoea. It 
may be administered with cannabis indica, morphine, nerve-sedatives or 
simple aromatics. No exact observations have been made regarding its 
action, and its therapeutical claims are denied by many who have used it. 
It often excites nausea and vomiting. 

Viburnum Opulus, Cramp-bark, Cranberry-tree, — another shrub of 
the same genus, is highly valued by many practitioners as a remedy in 
uterine and other abdominal pains, but is not official. The so-called 
"Viburnum Compound of Dr. Hay den," is stated by its manufacturers to 
consist of "the active principles of the Viburnum Opulus, Dioscorea 
Villosa, Scutellaria Lateriflora, and a combination of aromatics, prepared 
by a process peculiar to ourselves." This they call publishing the formula 
of the preparation. 

VIOLA TRICOLOR, Pansy,— is the wild-grown, flowering herb 
of Viola tricolor, the Heart's-ease Pansy, a plant of the nat. ord. Violaceae, 
native in Europe, but naturalized in the southern U. S. It has an angu- 
lar and nearly smooth stem ; leaves alternate, petiolate, ovate or oblong 
and crenate ; flowers with an obtuse spur and variegated petals, inodor- 
ous, taste somewhat bitter and acrid. It contains an active alkaloid, 
Violine, allied in many respects to Emetine, and poisonous. There are 
no official preparations. Dose, gr. x-^j, in decoction. 

Viola is mucilaginous, emollient, expectorant and slightly laxative. Its 
active principle is emeto-cathartic, but exists in very small quantity in the 



408 VISCUM VITELLUS. 

plant. A decoction of the fresh herb in milk, with a poultice of the 
same, was formerly highly recommended in crusta lactea and impetigo. 
It is used with benefit in some forms of eczema, especially in that of the 
head and face, and has had some reputation in bronchitis and constitu- 
tional syphilis. 

Viola Cucullata, the common Violet, is used in Pennsylvania with 
success as an internal antidote against rattlesnake venom. The leaves 
are eaten, and a poultice of salt and indigo is applied to the wound. 



VISCUM, Mistletoe (Unofficial), — occurs in two species, (i) Vis- 
cum album, the European Mistletoe, a small, parasitic, evergreen shrub, 
of the nat. ord. Loranthacese, growing chiefly on deciduous-leaved trees, 
and (2) Viscum flavescens, the American species, growing on oaks, elms, 
etc. They contain mucilage, starch, fixed oil, resin, salts, etc., and 
Viscin, or Bird-lime, which occurs also in Ilex aquifolium, Gentiana 
lutea and other plants. Dose, gr. x-^j in decoction, or nrv-xxx of a 
ten per cent, tincture. 

The berries of the mistletoes have produced emeto-catharsis, with great 
thirst, tenesmus, bloody stools, convulsions and even death in young 
children. The leaves and twigs have been used in epilepsy, hysteria, 
chorea, asthma and other nervous affections. The American plant is 
asserted to possess qualities similar to those of Digitalis, and to incite 
uterine contractions. It has been used in cardiac affections, dropsies, 
uterine hemorrhages and amenorrhcea, also as an abortifacient. 



VITELLUS, Yolk of Egg,— is the yolk of the egg of the domestic 
fowl, Gallus Bankiva, var. domesticus. It is a viscid, reddish-yellow, 
opaque liquid, of bland taste, alkaline reaction, odorless, and may be re- 
garded as a dense emulsion of oil suspended in water by means of albu- 
men. It is coagulated by heat or by alcohol and contains Vitellin, which 
is a proteid related to casein, Cholesterin and Albumin, besides fat? 
inorganic salts, sugar, etc. 

Preparation. 

Glyceritum Vitelli, Glycerite of Yolk of Egg, Glyconin, — consists of Vitellus 45, 
Glycerin 55 parts, rubbed together until thoroughly mixed. 

Yolk of Egg is highly nutritive and forms a useful article of diet in 
exhausted conditions of the system, but its chief use in medicine is for 
emulsion izing oils and camphors. The Glycerite has the consistence of. 
honey and forms an opaque emulsion with water. It is a very good 
vehicle for cod-liver oil (see ante, page 288), and an excellent protective 
application for burns, erysipelas, fissure of the nipples and many cutane- 



XANTHOXYLUM ZEA MAYS. 4O9 

ous disorders. It is also used as a cosmetic, and may be employed as an 
aliment. 



XANTHOXYLUM, Prickly Ash,— is the bark of Xanthoxylum 
fraxineum, the northern species, and of Xanthoxylum carolinianum, the 
southern species of an indigenous shrub of the nat. ord. Rutacese, having 
small, greenish flowers, alternate, unequally pinnate leaves, leaflets punc- 
tate with pellucid dots, stems and leafstalks armed with prickles. The 
bark of both species comes in curved or quilled fragments, of a brownish- 
gray color externally with whitish patches, and minute black dots, faintly 
furrowed, inodorous, bitter and pungent ; that of X. fraxineum is about 
Jg- inch thick, has several two-edged spines each ^ inch long ; the bark 
of X. caroliniaum is twice as thick as the other and is marked by many 
conical, corky projections, and by stout brown spines, arising from corky 
bases. It contains a volatile oil, a fixed oil, resin, gum, coloring matter 
and an alkaloid, Xanthoxyline, which is identical with Berberine (see ante, 
page 133). Dose, of the powdered bark, gr. x-xxx. 

Pj'eparotions, 
Extractum Xanthoxyli Fluidum, — Dose, gss-j. 

Decoctum Xanthoxyli (Unofficial), — ^j to the quart. Dose, a pint during 24 hours in 
divided doses. 

Physiological Action. 

Xanthoxylum is a stimulant and aromatic bitter, a local and systemic 
sialagogue, diaphoretic, diuretic and emmenagogue. Its taste is aromatic, 
soon becoming acrid. and bitter and causing profuse salivation, tingling 
in the tongue and increased secretion from stomach, intestines, liver and 
pancreas. It also increases the cardiac action and raises the arterial ten- 
sion, and is classed among the vegetable alteratives, with Mezereum, 
Guaiac, Stillingia, etc. 

Therapeutics. 

Xanthoxylum has a high reputation in chronic rheumatism, myalgia, 
lumbago and similar disorders, also in jaundice from catarrh of the bile- 
ducts, in dropsies, chronic pharyngitis and constitutional syphilis. In 
old cases of pharyngitis, the mucous membrane being glazed and dry, the 
decoction should be used as a gargle and lr^ x-xxx of the fluid extract 
taken internally thrice daily. The bark, used as a masticatory, is a popu- 
lar remedy for toothache, and has been frequently successful in paralysis 
of the tongue. 



ZEA MAYS, Maize, Indian Corn. — This well-known species of 
the nat. ord. Graminaceae, though itself unofficial, is the source of two 
drugs one of which is official, viz. : — 



4IO ZINCUM. 

Ustilago, Corn Smut, — Ustilago Maydis, nat. ord. Fungi, grown upon 
the stems, the pistils and the male inflorescence (tassel) of Zea Mays. It 
occurs in irregular, globular masses, sometimes 6 inches thick, and con- 
sisting of a blackish membrane, inclosing numerous globular, minute 
spores, their surfaces covered with echinulate warts. Its odor and taste 
are unpleasant, and it contains fixed oil, resin, pectin, gluten, sugar, an 
acid resembling the Sclerotic Acid of Ergot, and a volatile principle 
called Secaline, which is supposed to be identical with Trimethylamine. 

Preparation. 
Extractum Usiilaginis Fluidum (Unofficial), — may be made according to the general 
rule. Dose, YT^xv-g). 

Stigmata Maydis, Stigmata of Maize, Corn Silk (Unofficial), — 
should be gathered when the tassel has well shed its pollen. Its active 
principle is said to be Maizenic Acid. 

Preparation. 
Extractum Stigmatarum Maydis Fluidum (Unofficial), — made by the general rule for 
fluid extracts. Dose, gj-ij. 

Physiological Action and Therapeutics. 

The properties of Ustilago, so far as examined, resemble those of 
Ergot and Nux-vomica combined. It is a spinal excitant, exalts sensibil- 
ity and reflex action, producing tonic convulsions on the least irritation 
of the skin. It slows the heart by stimulation of the pneumogastric, 
dilates the pupils, causes muscular paresis, and death by tetanus of the 
respiratory muscles or by exhaustion. Experiments on its reputed oxy- 
tocic action have not substantiated the claims made for it in this respect, 
though it is said to have produced abortion in cows and other animals, 
after they had eaten the diseased grain. As a therapeutic agent Ustilago 
has been very little used, and when employed it has been as a substitute 
for Ergot. 

Stigmata Maydis is a certain but mild diuretic when given in full 
doses at short intervals. It is by some observers considered demulcent 
and anodyne, and is generally believed to have a specific or alterative 
influence over many disorders of the genito-urinary passages and the 
urinary bladder. It has been used with considerable success in inconti- 
nence of urine, uric and phosphatic gravel, gout, rheumatism, urethritis, 
pyelitis, acute and chronic cystitis, cardiac dropsy and obstructive valvu- 
lar disease of the heart. 



ZINCUM, Zinc, Zn, — is metallic Zinc, in the form of thin sheets, or 
irregular, granulated pieces, and is a bluish-white metal, having the sp. 
gr. 6.9. It occurs native as a Sulphide {Blende), as a Carbonate and a 



zincuvt. 411 

Silicate {Calamine), as a Red Oxide (Zincite), and as a mixture of Zinc 
Oxide with Oxide of Iron and Manganese {Franklinite). Zinc is soluble 
in the weakest acids, and therefore should never be used for culinary ves- 
sels. Its salts are all more or less active poisons. Metallic Zinc is not 
employed as a medicine. 

Zinc Compounds and their Preparations. 

Zinci Acetas, Acetate of Zinc, Zn(C 2 H 32 0) 2 .3H 2 0, — soft, white, micaceous or pearly, 
six-sided tablets or scales, somewhat efflorescent' in dry air, of faintly acetous odor, sharp 
metallic taste and a slightly acid reaction ; soluble in 3 of water and in 30 of alcohol at 
59° F., in \% of boiling water and in 3 of boiling alcohol. Used locally as an astrin- 
gent in solution of gr. j or ij to % j, or internally in doses of gr. ^-ij. 

Zinci Carbonas Prcecipitatus, Precipitated Carbonate of Zinc, (ZnC0 3 ) 2 .3Zn(HO) 2 , — 
a white, impalpable powder, permanent in the air, odorless and tasteless, insoluble in 
water or alcohol, but soluble in acids with copious effervescence. When strongly heated 
it loses water and carbonic acid gas, leaving a residue of oxide of zinc. Used locally 
as a protective. 

Zinci Chloridum, Chloride of Zinc, ZnCl 2 , — a white, crystalline powder, deliquescent, 
odorless, of caustic, saline, and metallic taste and acid reaction, very soluble in water and 
in alcohol, forming a clear or only faintly opalescent solution. Tonic and escharotic. For 
internal use a solution in Spirit of Ether is the most convenient form, of the strength 
of ^ss-^iij, of which from 4 to 8 drops may be given twice daily. Strength of injec- 
tions and collyria, gr. j-ij ad % j. 

Liquor Zinci Chloridi, — an aqueous solution of Zinc Chloride containing about 50 per 
cent, of the salt. A clear, colorless, odorless liquid, of a very astringent, sweetish taste 
and an acid reaction. A powerful disinfectant for sinks, drains, etc. Used also as an 
injection in gonorrhoea, leucorrhcea, etc., in dilute solution, ^ to I per cent. Burnett's 
Disinfecting Fluid 'is similar to the above but slightly stronger. 

Zinci Iodidum> Iodide of Zinc, Znl 2 , — a white, granular powder, very deliquescent, 
odorless, of sharp, saline and metallic taste and acid reaction, very soluble in water and 
in alcohol. Dose, gr. ss-ij in syrup. 

Zinci Oxidu?n, Oxide of Zinc, ZnO, — a soft, pale-yellowish powder, permanent in the 
air, odorless and tasteless, insoluble in water or alcohol, but soluble in acids without effer- 
vescence. Dose, gr. j-x, in pill. 

Unguentum Zinci Oxidi, — strength 20 per cent., made with Benzoinated Lard, thor- 
oughly mixed. 

Zinci Sulphas, Sulphate of Zinc, ZnS0 4> 7H 2 0, — small colorless prisms or acicular 
needles, slowly efflorescing in dry air, odorless, of sharp, saline, nauseous and metallic 
taste and acid reaction; soluble in 0.6 of water, insoluble in alcohol. Dose, as emetic, 
gr. x-xxx, — as a tonic and astringent, gr. -Jg— ij, in pill. For Villate'' s Solution, see ante, 
page 200. 

Zinci Valerianas, Valerianate of Zinc, Zn(C 5 H 9 2 ) 2 .H 2 0, — soft, white, pearly scales, 
of sweet and styptic taste and acid reaction ; soluble in 100 of water and in 40 of alco- 
hol at 59 F. Dose, gr j^-ij, in pill. 

[The Bromide of Zinc is described under Bromum, see page 136, and the Phosphide 
under Phosphorus, on page 312.] 



Physiological Action and Therapeutics. 
Zinc Salts are astringents, but milder ones than the salts of Lead. Its 
soluble compounds (the Chloride, Iodide, Sulphate and Acetate) are cor- 
rosive poisons, causing violent gastro-enteritis, and in some cases pro- 
found nervous depression. The Chloride is a very powerful and pain- 
ful escharotic or rather mummifier of the tissues, having great affinity for 
water, coagulating albumen and shrivelling the vessels. It is a very 
active disinfectant. The Sulphate is also escharotic and a specific 



412 ZIN'CUM. 

emetic, acting promptly by direct irritation of the stomach, and with- 
out much depression or after-nausea. In small doses it is tonic and 
astringent, in larger it would be a severe irritant but for its causing 
prompt emesis. The Acetate resembles the sulphate in action. The 
Oxide used externally is a mild, soothing astringent; used internally it 
enters the blood as a lactate or chloride, and acts as a mild astringent 
and as a nervous sedative. Being almost insoluble in the stomach, it has 
but feeble diffusive power and consequently but slight activity. The Car- 
bonate resembles the Oxide in action. The Iodide locally is a powerful 
escharotic and has been supposed to possess some alterative powers when 
given internally in addition to its astringent qualities as a zinc salt. The 
Valerianate acts as a nervous sedative, but its properties are in all proba- 
bility due to its base and not to the acid combined with it. 

Continued use of zinc salts produces symptoms similar to those .of 
chronic lead-poisoning, but of much less gravity. They manifest much 
less tendency to accumulate in the system than other metallic salts, and 
are excreted much more rapidly. Elimination takes place chiefly by the 
liver and intestinal glands. 

[The actions of the Bromide and Phosphide are described respectively 
on pages 137 and 312.] 

Antidotes and Inco?npatibles. 
Lime-water, mucilaginous drinks, soap, tannic acid, milk, Potassium and Sodium Car- 
bonates, if given early, are the antidotes in poisoning by the salts of zinc. Incompatibles 
are — lime-water, alkalies and their carbonates, nitrate of silver, and vegetable astringents. 
Acetate of Lead produces double decomposition with zinc salts, but it is often used in 
solution with the sulphate as an injection. 

Therapeutics. 
Zinc salts are chiefly employed in weak solution as mild astringent 
applications in catarrhs of mucous membranes, such as conjunctivitis, 
gonorrhoea, etc., and as unguents and lotions in skin-diseases, particularly 
eczema, impetigo, herpes, and erythema. The Chloride is made into a 
paste with flour and glycerin for the destruction of lupus, epithelioma and 
other morbid growths, and for opening abscesses in locations where punc- 
ture or incision might be dangerous. The cuticle, if unbroken, should 
be removed by strong water of ammonia before the paste is applied, as it 
will not act through the epidermic tissue. It is a commonly used disin- 
fectant and deodorant, and in weak solution (nxiij-v of the Liquor to ^j 
of water) makes a good lotion for putrid ulcers, and still weaker (gr. j-ij 
to the pint), is an excellent injection for gonorrhoea. The Iodide is not 
employed as an escharotic, nor has it ever been a favorite remedy for 
internal use. It is chiefly employed in solution as an application to 
enlarged tonsils, and as an ointment (1 part to 8 of lard) for the reduc- 
tion of glandular enlargements. The Sulphate is used locally as an 
astringent to mucous surfaces generally, internally as an emetic in nar- 



ZINGIBER. 413 

cotic poisoning and croup, and in small doses as a tonic and antispas- 
modic in convulsive diseases, as chorea, hysteria, epilepsy, angina pectoris, 
asthma, etc. In diarrhoeas and dysentery it is a good astringent, and is fre- 
quently combined with Opium and Ipecac. The Acetate is used for the 
same purposes as the Sulphate, but is usually preferred for collyria. The 
Oxide may be used as a dusting powder in intertrigo, and as an ointment 
in eczema and excoriated surfaces generally. In combination with Bis- 
muth and Pepsin it is an excellent remedy for the summer diarrhoea of 
children, and with Aromatic Powder and Morphine it is very efficient in 
gastralgia. It is a good remedy in 3-grain doses for the night-sweats of 
phthisis, and has been successfully employed in epilepsy and neuralgia, 
in whooping-cough, hysteria, nervous headache and in bronchorrhoea to 
check the profuse secretion. It is much employed as an ingredient 
of cosmetics. The Carbonate is by some preferred to the oxide for 
local use in skin diseases. Calamine Ointment, which is a mixture of the 
impure carbonate (calamine) with the oxide and an unguent basis, was 
until recently a favorite application as a soothing protective to abrasions 
and inflammations of the integument. The Valerianate has been used 
in chorea, epilepsy, neuralgia, and various anomalous nervous affections, 
such as the nervous headache of hysterical women, nervous coughs and 
aphonia due to uterine and ovarian irritation. 

[The Bromide and Phosphide are used entirely with reference to their 
respective non-metallic bases, under which titles their therapeutics are 
described.] 



ZINGIBER, Ginger, — is the rhizome of Zingiber officinale, a plant 
of the nat. ord. Zingiberaceae, having dingy-yellow flowers on a leafless 
flower-stalk, and long, lanceolate leaves on a separate stem. The plant 
is a native of Hindostan, but is cultivated in Jamaica, Sierra Leone, etc. 
The rhizome is about -f inch broad, flattish, on one side lobed or clavately 
branched, of a pale-puff color, striate, agreeably aromatic and of a warm, 
pungent taste. It breaks with a mealy, fibrous fracture showing numerous 
small resin- cells and fibro-vascular bundles. It contains an aromatic, vola- 
tile oil and a resin. 

Preparations. 

Extractum Zingiberis Fluidum, — Dose, TTLx-gss. 

Tinctura Zingiberis, — 20 per cent. Dose, TT^xx-^ij. 

Syr up us Zingiberis, — has of the fluid extract 2 per cent, in sugar and water. Dose, 
gss-ij. 

Trochisci Zingiberis, — each troche contains of the tincture 2 grains, with Tragacanth, 
Sugar and Syrup of Ginger. 

Oleoresina Zingiberis, — contains all the virtues of the root, and is extracted by ether. 
Dose, m^-j, well diluted. 

Ginger is also a constituent of Pulvis Aromaticus, Pulvis Rhei Compositus and Vinum 
Aloes. 



414 ZINGIBER. 

Physiological Action and Therapeutics. 
Ginger is sialagogue when chewed, sternutatory when inhaled, and 
externally a rubefacient. Internally it is a grateful stimulant and carmina- 
tive, produces a sensation of warmth at the epigastrium and promotes the 
expulsion of flatus. It is employed as a carminative in colic, as a masti- 
catory to increase the secretion of saliva and in relaxed conditions of the 
throat, also internally in atonic dyspepsia, to relieve flatulence, and as an 
adjunct to purgative agents to correct their griping properties. The 
syrup is in common use as a flavoring adjuvant in prescriptions. 



PART II. 

PHARMACY AND PRESCRIPTION WRITING. 



Pharmacy (<pdp/j.axov, a medicament), — may be defined as the art of 
selecting and preserving medicines, and preparing them for administra- 
tion. It may be divided into — 

Official or Galenical Pharmacy, — dealing with the processes and prepa- 
rations of the Pharmacopoeia ; and — 

Extemporaneous or Magistral Pharmacy, — which includes the opera- 
tions of compounding and dispensing remedies as directed by the prescrip- 
tions of physicians. 

Pharmacopoeias and Dispensatories. 

A Pharmacopoeia is an official list of the drugs and their prepara- 
tions recognized by the medical profession of a certain country. In 
foreign countries the Pharmacopoeias are published under government 
auspices and have the force of a legal standard ; in the United States its 
publication is left to the medical and pharmaceutical professions and is 
revised every ten years by a convention called for that purpose. The 
principal official Pharmacopoeias, with their dates of latest revision or 
additions, are the following, viz. — 

Pharmacopoeia of the United States of America, 1882. 

British Pharmacopoeia, 1885. 

Pharmacopoeia Gertnanica, 1882. 

Codex Medic amentarius (Pharmacepie Francaise), 1884. 

Besides the above there are the Russian (P. Rossica, 1880); the Austrian (P. Austriaca, 
1869); the Swedish (P. Suecica, 1869); the Norwegian (P. Norvegica, 1879); t^ e 
Danish (P. Danica, 1868, 1874, 1876); the Belgian (P. Belgica, 1881); the Swiss 
(P. Helvetica, 1872, 1876); the Spanish (F. Espafiola, 1865); the Portuguese (P. 
Portugueza, 1876); the Hungarian (P. Hungarica, 1871); the Netherlands (P. Neer- 
landica, 1871); the Roumanian (P. Romafia, 1862); the Finnish (P. Fennica, 1863); 
the Greek (P. Hellenica, 1868); the Mexican (Nueva Farmacopea Mexicana, 1884); 
and the Pharmacopoeia of India, 1 868, 1 869. Italy, Chili and Japan are each about 
to issue a national pharmacopoeia. 

A Dispensatory is a commentary on one or more pharmacopoeias, 
giving in extenso the physical and medicinal history of the drugs and 

415 



41 6 THE CONSTITUENTS OF VEGETABLE DRUGS. 

preparations, together with their doses, physiological action and thera- 
peutics, and includes similar information about many drugs which are not 
official in any pharmacopoeia, but are of occasional use or general inter- 
est. A dispensatory is a private publication, of authority according to the 
reputation of its author. The principal dispensatories are veritable drug- 
encyclopaedias, so elaborately do they deal with every subject embraced 
therein. Those of acknowledged value are — 

The Dispensatory of the United States of America, by Drs. Wood and Bache, of Phila- 
delphia, 1 6th edition, edited by Wood, Remington and Sadtler. Philadelphia, The J. 
B. Lippincott Company. 1888. 

The National Dispensatory, edited by Drs. Stille and Maisch. 4th edition. Philadel- 
phia, Lea, Bros. & Co. 1887. 

The American Dispensatory, by King & Lloyd, Cincinnati, is the recognized authority 
of the " eclectic " practitioners. 

A Companion to the U. S. Pharmacopoeia, by Drs. Oldberg and Wall. 2d edition, 
New York, Wm. Wood & Co. — is an excellent book, but not so exhaustive as the others 
in its method of treating the subjects embraced in it. 

A Companion to the British Pharmacopoeia, by Peter Squire, is the standard student's 
text-book on drugs in England, but in no degree compares with the United States or 
National Dispensatories. 



THE CONSTITUENTS OF VEGETABLE DRUGS. 

The constituents of vegetable drugs may be classified as soluble and 
insoluble, the first group containing those ingredients which may be 
extracted by suitable menstrua, the second such as resist the action of all 
ordinary solvents. 

The Soluble Constituents comprise both inert and active principles, 
the inert being chiefly starch, gum and pectin, which may be readily 
separated by water. The active principles are alkaloids, acids, salts, glu- 
cosides and other neutral principles, volatile oils, resins, etc. Some few 
of these may be extracted by Water alone {e. g., Morphine), and in some 
cases the addition of acids or alkalies to the water will effect the chemical 
solution of many ingredients which are insoluble in water alone. As a 
rule, however, Alcohol is the most generally applicable of all simple sol- 
vents, but from its hardening the cell-membranes instead of softening 
them it prevents the osmosis of their contents. Drugs subjected to alco- 
holic or ethereal menstrua should have their cells thoroughly broken or 
torn, so that the solvent may be brought into actual contact with the 
principles contained in them. The degree of disintegration required 
depends upon the size of the cells, ducts, tubes, intercellular spaces, etc., 
in which the active principles are enclosed. A very finely powdered state 
is however open to objection from the packing of the particles together 
into an almost impenetrable mass when treated by the solvent. The 
average size of vegetable cells is about -3-^- of an inch, while resin cells 
and other cavities are larger, averaging perhaps about y^ inch. The 
Pharmacopoeia prescribes in each instance the degree of fineness of the 



THE CONSTITUENTS OF VEGETABLE DRUGS. 



417 



powdered drug employed in making certain of its preparations, or its 
bruising, slicing, etc., when such operations will answer. [Compare the 
article on Comminution in the following section.] 

Alkaloidea, Alkaloids, (termination, — ina, — ine,) are natural principles 
existing in plants, and extracted therefrom by chemical art. They are 
organic bases, forming salts with acids, and regarded as compound 
ammonias, products of albuminous decomposition in the plant-cells during 
the process of growth. Like ammonia, they all contain N, with C and 
H; most of them also containing O, though a few are devoid of the latter 
element, occurring as oily liquids, — e. g., Nicotine, Coniine, Sparteine, 
Piperidine, Lupuline, Lobeline, Muscarine. Alkaloids are generally 
insoluble in water, but soluble in alcohol ; and their salts are more soluble 
in water than in any other liquid. They are easily decomposed by alka- 
lies or alkaline carbonates ; and are precipitated from their solutions by a 
solution Of Iodine in Iodide of Potassium, by Potassio-mercuric Iodide, 
and by Picric, Phospho-molybdic and Phospho-tungstic Acids. They 
generally have a powerful physiological action, and their official names 
always end in — ina, ( — ine). 

There are 15 alkaloids official, either under their own names or under 
those of one or more of their salts. Of the latter there are 8 Sulphates, 4 
Hydrochlorates, and 1 each Bisulphate, Acetate, Hydrobromate, Salicy* 
late and Valerianate. The official alkaloids are as follows, viz. — 



Apomorphina. 

Atropina. 

CafTeina. 

Cinchonidina. 

Cinchonina. 



Codeina. 

Hyoscyamina. 

Morphina. 

Physostigmina. 

Pilocarpina. 



Piperina. 

Quinidina. 

Quinina. 

Strychnina. 

Veratrina. 



Unofficial, but Important Alkaloids are the following, viz. — 

Aconitine. Colchicine. Gelsemine. 

Antifebrine. Coniine. Homatropine. 

Antipyrine. Curarine. Kairine. 

Berberine. Daturine. Muscarine. 

Chinoline. Duboisme. Pelletierine. 

Cocaine. Emetine. Thalline. 



Glucosidea, Glucosides, (terminations, — inum, — in), — are organic 
compounds, belonging to the group of Neutral Principles which exist in 
plants ; and which are resolved into glucose and some other principle, by 
the action of reagents or natural ferments. Few, if any, of these com- 
pounds, contain any N, — but among them are some very active agents. 
The official glucosides number six, and like other neutral principles, are 
designated by titles which end, in Latin in — inum, (English, — in), viz. — 
27 



4-l8 OFFICIAL OPERATIONS. 

Chrysarobinum, (^Chrysarobin). Picrotoxinum, (Picrotoxin). 
Elaterinum, (Elaterin). Salicinum, (Salicin). 

Glycyrrhizinum, (Glycyrrhizin). Santoninum, (Santonin). 

Besides these, there are several other substances recognized by pharmaccpoeial names 
which terminate in — inum, — in, but which have no relationship to the group of Gluco- 
sides. They are the following, viz. — 

Benzinum, Benzin, — A distillate consisting of hydrocarbons. 

Benzoinum, Benzoin, — A balsamic resin. 

Chinoidinum, Chinoidin, — A mixture of Cinchona alkaloids. 

Glycerinum, Glycerin, — A liquid obtained from fats or fixed oils. 

Lupulinum, Lupulin, — A glandular powder from the hop. 

Pepsin um, Pepsin, — A digestive principle. 

Pyroxylinum, Pyroxylin, — Soluble gun-cotton. 

The Insoluble Constituents are cellulose, lignin and sclerogen, 
which make up the cell-walls of vegetable substances, and are extremely 
intractable. 



OFFICIAL PHARMACY. 
OFFICIAL OPERATIONS. 
The official operations are those processes which are directed in the 
pharmacopoeia to be used in the preparation of medicines. Many of them 
are processes which are common to both chemistry and pharmacy, as pre- 
cipitation and crystallization, — while others are peculiar to pharmacy, as 
percolation, trituration, etc. The most important of the pharmaceutical 
operations are briefly described below ; for full details of the various 
apparatus used the student is referred to the more exhaustive treatises on 
Pharmacy. 

Vaporization includes the various operations by which volatile mat- 
ters are separated from fixed substances or from other matters which are 
less volatile, heat at varying temperatures being the agent used. The 
operations under this head are — Evaporation, Distillation, Desiccation, 
and Sublimation. 

Evaporation in Pharmacy is the process by which the more volatile 
constituents of a liquid are driven off by heat for the purpose of reducing 
its volume or of purifying it, as in the preparation of extracts and fluid 
extracts, the crystallization of salts, etc. The vessels used should be shal- 
low so as to expose a large surface of the liquid to the atmosphere. The 
heat used may be regulated by a water-bath, a steam-bath or sand-bath, 
and ordinarily should be kept below but near to the boiling-point of the 
liquid treated. As organic substances are usually injured by long heating, 
small portions only of vegetable preparations should be subjected to this 
process, and the liquid should be frequently stirred in order to hasten the 



OFFICIAL OPERATIONS. 4I9 

operation. In large laboratories vacuum-pans are employed to remove 

the atmospheric pressure, enabling the evaporation to be accomplished at 

a much less degree of heat than if the liquid were exposed to the air. 

Ebullition or Boiling is a form of evaporation. 

Spontaneous Evaporation is the evaporation of a liquid without the direct applica- 
tion of strong heat, but at the temperature of the room or closet used for the purpose. 
It is especially applicable to cases in which the residue is liable to injury or loss from 
much heat, or to secure finer crystals than can be obtained by quick evaporation of their 
solution. 

Distillation consists of two processes, (i) the evaporation of a liquid, 
(2) the condensation of the vapor into a liquid in a separate vessel. The 
agent used in the first part of the operation is heat, in the second part 
cold. Its object is to separate mixed volatile and fixed substances, or to 
combine volatile substances which cannot otherwise be mixed, as in the 
preparation of some of the official Waters. The apparatus used is of 
great variety, from the simple retort and receiver to the elaborate and 
costly stills. 

Destructive or Dry Distillation is a process of decomposing an organic substance 
by heat into volatile products which are collected in a separate vessel, the residue being 
said to be carbonized. It is only employed by large manufacturers, for the preparation of 
Acetic and Succinic Acids, Oil of Amber, Wood-tar, etc. 

Fractional Distillation is the separation by distillation of substances which are 
volatile at different temperatures, each being separately driven over and received in a vessel 
by itself. Different degrees of heat are successively employed in accordance with the 
volatilizing points of the substances to be obtained. 

Sublimation is the distillation of a volatile solid, the product being 
termed a sublimate. Its objects are to purify volatile solids from impuri- 
ties, and to collect such as result from chemical action at high tempera- 
tures. The operation is carried on in iron, glass or stoneware retorts, and 
results in cake sublifiiates or powder sublimates according as the tempera- 
ture of the condensing surface is high or low. 

Desiccation is the process of removing moisture from solids, and has 
for its object either the preservation of the substance, the reduction of its 
bulk or the facilitation of its comminution. The operation should be con- 
ducted at as low a temperature as possible. Roots, leaves and seeds are 
generally dried by being placed in trays of wire net-work and exposed to 
a uniform temperature in a room heated by steam. A better method is 
to suspend organic substances from the ceiling of an attic during warm 
weather ; a slow process, but one which does not result in much loss of 
the active volatile principles. Crsytals and precipitates require a higher 
temperature and are usually dried on a water-bath. When the water of 
crystallization is to be expelled, as in desiccating Alum and Sulphate of 
Iron, a temperature of about 400 F. is required. In absorbing water 
from alcohol Carbonate of Potassium and slaked Lime heated are em- 
ployed, and in several instances Sulphuric Acid is the desiccator used. 



420 OFFICIAL OPERATIONS. 

Fusion is the process of liquefying solids by the application of high 
heat without the use of a solvent. It is employed in making ointments, 
plasters, etc., in purifying resins, and for the purpose of decomposition. 
The degree of heat required varies from a temperature of 90 F., suffi- 
cient to melt lard in an open vessel, to one of 8oo° F., employed in fusing 
Zinc in an earthen crucible ; and may be regulated by the aid of the 
water-, steam- or sand-bath. The two former appliances limit the degree 
of heat applied, while the sand-bath prevents sudden changes in the tem- 
perature. Oil-baths and glycerin baths are employed in fractional distil- 
lation on a large scale. 

Exsiccation or Calcination is the process of depriving a solid of its 
moisture or other volatile constituents by the application of heat without 
fusion. The term Exsiccation is usually applied to the vaporization of 
the water of crystallization from a crystalline body, Calcination, to such 
operations as the expulsion of carbonic acid and water from carbonates, 
as in the manufacture of Lime, Magnesia, etc. 

Carbonization is the heating of organic substances without exposure 
to the air until the volatile constituents are driven off, and the residue 
assumes the characteristic appearance of carbon. 

Incineration is the heating of organic substances with access of air until 
the carbon is consumed, the ashes remaining being the product desired. 

Ignition in pharmacy means the process of strongly heating solids or 
semi-solid substances, the residue left being the product desired. It is 
used in the official quantitative tests for Phosphoric Acid, Phosphate of 
Ammonium and purified Sulphide of Antimony. 

Deflagration is the heating of an inorganic substance with another 
which yields oxygen (usually a nitrate or a chlorate), the result being the 
decomposition of the body, with violent and sudden combustion. 

Torrefaction or Roasting is the application of heat, in a less 
degree than for carbonization, to anorganic substance for the purpose of 
modifying some of its constituents, as in the roasting of coffee and 
rhubarb. The latter substance when subjected to this process, loses its 
cathartic properties but retains its astringency, and is known as Torrefied 
Rhubarb. 

Comminution is the process by which the aggregation of the particles 
of a solid body is overcome, and the body is reduced to pieces of vary- 
ing sizes. Its object is to increase the surface exposed to the action of 
solvents, and it includes the mechanical operations of cutting, rasping, 
grating, crushing, stamping, grinding, pulverizing, triturating, levigating, 



OFFICIAL OPERATIONS. 421 

elutriating, granulating, etc. Apparatus of various kinds, as cutters, 
mortars and pestles, mills, etc., are used for the comminution, while 
spatulas are employed to loosen the particles, and sieves to sift the 
coarser from the finer. These last-named contrivances are of five sizes, 
designated by the number of their meshes to the inch, 80, 60, 50, 40 and 
20, respectively permitting the passage of powders termed very fine, fine, 
moderately fine, moderately coarse and coarse. 

Trituration is the comminution of a solid to an extremely fine pow- 
der by continued rubbing in a wedgewood mortar with an inert and- 
gritty powder, Sugar of Milk being the substance directed to be used. 
The product is called a Trituration (see that title under Official Prepa- 
rations). The surfaces of the mortar and pestle-head should coincide 
closely, and the thorough comminution of the trituration is best accom- 
plished by a circular motion of the pestle in gradually increasing circles, 
until the side of the mortar is reached, then reversing the motion, and 
gradually lessening the circles until the pestle reaches the centre again. 
The process is greatly facilitated by having the pestle attached to a long 
handle playing in an opening made in a piece of wood which is nailed 
at a convenient height. A weight may be fixed on top of the handle if a 
greater degree of friction be desired. 

Pulverization by Intervention is only another name for trituration when per- 
formed in a mortar and with solid bodies, the foreign substance used being subsequently 
removed. Potassium Sulphate may be employed as the medium for the pulverization of 
Gold, and is then dissolved out with water. Alcohol or Chloroform may be added to 
Camphor to aid its pulverization, and then removed by evaporation. Phosphorus may be 
pulverized by placing it in water, gently heating the latter until the phosphorus is melted, 
and agitating the whole while cooling. 

Levigation is trituration of a substance mide into paste with water or some other 
liquid, and resembles the old process of grinding oil paints by hand on a slab of stone. 
The process is used for coarse materials, as chalk, etc., where the refuse is rejected, or 
for such substances as Red Oxide of Mercury, Oxide of Zinc, etc. When performed with 
a porphyry slab and muller it is termed Porphyrization. 

Elutriation is a water-sifting process for separating the coarser particles of insoluble 
substances from the finer. The substance is mixed with water and after the larger par- 
ticles have fallen to the bottom, the liquid is decanted into another vessel, in which the 
light and powdery particles are collected. 

Solution is the dissolving of a solid or a gaseous substance in a liquid, 
and may be simple when the substance undergoes no alteration, being 
recovered unchanged on evaporation, or chemical, when the dissolved 
body is chemically altered by the solvent of some other substance present, 
and cannot be recovered on evaporation. Simple Syrup is an instance 
of simple, solution, the Syrup of Lime one of chemical solution. The 
liquid employed is termed a solvent before the substance is added to it, 
after the operation is completed the combined preparation is called a solu- 
tion. If fully charged with the dissolved substance so that it will retain 
no more, it is known as & saturated solution. One liquid may be dissolved 
in another, or a gas may be dissolved in a liquid. The solution of solids 



422 OFFICIAL OPERATIONS. 

is greatly facilitated by pulverization and by stirring the menstruum. Heat 

generally aids solution, most substances being more soluble in hot liquids 

than in cold ones. A saturated solution of one substance may still be 

capable of dissolving others. Rapid solution of solids without chemical 

change causes reduction of temperature, while chemical solution produces 

elevated temperature. Circulatory Solution is performed by suspending 

the substance to be dissolved near the surface of the solvent in a gauze bag 

or on a porous shelf. The portion first acted on descends and produces 

a circulatory movement in the fluid, facilitating the solution of the whole. 

Solvents employed are chiefly Water, Alcohol, Glycerin, Acids and Oils. Others less 
frequently used are Ether, Chloroform, Benzin and Carbon Disulphide. 

Washing is a simple mechanical process for separating soluble from 
insoluble matter, by pouring upon it a liquid which will dissolve the solu- 
ble portion. Various methods of doing this are in vogue and are often 
dignified with very high-sounding terms, as Lotion, Affusion, Ablution, 
etc. An ordinary wash-bottle, with the two glass tubes perforating the 
cork, is a convenient implement for directing a continuous stream upon a 
precipitate, while for continuous washing a combination of bottles with a 
funnel may be used. 

Decantation is the pouring or drawing off a supernatant liquid into 
another vessel. If done by pouring, a guiding-rod for the liquid to run 
on is an effective adjuvant ; if by drawing, the siphon in some form is 
usually employed. 

Colation, or Straining is another very simple operation, so familiar 
to every one of ordinary experience as to be scarcely worth describing. 
The strainers are made of cotton flannel, fine muslin, gauze, woolen felt 
and other fabrics. 

Filtration is a process of straining through a medium so fine as to 
deliver the filtrate in transparent condition. The filters are made of paper 
usually, though charcoal, asbestos, sand and other articles are sometimes 
employed, and are supported in a funnel of glass or other material held by 
the ring of a retort-stand. The beat filtering-paper is made in Sweden by 
Munktell, and is white; but a good paper for ordinary use is the "Prat 
Dumas White," which should always be employed for filtering alkaline or 
alkaloidal solutions. The gray French papers answer well enough for 
fluid extracts, tinctures or colored liquids, but should never be used for 
solutions containing free alkali. 

Filtering- pa per is folded by doubling a sheet upon itself, and then folding it again 
directly in the middle. When opened four distinct sections appear, one of which is- 
separated from the other three, and the filter thus formed is placed in a funnel. This 
arrangement is known as a plain filter, which by repeated creasing is converted into 
the plaited filter ; the latter being the form generally used in pharmaceutical operations 



OFFICIAL OPERATIONS. 423 

of small extent. In large laboratories special processes of filtration are employed with 
apparatus of more or less complexity for hot filtration, rapid filtration, etc. 

Clarification is the separation from liquids of solid matter, which pre- 
vents their being transparent, without using niters or strainers. It may 
be effected by heat (as in the case of Mel Despumatum), by adding 
a lighter liquid, by adding albumen, gelatin, milk, or paper-pulp, by fer- 
mentation, or by subsidence of the particles in the form of a sediment 
through long standing. 

Decoloration, or the removal .of coloring-matter from liquids or from 
solids in solution, is effected by the use of animal charcoal, which in small 
operations may be arranged in a funnel or a percolator, and the liquid 
placed thereon. It should not be forgotten that charcoal absorbs many 
other principles besides coloring-matter, especially alkaloids, bitters, and 
astringents, so that the process of decoloration may be one of serious 
injury to the efficiency of the preparation. 

Separation of liquids which do not mix with each other is a simple 
mechanical process performed with pipettes of various forms, or with fun- 
nels having stop-cocks in their necks. Special forms of receivers are used 
for the separation of volatile oils from the water which may accompany 
them during distillation. 

Precipitation is the process of separating solids from their solutions, 
and is usually effected by chemical reaction, though it may be accom- 
plished by other methods, as by adding a second liquid in which the sub- 
stance is insoluble, by heating albuminous solutions, or by exposing 
solutions of silver salts to the action of light. The most familiar example 
of chemical precipitation is the addition of a solution of Mercuric 
Chloride to one of Potassium Iodide, the result being a double decompo- 
sition of the salts and the formation of Mercuric Iodide, which falls to 
the bottom of the vessel as a brilliant, red, insoluble and crystalline pow- 
der. The precipitate is the separated substance, which is usually thrown 
down, but it remains suspended in some cases, and in others it rises to the 
top. The precipitant is the substance which is added to produce the pre- 
cipitation. A magma is a thick, tenacious precipitant remaining behind 
after the supernatant liquid is removed by decantation or otherwise. Pre- 
cipitates are termed flocculent, gelatinous, curdy, granular, crystalline, etc., 
according to the forms assumed. In small operations they are usually 
collected on plain filters, and washed by the repeated addition of water. 

Crystallization is the process which bodies undergo in passing from 
the liquid or the gaseous state to the geometrical forms called crystals. 
Six systems of crystals are recognized by crystallography, which has 
assumed the dignity of a separate science. Bodies which are not capable 



424 OFFICIAL OPERATIONS. 

of crystallization are termed amorphous. Every crystallizable body 
assumes its own peculiar form, or some Other form directly derived from 
or related to it. The process of crystallization is effected (i) by fusion 
and partial cooling, as in the cases of some metals and Sulphur ; (2) by 
sublimation, as Benzoic Acid, Mercuric Chloride, etc. ; (3) by deposition 
from hot saturated solutions while cooling ; (4) by deposition from a solu- 
tion during evaporation ; (5) by deposition caused by passing a galvanic 
current through the solution; (6) by precipitation, as in the case of the 
Mercuric Iodide; (7) by the addition to the solution of a substance 
having a strong affinity for water, as in the adding of Calcium Chloride 
to an aqueous solution of Sodium Chloride, or Alcohol to a solution of 
Potassium Nitrate, or to an aqueous syrup. In a few cases amorphous 
solids may crystallize without undergoing liquefaction, as Sulphur, Barley- 
sugar, Iron or Brass wire. The methods most frequently employed are 
those by deposition from supersaturated solutions, and by deposition during 
evaporation. The more slowly the process is carried on the larger and 
more regular will be the crystals. The process is facilitated by use of 
foreign bodies as nuclei around which the crystals are deposited ; a familiar 
instance being the thread in the centre of a mass of rock-candy. 

The Water of Crystallization is the H 2 with which most substances combine in the 
act of crystallization, and the number of molecules thereof differs for each body and for 
the same body frequently under different conditions. Exsiccation is the driving off of this 
combined water by heat, the crystals assuming thereby the form of a dry powder. Efflo- 
rescence is a similar process occurring spontaneously on exposure of the crystals to the air, 
the effloresced portion appearing as a dry powder on the surface of the crystals. Deliques- 
cence, on the other hand, is the act of absorbing water from the atmosphere, a property 
possessed by some substances which are therefore said to be hygroscopic. 

Granulation is a process of reducing a coarsely crystalline substance 
to a granular powder by dissolving it in water and evaporating the solu- 
tion with constant stirring until the product becomes perfectly dry. Many 
salts are thus treated for convenience in dispensing, as the Bromide, the 
Iodide, the Carbonate and the Citrate of Potassium. Sulphate of Iron, 
though generally dispensed in the exsiccated powder, may be granulated 
into minute crystals by filtering an aqueous solution of it into alcohol. 

Dialysis is a process by which crystallizable substances are separated 
from non-crystallizable ones, by suspending a solution containing both 
upon a porous diaphragm having its under surface in contact with water. 
The crystalloids pass through the diaphragm, while the non-crystalline 
remain above it, and are termed colloids. Examples of the latter class are 
gelatin, gum, glue, starch, dextrin, albumen and extractive matters, which 
are generally the inert and valueless constituents of vegetable drugs. 
Parchment-paper and bladders are used for the diaphragm ; the whole 
apparatus being termed the dialyzer, while the water into which the crys- 
talloids pass is called the diffusate. 



OFFICIAL OPERATIONS. 425 

The unofficial preparation known as Dialyzed Iron or Ferrum Dialysatum is a col- 
loidal substance obtained by treating Ferric Chloride in solution with Ammonia, whereby 
Ferric Hydrate is precipitated and then dissolved by agitation. The mixture being placed 
on a dialyzer, the crystalloids formed (Ammonium Chloride and Ferric Chloride), together 
with any free acid present, pass into the diffusate, leaving the neutral colloidal liquid 
(solution of Ferric Oxychloride) above on the septum. 

Maceration is one of the processes of extracting the soluble princi- 
ples from drugs, and consists in steeping or soaking the comminuted sub- 
stance in a suitable liquid called the menstruum, generally alcohol, for a 
period varying from 2 to 14 days, during which it is occasionally agitated. 
The liquid is then poured off, the residue is expressed, and the mixed 
liquors are filtered. Several of the official tinctures are prepared by this 
method, and many others are subjected to maceration first and perco- 
lation afterwards. 

Expression is the forcible separation of liquids from solids, by sub- 
jecting them to pressure. Hand-pressure through straining-cloths may be 
employed, but mechanical presses are more efficient and are coming into 
general use. Oils obtained in this manner are called expressed or fixed 
oils, to distinguish them from the volatile oils obtained by distillation. 

Percolation or Displacement is a process of obtaining the soluble 
constituents of a substance in powder by the descent of a solvent through 
it. Though an ancient process for the making of lye from wood-ashes 
(lixiviation), it has only within the last forty years been adopted as an 
official process in pharmacy, and it is gradually taking the place of macera- 
tion as a means of extracting the soluble principles of drugs. The vessel 
used to hold the powdered drug is called the percolator, of which there 
are many forms employed by the manufacturers. The liquid used as a 
solvent is called the menstruum, and when coming from the percolator it 
is termed the percolate. The U. S. Pharmacopoeia gives the following 
directions concerning this process: — 

"The process of percolation, or displacement, directed in this Pharmacopoeia, consists 
in subjecting a substance, or substances, in powder, contained in a vessel called a percolator, 
to the solvent action of successive portions of menstruum in such a manner that the liquid, 
as it traverses the powder in its descent to the recipient, shall be charged with the soluble 
portion of it, and pass from the percolator free from insoluble matter. 

"When the process is successfully conducted, the first portion of the liquid, or percolate, 
passing through the percolator will be nearly saturated with the soluble constituents of the 
substance treated ; and if the quantity of menstruum be sufficient for its exhaustion, the 
last portion of the percolate will be destitute of color, odor, and taste, other than that 
possessed by the menstruum itself. 

" The percolator most suitable for the quantities contemplated by this Pharmacopoeia 
should be nearly cylindrical, or slightly conical, with a funnel-shaped termination at the 
smaller end. The neck of this funnel-end should be rather short, and should gradually 
and regularly become narrower toward the orifice, so that a perforated cork, bearing a 
short glass tube, may be tightly wedged into it from within until the end of the cork is 
flush with its outer edge. The glass tube, which must not protrude above the inner surface 
of the cork, should extend from one and one-eighth to one and one-half inch (3 to 4 cen- 
timeters) beyond the outer surface of the cork, and should be provided with a closely fit- 



426 OFFICIAL OPERATIONS. 

ting rubber tube, at least one-fourth longer than the percolator itself, and ending in another 
short glass tube, whereby the rubber tube may be so suspended that its orifice shall be 
above the surface of the menstruum in the percolator, a rubber band holding it in position. 

" The dimensions of such a percolator, conveniently holding five hundred grammes of 
powdered material, are preferably the following : Length of body, fourteen inches (36 cen- 
timeters) ; length of neck, two inches (5 centimeters) ; internal diameter at top, four 
inches (10 centimeters); internal diameter at beginning of funnel-shaped end, two and 
one-half inches (6.5 centimeters) ; internal diameter of the neck, one-half inch (12 milli- 
meters), gradually reduced at the end to two-fifths of an inch (10 millimeters). It is best 
constructed of glass, but unless so directed, may be constructed of a different material. 

" The percolator is prepared for percolation by gently pressing a small tuft of cotton into 
the space of the neck above the cork, and a small layer of clean and dry sand is then 
poured upon the surface of the cotton to hold it in place. 

" The powdered substance to be percolated (which must be uniformly of the fineness 
directed in the formula, and should be perfectly air-dry before it is weighed) is put into 
a basin, the specified quantity of menstruum is poured on, and it is thoroughly stirred with 
a spatula, or other suitable instrument, until it appears uniformly moistened. The moist 
powder is then passed through a coarse sieve — No. 40 powders, and those which are finer, 
requiring a No. 20 sieve, whilst No. 30 powders require a No. 15 sieve for this purpose. 
Powders of a less degree of fineness usually do not require this additional treatment after 
the moistening. The moist powder is now transferred to a sheet of thick paper and the 
whole quantity poured from it into the percolator. It is then shaken down lightly and 
allowed to remain in that condition for a period varying from fifteen minutes to several 
hours, unless otherwise directed ; after which the powder is pressed, by the aid of a plunger 
of suitable dimensions, more or less firmly, in proportion to the character of the powdered sub- 
stance and the alcoholic strength of the menstruum ; strongly alcoholic menstrua, as a rule, 
permitting firmer packing of the powder than the weaker. The percolator is now placed in 
position for percolation, and the rubber tube having been fastened at a suitable height, the 
surface of the powder is covered by an accurately fitting disk of filtering paper, or other 
suitable material, and a sufficient quantity of menstruum poured on through a funnel reach- 
ing nearly to the surface of the paper. If these conditions are accurately observed, the 
menstruum will penetrate the powder equally until it has passed into the rubber tube and 
has reached, in this, the height corresponding to its level in the percolator, which is now 
closely covered to prevent evaporation, and the apparatus allowed to stand at rest for the 
time specified in the formula. 

"To begin percolation, the rubber tube is lowered and its glass end introduced into the 
neck of a bottle previously marked for the quantity of liquid to be percolated, if the per- 
colate is to be measured, or of a tared bottle, if the percolate is to be weighed ; and by 
raising or lowering this recipient, the rapidity of percolation may be increased or lessened 
as may be desirable, observing, however, that the rate of percolation, unless the quantity 
of material taken in operation is largely in excess of the pharmacopceial quantities, shall 
not exceed the limit of ten to thirty drops in a minute. A layer of menstruum must con- 
stantly be maintained above the powder, so as to prevent the access of air to its interstices, 
until all has been added, or the requisite quantity of percolate obtained. This is conveni- 
ently accomplished, if the space above the powder will admit of it, by inverting a bottle 
containing the entire quantity of menstruum over the percolator in such a manner that its 
mouth may dip beneath the surface of the liquid, the bottle being of such shape that its 
shoulder will serve as a cover for the percolator. 

"When the dregs of a tincture, or similar preparation, are to be subjected to percola- 
tion, after maceration with all or with the greater portion of the menstruum, the liquid 
portion should be drained off as completely as possible, the solid portion packed in a per- 
colator, as before described, and the liquid poured on, until all has passed from the sur» 
face, when immediately a sufficient quantity of the original menstruum should be poured 
on to displace the absorbed liquid, until the prescribed quantity has been obtained " 

Modification of the above Process. 

" Authority is given to employ, in the case of Fluid Extracts, where it may be applica- 
ble, the process of Repercolation, without change of the original menstruum." 

Testing is directed by the Pharmacopoeia in convenient cases, for the 
purpose of ascertaining the identity and purity of its preparations ; and 



OFFICIAL PREPARATIONS. 42/ 

a List of Reagents used is given at the end of the book, which is divided 
into three parts, — (i) Articles used in Testing, (2) Test-solutions, (3) Volu- 
metric Solutions. The analysis directed under the title of each prepara- 
tion is frequently Qualitative., but often Quantitative, and of the latter 
both the Gravimetric and the Volumetric methods are used. Pharmaco- 
pceial testing and volumetric analysis are necessary to the work of the 
practical pharmacist, and as the apparatus used is simple and the operations 
are those in the line of his daily work, he should be familiar therewith. 
On the other hand the proximate analysis of organic substances for their 
principles, and the ultimate analysis of the same bodies for their elements, 
require a high degree of skill and long experience, and should be left to 
the professional chemist. 

The apparatus used in testing consists of graduated flasks and jars, 
burettes, pipettes, funnels, beakers, test-tubes, capsules, crucibles, reagent- 
bottles, etc. The metric system is directed for all analytical work, and 
the apparatus employed should be graduated accordingly. 



OFFICIAL PREPARATIONS. 
The pharmacopceial preparations may be presented under various 
methods of classification, one of the simplest being that which divides 
them into liquids and solids, the former being subdivided into groups 
named after their principal bases, viz. : — 

Liquid Preparations. 
Aqueous, — Waters, Solutions, Infusions, Decoctions, Syrups, Honeys, Mucilages, Mix- 
tures ; the last four containing sweet or viscid substances. 

Alcoholic, — Fluid Extracts, Tinctures, Wines, Spirits, Elixirs. 
Ethereal, — Oleoresins, Collodions. 
Oleaginous, — Liniments, Oleates. 

Acetous, — Vinegars. Glycerines, — Glycerites. 

Solid Preparations. 



Extracts. 


Troches. 


Ointments 


Abstracts. 


Confections. 


Cerates. 


Resins. 


Powders. 


Plasters. 


Masses. 


Triturations. 


Papers. 


Pills. 


Suppositories. 





In the following descriptions of the pharmacopceial groups the compo- 
sition and dosage of the various preparations are omitted, as they are 
fully detailed in the section on Materia Medica, under the title in each 
case of the principal constituent. 

Aqueous Preparations. 
Aquae, Waters, — are aqueous solutions of volatile substances, which 
may be either solids, liquids, or gases, dissolved either by solution in cold 
or hot water, by filtration through an absorbent powder, by percolation 



428 OFFICIAL PREPARATIONS. 

through cotton saturated with the substance, or by distillation. The offi- 
cial waters number 15, including the two forms of Aqua itself, as follows, 
viz. : — 

Aqua. Aqua Chlori. 

Aqua Destillata. Aqua Cinnamomi. 

Aqua Ammoniae. Aqua Creasoti. 

Aqua Ammoniae Fortior. Aqua Foeniculi. 

Aqua Amygdalae Amarae. Aqua Menthae Piperita?. 

Aqua Anisi. Aqua Menthae Viridis. 

Aqua Aurantii Florum. Aqua Rosae. 
Aqua Camphorae. 

Of the above-named two are made by simple solution (A. Amygdalae 
Amarae and A. Creasoti), three are made by passing gases through water 
(A. Ammoniae, A. Ammoniae Fortior, and A. Chlori), three are made by 
distillation (A. Aurantii Florum, A. Destillata and A. Rosae), and the 
other six are made by percolation through cotton impregnated with the 
substance. All waters deteriorate when long kept, microscopic plants 
being propagated in them from spores from the atmosphere. They should 
be prepared only in such quantities as are needed for use within a reason- 
able time. 

Liquores, Solutions, — comprise all aqueous solutions of non-volatile 
substances except the syrups, infusions and decoctions, which naturally 
form distinctive classes. Included among the Liquores is the Solution of 
Gutta-percha, the solvent of which is Chloroform; all the others being 
made with water. There are 28 official solutions, as follows, — the first 11 
being simple aqueous solutions;. the next 16 being chemical aqueous solu- 
tions, in which the properties of the dissolved substances are altered by 
chemical action ; and the last-named being a solution in Chloroform. 

Liquor Acidi Arsenici. Liquor Ferri Citratis. 

Liquor Arsenii et Hydrargyri Iodidi. Liquor Ferri Nitratis. 

Liquor Calcis. Liquor Ferri Subsulphatis. 

Liquor Ferri et Quininae Citratis. Liquor Ferri Tersulphatis. 

Liquor Iodi Compositus. Liquor Hydrargyri Nitratis. 

Liquor Pepsini. Liquor Magnesii Citratis. 

Liquor Plumbi Subacetatis Dilutus. Liquor Plumbi Subacetatis. 

Liquor Potassae. Liquor Potassae. 

Liquor Sodae. Liquor Potassii Citratis. 

Liquor Sodii Arseniatis. Liquor Potassii Arsenitis. 

Liquor Sodii Silicatis. Liquor Sodae. 

Liquor Ammonii Acetatis. Liquor Sodae Chloratae. 

Liquor Ferri Acetatis. Liquor Zinci Chloridi. 

Liquor Ferri Chloridi. Liquor Gutta-Perchae. 

Syrupi, Syrups,- — are concentrated solutions of Sugar in Water or in 
aqueous liquids. They sometimes contain Acetic Acid, and occasionally 
Alcohol ; and are termed simple, medicated ox flavored, according as they 
are simple solutions of sugar in water alone, or contain soluble medicinal 
substances, or flavoring ingredients. The Sugar used should be very dry, 



OFFICIAL PREPARATIONS. 429 

and its official description corresponds with the granulated sugar of com- 
merce. The permanency of these preparations chiefly depends on their 
possessing the proper relative proportions of sugar and water. They are 
prepared either by solution with heat, by agitation without heat, by add- 
ing a medicated liquid to simple syrup, by digestion or maceration, or by 
cold percolation ; these processes being all officially directed except the 
last. They are best preserved by being poured while hot into pint bottles, 
which should be corked securely while full, and the tops dipped into 
melted sealing-wax. Fermented syrups are useless for dispensing pur- 
poses. The number of official syrups is 34, as follows, viz. : — 

Syrupus, Syrupus Ipecacuanhas. 

Syrupus Acacias. Syrupus Kramerias. 

Syrupus Acidi Citrici. Syrupus Lactucani. 

Syrupus Acidi Hydriodici. Syrupus Limonis. 

Syrupus Allii. Syrupus Picis Liquidas. 

Syrupus Altheae. Syrupus Pruni Virginianas. 

Syrupus Amygdalae. Syrupus Rhei. 

Syrupus Aurantii. Syrupus Rhei Aromaticus. 

Syrupus Aurantii Florum. Syrupus Rosae. 

Syrupus Calcii Lactophosphatis. Syrupus Rubi. 

Syrupus Calcis. Syrupus Rubi Idaei. 

Syrupus Ferri Bromidi. Syrupus Sarsaparillas Compositus. 

Syrupus Ferri Iodidi. Syrupus Scillae. 

Syrupus Ferri Quininae et Strychnines Syrupus Scillae Compositus. 

Phosphatum. Syrupus Senegas. 

Syrupus Hypophosphitum. Syrupus Sennas. 

Syrupus Hypophosphitum cum Ferro. Syrupus Tolutanus. 
Syrupus Zingiberis. 

Mellita, Honeys, — differ from syrups merely in their being prepared 
with honey as a base. The Oxy??iel and Oxymel Scillaz of the B. P. are 
similar preparations, containing also Acetic Acid. There are 3 official 
Honeys, including two forms of honey itself, viz. : — 

Mel. Mel Despumatum. Mel Rosas. 

Mucilagines, Mucilages, — are thick, viscid liquids prepared by dis- 
solving gum in water, or by extracting with water the mucilaginous prin- 
ciples from certain plants. They are easily spoiled and should be kept 
only in small quantities. The official Mucilages number 5, as follows, 
the three first-named being prepared without heat, the two last-named 
with heat, viz. : — 

Mucilago Acacias. Mucilago Sassafras Medullas. * 

Mucilago Cydonii. Mucilago Tragacanthas. 

Mucilago Ulmi. 

Misturse, Mixtures, — in official pharmacy are aqueous preparations of 
insoluble substances held in suspension by a suitable vehicle. In extem- 
poraneous pharmacy the term mixture has a wider signification, as ex- 
plained under that head. They are generally prepared extemporaneously 
upon prescriptions, as few of them are of the stability necessary to insure 



430 OFFICIAL PREPARATIONS. 

their preservation beyond a few days. The official Mixtures number n, 
of which one (Mistura Ferri et Ammonii Acetatis) is misnamed, and 
should be entitled a Solution, as it does not contain any insoluble sub- 
stance. Their names are as follows, viz. : — 

Mistura Ammoniaci. Mistura Ferri Composita. 

Mistura Asafoetidae. Mistura Glycyrrhizae Composita. 

Mistura Amygdalae. Mistura Magnesii et Asafoetidse. 

Mistura Chloroformi. Mistura Ferri et Ammonii Acetatis. 

Mistura Cretae. Mistura Rhei et Sodae. 

Mistura Potassii Citratis. 

Of the above-named, the first two are simple gum-resin emulsions, the 
third is a seed-emulsion, the fourth an egg-emulsion ; the next four con- 
tain insoluble powders in suspension by the aid of gum arabic, sugar, etc., 
the next two do not contain insoluble powders in suspension, while the 
last is an effervescing mixture. 



Infusa, Infusions, — are prepared by treating vegetable substances 
with hot or cold water without boiling. Cold water is preferred when the 
drug contains a desirable volatile principle, or when its active ingredient 
is injured by heat. The drug should be coarsely comminuted, sliced or 
bruised, and treated by maceration or percolation with the proper quan- 
tity of water, which in the absence of specific directions to the contrary 
should be 10 parts by weight to i of the drug. These preparations 
should be freshly made when required, as they are very prone to decom- 
position. The number of official Infusions is 5, viz. : — 

Infusum Brayerae. Infusum Digitalis. 

Infusum Cinchonae. Infusum Pruni Virginians. 

Infusum Sennae Compositum. 

The proportions of drug to menstruum in the official infusions vary from 
\]/ 2 per cent, in the case of Digitalis to 4 per cent, in the case of Wild 
Cherry and 6 per cent, in the case of the others. Alcohol is an ingre- 
dient of the Infusion of Digitalis to prevent decomposition. 

Many dispensing pharmaceutists are in the habit of making infusions 
from concentrated alcoholic tinctures or from fluid extracts. It is a very 
reprehensible practice, especially in those cases where the active ingre- 
dients are of a resinous nature and therefore precipitated when the alco- 
holic solution is added to water. 



Decocta, Decoctions, — are made by boiling vegetable substances with 
water. As very few drugs contain active ingredients which are not 
injured by heat, these preparations have never obtained favor with scien- 
tific physicians. There are only 2 official Decoctions, viz. : — 

Decoctum Cetrariae. Decoctum Sarsaparillae Compositum. 






OFFICIAL PREPARATIONS. 43 I 

The general official formula prescribes that an ordinary decoction, the 
strength of which is not directed by the physician, nor specified by the 
Pharmacopoeia, shall be prepared in the proportion of i part of the sub- 
stance to 9 of water. Decoctum Cetrarise is one-half the aforesaid strength, 
while the Compound Decoction of Sarsaparilla is of the full strength as to 
its chief ingredient. 

Alcoholic Preparations. 
Extracta Fluida, Fluid Extracts, — are permanent concentrated solu- 
tions of vegetable drugs, of uniformly definite strength if the crude drugs 
are so, a cubic centimeter (1^16.23) in each case representing the medi- 
cinal powers of one gramme (gr. 15.43) of the drug, or approximately a 
minim of the finished preparation representing the active constituents of a 
grain of the drug. They are officially directed to be prepared by perco- 
lation and partial evaporation, the menstrua employed being usually Alco- 
hol, diluted Alcohol, or Alcohol and Water in various proportions, though 
a few are percolated with water, the alcohol being afterwards added. In 
several instances Glycerin in different proportions is added to the first 
menstruum, and in the menstruum used for the extraction of Aconite 
root Tartaric Acid is an ingredient. In the preparation of the fluid 
extract of Prunus Virginiana, the extraction is preceded by maceration 
with water and glycerin, in order to permit of the formation of Hydro- 
cyanic Acid by the reaction of the amygdalin and emulsin of the bark upon 
each other, which takes place only in the presence of water. The glycerin 
aids to keep the dissolved matters in perfect solution, and also to better 
retain the acid and volatile oil formed during the process. The fluid extract 
of Glycyrrhiza is prepared with a first menstruum containing Ammonia, 
and that of Lactucarium is first treated with Ether and then put through 
an elaborate process in order to obtain a preparation which will make a 
clear mixture with water, syrup or glycerin. The menstruum directed to be 
used in each case is intended to be that which will thoroughly extract all 
the active constituents of the drug and at the same time will leave the inert 
soluble matters behind in the rejected portion, known as the marc. In 
manufacturing fluid extracts on a large scale, modifications of the official 
processes are necessary, and the methods used are generally percolation 
and maceration with hydraulic pressure, vacuum maceration followed by 
percolation, percolation with incomplete exhaustion, or repercolation. 
The number of official Fluid Extracts is 79. They are named in the fol- 
lowing list, the letters following each one in parentheses showing the 
character of its menstruum, and representing Alcohol, Diluted Alcohol, 
Alcohol and Water, or Glycerin, by their respective initials. 

Extractum Aconiti Fluidum (A). Ext. Aurantii Amari Fl. (A 2 W,). 

Ext. Arnicse Radicis Fl. (DA). Ext. Belladonnas Fl. (A). 

Ext. Aromaticum Fl. (A). Ext. Brayerse Fl. (A). 



43: 



OFFICIAL PREPARATIONS. 



Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 
Ext. 



Buchu Fl. (A 2 W\). 
Calami Fl. (A). 
Calumbas Fl. (DA). 
Cannabis Indicas Fl. (A). 
Capsici Fl. (A). 
Castanet Fl. (WA). 
Chimaphilas Fl. (DAgG^. 
Chiratas Fl. (DAgG^. 
Cimicifugas Fl. (A). 
Cinchonas Fl. (DjAgG^. 



(A.W,). 



Colchici Radicis Fl 
Colchici Seminis Fl. 
Conii Fl. (DA). 
Cornus Fl. (DA 4 G X ). 
Cubebas Fl. (A). 
Cypripedii Fl. (A). 
Digitalis Fl. (AgWj). 
Dulcamaras Fl. (DA). 
Ergotas Fl. (A 3 W 4 ). 
Erythroxyli Fl. (DA). 
Eucalypti Fl. (A). 
Eupatorii Fl. (DA). 
Frangulas Fl. (AjWg). 
Gelsemii Fl. (A). 
Gentianas Fl. (DA). 
Geranii Fl. (DA 9 Gj). 
Glycyrrhizas Fl. (DA). 
Gossypii Radicis Fl. (A 3 G 7 ). 
Grindelias Fl. (AgWj). 
Guaranas Fl. (A^Vj). 
Hamamelidis Fl. (AjWg). 
Hydrastis Fl. (AgWj). 
Hyoscyami Fl. (AgW^). 
Ipecacuanhas Fl. (A). 
Iridis Fl. (A 8 W,). 
Kramerias FL (DA 4 G X ). 

Extractum Zingiberis 



Ext. Lactucarii Fl. (A^g). 
Ext. Leptandras Fl. (DA 17 G 3 ). 
Ext. Lobelias Fl. (DA). 
Ext. Lupulini Fl. (A). 
Ext. Matico Fl. (A 15 W 5 G 2 ). 
Ext. Mezerei Fl. (A). 
Ext. Nucis Vomicas Fl. (AgW^. 
Ext. Pareiras Fl. (DA^). 
Ext. Pilocarpi Fl. (Da). 
Ext. Podophylli Fl. (AgW^. 
Ext. Pruni Virginianas Fl. (W^). 
Ext. Quassias Fl. (DA). 
Ext. Rhei Fl. (AgW^. 
Ext. Rhois Glabras Fl. (DA^). 
Ext. Rosas Fl. (DAgGj). 
Ext. Rubi Fl. (A 9 W 7 G 4 ). 
Ext. Rumicis Fl. (DA). 
Ext. Sabinas Fl. (A). 
Ext. Sanguinarias Fl. (A). 
Ext. Sarsaparillas Co. Fl. (A 5 W 6 G^ 
Ext. Sarsaparillas Fl. (AgWgGj). 
Ext. Scillas Fl. (A). 
Ext. Scutellaras Fl. (A^). 
Ext. Senegas Fl. (A 2 Wj). 
Ext. Sennas M. (A 3 W 4 ). 
Ext. Serpentarias Fl. (AjWj). 
Ext. Spigelias Fl. (DA). 
Ext. Stillingias Fl. (DA). 
Ext. Stramonii Fl. (AgWj). 
Ext. Taraxaci Fl. (A 2 W 3 ). 
Ext. Tritici Fl. (WA). 
Ext. Uvas Ursi Fl. (DAgG^. 
Ext. Valerian as Fl. (A^). 
Ext. Veratri Viridis Fl. (A). 
Ext. Viburni Fl. (AjWj). 
Ext. Xanthoxyli Fl. (A). 
Fluidum (A). 



In nine instances only does the Pharmacopoeia direct the making of 
other preparations from corresponding fluid extracts, these nine being the 
Syrups of Krameria, Lactucarium, Rubus, Senega, and Ginger, the Extract 
of Ergot, the Liniment of Belladonna, the Ointment of Mezereum, and 
the mixture of Rhubarb and Soda. Notwithstanding this fact it is a com- 
mon practice for dispensing pharmaceutists to make tinctures, syrups, 
infusions, etc., from fluid extracts; and some manufacturers put a label 
on the bottles containing their fluid extracts, giving the formulae for so 
preparing other preparations. This practice is illegitimate, and tends to 
still further degrade the profession of pharmacy into a mere trade, so far 
as all dispensing is concerned. 



A large number of unofficial fluid extracts are manufactured and for sale, one house 
alone carrying over 400 such on their catalogue. Normal Liquids are a class of superior 
fluid extracts introduced by Parke, Davis & Co., which are claimed to be adjusted to a 
maximum strength by accurate assays for alkaloidal strength made at each stage of their 
manipulation, irrespective of the amount of material required, which in the case of official 
fluid extracts is prescribed by the Pharmacopoeia, regardless of the varying quality of drugs 
in the market. This firm prepares Normal Liquids of Aconite, Veratrum Viride, Bella- 
donna (root or leaves), Cannabis Indica, Cinchona Calisaya, Cinchona Rubra, Colchicum 



OFFICIAL PREPARATIONS. 



433 



(root or seed), Conium, Ergot, Digitalis, Gelsemium, Hyoscyamus, Ipecacuanha, Podo- 
phyllum, Nux Vomica, Rhubarb, and Stramonium (seed or leaves). Of these prepara- 
tions one cubic centimeter is equivalent to one gramme of the corresponding drug of 
standard alkaloidal strength. A fluid extract of Belladonna leaves may contain .25 or 
.45 per cent, of atropine, according to the quality of the drug employed; a Normal 
Liquid will contain invariably .4 per cent, of the alkaloid, so that in a given dose it may 
be relied upon to produce a certain effect. 

Tincturse, Tinctures, — are alcoholic solutions of medicinal substances ; 
and with one official exception (Tincture of Iodine), are made from non- 
volatile bodies. They are prepared by percolation, maceration, solution 
or dilution ; the menstrua employed being chiefly Alcohol, and diluted 
Alcohol of various strengths, though in a few cases the Aromatic Spirit 
of Ammonia, and mixtures of Alcohol,. Water and Glycerin are directed 
to be used. The Pharmacopoeia prescribes a general formula for Tinctures 
of Fresh Herbs, according to which, when not otherwise directed, these 
preparations are to be made by macerating 50 parts of the Fresh Herb, 
bruised or crushed, with 100 parts of Alcohol for 14 days, then expressing 
the liquid and filtering. Of the 72 official Tinctures 2 are made with 5 
per cent, of the ingredient, 20 with 10 per cent., 9 with 15 per cent., 23 
with 20 per cent., 1 with 35 per cent., 1 (Aconite) with 40 per cent., 3 
with 50 per cent., and 1 (Soap) with 65 per cent.; the others varying in 
strength from 0.4 per cent, in the case of Paregoric to 26 per cent, in that 
of the Compound Tincture of Benzoin. Fifty-four are made by percola- 
tion, a few by solution or dilution, and the rest by maceration.. The offi- 
cial Tinctures are as follows, the figures placed after each giving the num- 
ber of grains of the active ingredients in each fluid-drachm, viz.: — 



Tinctura Aconiti, 19. 
Tinctura Aloes, ioj^. 
Tinctura Aloes et Myrrhae, 10^. 
Tinctura Arnicas Florum, 10^. 
Tinctura Arnicas Radicis, 5^. 
Tinctura Asafcetidas, 10^. 
Tinctura Aurantii Amari, 10^. 
Tinctura Aurantii Dulcis, \o]^. 
Tinctura Belladonnas, 8^. 
Tinctura Benzoini, 10^. 
Tinctura Benzoini Composita, 13^. 
Tinctura Bryonias, 4^. 
Tinctura Calendulas, \o]^. 
Tinctura Calumbae, 5^3. 
Tinctura Cannabis Indicse, io^". 
Tinctura Cantharidis, 2^. 
Tinctura Capsici, 21^. 
Tinctura Cardamomi,8^. 
Tinctura Cardamomi Composita, 2^. 
Tinctura Catechu Composita, io^f. 
Tinctura Chiratas, 5^. 
Tinctura Cimicifugae, io^". 
Tinctura Cinchonas, io^(. 
Tinctura Cinchonas Composita, \0%. 
Tinctura Cinnamomi, 5^. 
Tinctura Colchici, 8^. 
28 



Tinctura Conii, 2>y£. 

Tinctura Croci, 5^. 

Tinctura Cubebas, 5^. 

Tinctura Digitalis, 8j^. 

Tinctura Ferri Acetatis. 

Tinctura Ferri Chloridi. 

Tinctura Gallas, io^(. 

Tinctura Gelsemii, 7 *^. 

Tinctura Gentians Composita, 7^. 

Tinctura Guaiaci, io*^. 

Tinctura Guaiaci Ammoniata, 10^. 

Tinctura Humuli, 10^. 

Tinctura Hydrastis, 10^. 

Tinctura Hyoscyami, &}4. 

Tmctura Ignatias, gr. y^ of Extract. 

Tinctura Iodi, 4. 

Tinctura Ipecacuanhas et Opii, ioj^. 

Tinctura Kino, 5^. 

Tinctura Kramenae, 10^. 

Tinctura Lavendulae Composita, 2)/$ 

Tinctura Lobelias, ioj^ - . 

Tinctura Matico, 5*^. 

Tinctura Moschi, 5^. 

Tinctura Myrrhae, 10^ 

Tinctura Nucis Vomicae, io^\ 

Tinctura Opii, 5^. 



434 OFFICIAL PREPARATIONS. 

Tinctura Opii Camphorata, A. Tinctura Scillas, 8^. 

Tinctura Opii Deodorata, 5*4- Tinctura Serpentariae, 5y 8 '. 

Tinctura Physostigmatis, 4^. Tinctura Stramonii, 5^. 

Tinctura Pyrethri, 10^. Tinctura Sumbul, 4^. 

Tinctura Quassias, 5^. Tinctura Tolutana, 5^3. 

Tinctura Rhei, J}4' Tinctura Valerianae, 10^. 

Tinctura Rhei Aromatica, 16^. Tinctura Valerianae Ammoniata, io^". 

Tinctura Rhei Dulcis, 9. Tinctura Vanillae, 5^5. 

Tinctura Sanguinariae, 8j^. Tinctura Veratri Viridis, 24. 

Tinctura Saponis Viridis, 36^. Tinctura Zingiberis. 

Vina, Wines, — when medicated are practically the same as Tinctures, 
White Wine brought to a definite alcoholic strength (Vinum Album For- 
tius) being the menstruum used. The official Wines number 14, of which 
3 are not medicated, 4 are made by solution or admixture, 3 by macera- 
tion and 4 by percolation. They are as follows, viz.: — 

Vinum Album, 10-12. Vinum Colchici Seminis, 15. 

Vinum Album Fortius, 20-25. Vinum Ergotae, 15. 

Vinum Rubrum, 10-12. Vinum Ferri Amari, 8. 

Vinum Aloes, 6. Vinum Ferri Citratis, 4. 

Vinum Antimonii, 0.4. Vinum Ipecacuanhas, 7. 

Vinum Aromaticum, 6. Vinum Opii, 10. 

Vinum Colchici Radicis, 40. Vinum Rhei, 10. A 

The figures placed after the first three show the percentage of absolute 
alcohol which is required in each ; those placed after the other members 
of the group show the quantity of the active ingredient used in preparing 
100 parts of the Wine. 

Spiritus, Spirits, — are alcoholic solutions of volatile substances, which 
may be solids, liquids or gases. They are officially prepared either by 
simple solution, by solution with maceration, by gaseous solution, by 
chemical reaction, or by distillation. The number of official Spirits is 
22, as follows, viz.: — 

Spiritus Athens. Spiritus Lavandulae. 

Spiritus yEtheris Compositus. Spiritus Myrciae. 

Spiritus Ammonias Aromaticus. Spiritus Myristicae. 

Spiritus Anisi. Spiritus Odoratus. 

Spiritus Aurantii. Spiritus Limonis. 

Spiritus Camphoras. Spiritus Menthas Piperitae. 

Spiritus Chloroformi. Spiritus Menthae Viridis. 

Spiritus Cinnamomi. Spiritus Ammonias. 

Spiritus Gaultheriae. Spiritus yEtheris Nitrosi. 

Spiritus Juniperi. Spiritus Frumenti. 

Spiritus Juniperi Compositus. Spiritus Vini Gallici. 

Of these, the first fifteen are prepared by simple solution, the next three 
by solution with maceration, the next one by gaseous solution, the next 
one by chemical reaction, and the last two by distillation. 

Elixiria, Elixirs, are sweetened, aromatic, spirituous preparations con- 
taining active medicinal substances in small quantities. There is but one 
official Elixir (Elixir Aurantii), which is intended as a type of the class 



OFFICIAL PREPARATIONS. 435 

of unofficial elixirs so largely employed in extemporaneous pharmacy. It 
is practically a flavored alcoholized syrup, designed for use as an excipient 
with extracts, salts and tinctures. 

Ethereal Preparations. 
Oleoresinae, Oleoresins, — are liquid preparations consisting princi- 
pally of natural oils and resins extracted from vegetable substances by per- 
colation with Stronger Ether. They differ from fluid extracts in not 
bearing any uniform relation to the drug of gramme to cubic centimeter, 
in containing principles which though soluble in ether are not in alcohol, 
and in some instances being devoid of principles which are insoluble in 
ether but soluble in alcohol. They are the most concentrated liquid pre- 
parations of drugs which can be produced, and are prepared by percolat- 
ing the powdered drug with Stronger Ether until exhausted, recovering 
the greater part of the ether by distillation, and exposing the residue in a 
capsule to spontaneous evaporation until the remaining ether has evapo- 
rated. There are 6 official Oleoresins, viz. : — 

Oleoresina Aspidii (10-15). Oleoresina Lupulini (50). 

Oleoresina Capsici (5). Oleoresina Piperis (5), 

Oleoresina Cubebae (18-25). Oleoresina Zingiberis (6-8). 

The figures in parentheses show the percentage of oleoresin yielded by 
each drug. 

Collodia, Collodions, — are liquid preparations having for their base a 
solution of Pyroxylin in a mixture of Ether and Alcohol. They are in- 
tended for external use, being applied to the skin by means of a brush, 
and producing a film on the surface after the evaporation of the men- 
struum. There are 4 official Collodions, viz. .: — 

Collodium. Collodium Flexile. 

Collodium cum Cantharide. Collodium Stypticum. 

The Flexible Collodion contains 5 per cent, of Canada Turpentine, and 
3 per cent, of Castor Oil. Styptic Collodion contains 20 per cent, of 
Tannic Acjd. 

Oleaginous Preparations. 

Linimenta, Liniments, — are very thin ointments for external applica- 
tion and intended to be applied with friction to the skin. They are solu- 
tions of various substances in oily liquids or in alcoholic liquids contain- 
ing fatty oils. Of the following 10 official Liniments the first 4 have 
Cotton-seed Oil, the next 4 have Alcohol and the last 2 have Oil of Tur- 
pentine as their respective bases. 

Linimentum Ammoniae. Linimentum Belladonnas. 

Linimentum Calcis. Linimentum Chloroformi. 

Linimentum Camphorae. Linimentum Saponis. 

Linimentum Plumbi Subacetatis. Linimentum Sinapis Comp. 

Linimentum Cantharidis. 

Linimentum Terebinthinae. 



436 OFFICIAL PREPARATIONS. 

Oleata, Oleates, — are liquid solutions of metallic salts or alkaloids in 
Oleic Acid, intended for external administration. They are not definite 
chemical compounds, though the term is also employed in trade to desig- 
nate certain solid preparations which are claimed to be chemical com- 
pounds of the same acid with various bases. [See under Acidum Olei- 
CUM, ante, page 71.] There are two official Oleates as follows, viz.: — 
Oleatum Hydrargyri (10 per cent.). Oleatum Veratrinse (2 per cent.). 

Acetous Preparations. 

Aceta, Vinegars, — are solutions of the active principles of certain 

drugs in Diluted Acetic Acid. They are made by percolation and each 

contain the soluble principles from 10 per cent, of drug. Acidulous 

menstrua form soluble salts with the alkaloids and possess antiseptic 

qualities. The official Vinegars number 4, viz.: — 

Acetum Lobeliae. Acetum Sanguinarise. 

Acetum Opii. Aceturn Scilke. 

Glycerin Preparations. 
Glycerita, Glycerites, — are mixtures of medicinal substances with 
Glycerin. In the U. S. Phar. of 1870 there were 5 official Glycerites, 
which were solutions of Carbolic, Gallic, and Tannic Acids, Tar, and 
Sodium Borate, in Glycerin. They were very useful preparations for dis- 
pensing purposes, as they could be readily diluted with water or alcohol 
without precipitation. Only 2 Glycerites are now official, viz: — ■ 
Glyceritum Amyli. Glyceritum Vitelli. 

Solid Preparations. 
Extracta, Extracts, — are solid or semi-solid preparations obtained by 
evaporating solutions of vegetable principles. The drug is first powdered, 
then percolated with the appropriate menstruum to exhaustion. The first 
third of the percolate is reserved, the remainder is evaporated at a tem- 
perature not above i22°F. until its weight is ten per cent, of that of the 
drug used, then mixed with the reserved portion, and both are evaporated 
to a pilular consistence. The above is the general rule, but in several 
instances maceration is directed for 1 to 4 days before percolation ; and 
in other cases, instead of reserving a portion of the percolate, the whole 
quantity is distilled until the alcohol is removed, and the residue is evapo- 
rated to a pilular consistence. The menstrua used are, — in 5 cases Alco- 
hol, in 15 cases Diluted Alcohol of varying strength, in 8 Water, in 
1 Water with 5 per cent, of Aqua Ammoniae, and in 1 a diluted Acetic 
Acid. One extract is an inspissated juice (Ext. Taraxaci) ; one is made 
by evaporating a fluid extract (Ext. Ergotae), and one by mixing extracts 
with aromatics (Ext. Colocynthidis Comp.). Five per cent, of Glycerin 
is added to 10 to prevent their becoming hard. The official Extracts 



OFFICIAL PREPARATIONS. 437 

number 32, and are named as follows, the letters in parentheses showing 
the nature of the menstruum used in extraction in each case, viz. : — 

Extractum Aconiti (A). Extractum Haematoxyli (W). 

Ext. Aloes Aquosum (W). Ext. Hyoscyami Alcoholicum (A 2 W 1 ). 

Ext. Arnicse Radicis (DA). Ext. Iridis (A 3 W X ). 

Ext. Belladonna? Alcoholicum (A^^. Ext. Juglandis (A). 

Ext. Cannabis Indicae (A). Ext. Krameriae (W). 

Ext. Cinchona (A S W X ). Ext. Leptandrse (A^). 

Ext. Colchici Radicis (W). Ext. Malti (W). 

Ext. Colocynthidis (DA). Ext. Mezerei (A). 

Ext. Colocynthidis Compositum. Ext. Nucis Vomicae (A 8 W X ). 

Ext. Conii Alcoholicum (DA). Ext. Opii (W). 

Ext. Digitalis (AjWj). Ext. Physostigmatis (A). 

Ext. Ergotae (A„W 4 ). Ext. Podophylli (A 3 W X ). 

Ext. Euonymi (DA). Ext. Quassiae (W). 

Ext. Gentianae (W). Ext. Rhei (A 3 W X ). 

Ext. Glycyrrhizae (W). Ext. Stramonii (DA). 

Ext. Glycyrrhizae Purum (W). Ext. Taraxaci. 

The proximate principles which are generally present in extracts, 
besides the peculiar principles of plants, are sugar, tannin, extractive, 
chlorophyll, coloring-matter, and salts. When an alcoholic solvent is used 
there are also present resins, fats, and often volatile oil, and when the 
menstruum is not purely alcohol there is more or less gum and starch. 
One of these ingredients, named Extractive or Apotheme, is a deposit, 
soluble in water and alcohol, which has the singular property of passing 
into an insoluble substance under the influence of the atmospheric air 
with heat. It also has a tendency, when precipitated from solutions, to 
unite with other principles, carrying them down with it. It is frequently 
present in extracts, hence its name. 



Abstracta, Abstracts, — are solid, dry, powdered preparations, con- 
taining the soluble principles of the drugs from which they are made, 
and each representing twice the strength of the corresponding drug or its 
fluid extract. They are prepared by spontaneous evaporation of an alco- 
holic tincture at a low temperature (not exceeding 122 F.), mixing with 
it enough dried Sugar of Milk to make the product weigh one-half the 
weight of the drug, and then reducing it to a fine and uniform powder. 
They are permanent and portable preparations, not subject to variation 
in strength, nor to become hard and brittle. They were first introduced 
into the U. S. Pharmacopoeia in the edition of 1880, and are 11 in 
number, viz. : — 

Abstractum Aconiti. Abstractum Jalapae. 

Abstractum Belladonnas. Abstractum Podophylli. 

Abstractum Conii. Abstractum Senegae. 

Abstractum Digitalis. Abstractum Valerianae. 

Abstractum Hyoscyami. Abstractum Ignatiae. 

Abstractum Nucis Vomicae. 

The menstrua used for these are Alcohol 8, Water 1 for the two last- 



43$ OFFICIAL PREPARATIONS. 

named, and Alcohol for the others ; but 2 per cent, of Tartaric Acid is 
added in the case of Aconite, and 6 per cent, of HC1 in the case of Conium. 

Resinae, Resins, — are solid preparations obtained by precipitating the 
resinous principle of plants from their alcoholic solution by the agency 
of water. They differ from alcoholic extracts in containing only those 
principles which are soluble in alcohol and insoluble in water, while the 
extracts contain all principles which are soluble in alcohol. There are 4 
official Resins, viz. : — 

Resina Copaibae. Resina Podophylli. . 

Resina Jalapae. Resina Scammonii. 

Massse, Masses, — are Pill-masses prepared as described in the next 
paragraph. The official Masses number 3, viz. : — 

Massa Copaibae. Massa Ferri Carbonatis. 

Massa Hydrargyri. 

Pilulse, Pills, — are spherical masses composed of medicinal agents and 
intended to be swallowed whole. The "mass" consists of the active 
ingredients and the excipient, the latter being the substance which gives 
to the mass its adhesive and plastic qualities. In official pharmacy the 
excipients are specified both as to composition and quantity in each case, 
and those directed to be used in the preparation of the 3 official Masses 
and the 15 official Pills are as follows, viz. : — 

5 are made with Soap and Water ; viz. — Pil. Aloes, Pil. Aloes et Asafoetidae, Pil. Asa- 

foetidse, Pil. Opii. Pil. Rhei. 
3 are made with Water alone, viz. — Pil. Aloes et Mastiches, Pil. Catharticae Comp., 

Pil. Rhei Comp. 
3 are made with Syrup, viz. — Pil. Aloes et Myrrhae, Pil. Ferri Comp., Pil. Galbani 

Comp. 
1 with Mucilage of Tragacanth, viz. — Pil. Antimonii Comp. 
I with Acacia and Water, viz. — Pil. Ferri Iodidi. 
I with Glycerin and Water, viz. — Pilulae Phosphori. 
I with Confection of Rose, viz. — Pilulae Aloes et Ferri. 
1 with Honey, Syrup and Water, viz. — Massa Ferri Carbonatis. 
I with Glycerin and Honey of Rose, viz. — Massa Hydrargyri. 
I has no excipient, viz. — Massa Copaibae. 

The pharmacopceial directions for the formation of the pill-mass vary 
in each case, but in general they prescribe that the ingredients shall be 
mixed intimately, then, beaten with the excipient to form a mass and 
divided into a certain number of pills. Two of the official pills are 
directed to be coated with an ethereal solution of the Balsam of Tolu, 
viz. — Pilulae Ferri Iodidi and Pilulae Phosphori. Full descriptions of the 
various details of pill-making are given in the section on Extemporaneous 
Pharmacy. The number of official pills is 15, for the composition of 
which the student is referred to their several titles in the section of Materia 
Medica. They are named as follows, viz. : — 



OFFICIAL PREPARATIONS. 



439 



Pilulae Aloes. 

Pilulae Aloes et Asafoetidae. 
Pilulae Aloes et Ferri. 
Pilulae Aloes et Mastiches. 
Pilulae Aloes et Myrrhae. 
Pilulae Antimonii Compositae. 
Pilulae Asafoetidae. 



Pilulae Catharticae Compositae. 
Pilulae Ferri Compositae. 
Pilulae Ferri Iodidi. 
Pilulae Galbani Compositae. 
Pilulae Opii. 
Pilulae Phosphori. 
Pilulae Rhei. 



Pilulae Rhei Compositae. 

Trochisci, Troches, — also called Pastilles, Tablets, or Lozenges, — are 
small flattened cakes of medicinal substances, prepared from a mass 
made with a basis of Sugar, some having Mucilage of Tragacanth, others 
Orange-flower Water, Syrup of Tolu, etc., as excipients. They are con- 
venient preparations for the pocket-case, and are especially useful when 
the active ingredients are intended to come into contact with the mucous 
surface of the throat. There are 16 official Troches, named as follows, 



Trochisci Acidi Tannici. 
Trochisci Ammonii Chloridi. 
Trochisci Catechu. 
Trochisci Cretae. 
Trochisci Cubebae. 
Trochisci Ferri. 
Trochisci Glycyrrhizae et Opii. 
Trochisci Ipecacuanhae. 



Trochisci Krameriae. 
Trochisci Magnesiae. 
Trochisci Menthae Piperitae. 
Trochisci Morphinae et Ipecac. 
Trochisci Potassii Chloratis. 
Trochisci Sodii Bicarbonatis. 
Trochisci Sodii Santoninatis. 
Trochisci Zineiberis. 



Confectiones, Confections, — consist of medicinal substances formed 
into a mass with Sugar, Honey, Water, etc., with the object of rendering 
them palatable and of preserving them from change. Electuaries are 
similar preparations, but this term is now obsolete. There are only two 
official Confections, viz. : — 

Confectio Rosae. Confectio Sennae. 

Pulveres, Powders, — are usually prepared extemporaneously, but a 
few compound ones have been made official, the ingredients being simply 
directed to be rubbed together until reduced to a fine powder and thor- 
oughly mixed. Special directions are given for the preparation of two, — 
the Compound Effervescing Powder and the Compound Powder of Mor- 
phine. There are 9 official powders, named as follows, viz. : — 

Pulvis Antimonialis. Pulvis Glycyrrhizae Compositus. 

Pulvis Aromaticus. Pulvis Ipecacuanhae et Opii. 

Pulvis Cretae Compositus. Pulvis Jalapae Compositus. 

Pulvis Effervescens Compositus. Pulvis Morphinae Compositus. 

Pulvis Rhei Compositus. 

The composition of each of these preparations will be found in the 
section on Materia Medica, and under the title from which its name is 
derived, except that of the Compound Effervescing Powder, which is 
placed under the title Potassium. Pulvis Ipecacuanhae et Opii is really 
a trituration. 



440 



OFFICIAL PREPARATIONS. 



Triturationes, Triturations, — form a class of powders having for their 
diluent Sugar of Milk, and possessing a definite relation between the 
active ingredient and the diluent. The Pharmacopoeia prescribes a gen- 
eral formula for these preparations, according to which 10 parts of the 
Substance and 90 parts of Sugar of Milk are to be well mixed by a spatula, 
the latter being added in successive quantities, and both triturated in a 
mortar until the substance is intimately mixed with the diluent and finely 
comminuted. There is but one official Trituration (Trituratio Elaterini), 
though the Pulvis Ipecacuanhas et Opii practically belongs to this class, 
except in respect of the proportions prescribed. For a further discussion 
of this subject see the article Triturations under the heading Extempo- 
raneous Preparations. 

Suppositoria, Suppositories, — are solid bodies containing medicinal 
substances, and intended for introduction into the vagina, rectum or ure- 
thra. There are no official suppositories enumerated, but the Pharma- 
copoeia prescribes a general formula for their preparation, according to 
which the medicinal portion should be incorporated with Oil of Theo- 
broma by rubbing them together at a temperature of 95 ° F. The mix- 
ture should then be poured into suitable moulds, and cooled on ice or in 
ice-cold water. Unless otherwise specified they shall be made to weigh 
about 15 grains each. 

Unguenta, Ointments, — are soft, fatty mixtures of medicinal agents 
with a basis of lard, petrolatum, or fixed oils with a solid fat such as wax 
or spermaceti. They are intended for application to the skin by inunc- 
tion, and have a melting point which is below the ordinary temperature 
of the human body. Of the 26 official Ointments 1 is prepared by chem- 
ical reaction, viz. — Unguentum Hydrargyri Nitratis ; 5 by fusion and 20 
by incorporation of the ingredients with each other by mixing them 
through the agency of a spatula and a porcelain slab. Unguentum itself 
is prepared by fusing together 80 parts of Lard and 20 of yellow Wax, 
and is the basis of 3 other ointments, while 16 have Benzoinated Lard as 
their basis. 



Unguentum. 

Unguentum Acidi Carbolici (10). 
Unguentum Acidi Gallici (10). 
Unguentum Acidi Tannici (1.0). 
Unguentum Aquae Rosre. 
Unguentum Belladonnse (10). 
Unguentum Chrysarobini (10). 
Unguentum Diachylon. 
Unguentum Gallae (10). 
Unguentum Hydrargyri (45). 
Ung. Hydrargyri Ammoniati (10). 
Ung. Hydrargyri Nitratis. 
Ung. Hydrargyri Oxidi Flavi (io). 



Ung. Hydrargyri Oxidi Rubri (10) 
Unguentum Iodi (4). 
Unguentum Iodoformi (10). 
Unguentum Mezerei (25). 
Unguentum Picis Liquidae (50). 
Ung. Plumbi Carbonatis (10). 
Ung. Plumbi Iodidi (10). 
Ung. Potassii Iodidi (12). 
Unguentum Stramonii (10). 
Unguentum Sulphuris (30). 
Ung. Sulphuris Alkalinum (20). 
Unguentum Veratrinae (4). 
Unguentum Zinci Oxidi (20). 



OFFICIAL PREPARATIONS. 44 1 

The figures in parentheses show the percentage of extract or other active 
ingredient in the ointment. The composition of each may be found in 
the section on Materia Medica under the title from which the preparation 
is named, except Unguentum, which will be found under the title Adeps, 
and Unguentum Diachylon under Plumbum. 

Cerata, Cerates, — are unctuous preparations similar to ointments but 
of a much firmer consistence. They all contain Wax (Cera), and do not 
melt at temperatures below 104 F. They are intended for external use, 
and are generally spread on lint before being applied. There are 8 official 
Cerates, including Ceratum itself, which is made by fusing together 30 
parts of White Wax and 70 of Lard. The composition of the others may 
be found in the section on Materia Medica under the appropriate titles, 
but the figures in parentheses below give the percentage of drug to basis 
in each. Of the following-named 6 are prepared by fusion and 2 by in- 
corporation. 

Ceratum. Ceratum Extracti Cantharidis (30). 

Ceratum Camphorae (0.6). Ceratum Plumbi Subacetatis (5). 

Ceratum Cantharidis (35). Ceratum Resinre (35). 

Ceratum Cetacei (10). Ceratum Sabinae (25). 

Emplastra, Plasters, — are solid compounds, insoluble in water, of a 
tenacious but pliable consistence and intended for external application to 
limited areas of the body surface. They are prepared by incorporating 
medicinal substances with certain bases, which are usually Lead Plaster 
(Oleate of Lead), a Gum-resin, or Burgundy Pitch. The heat employed 
should be low so as to avoid decomposing the active agents, and should 
not be continued long enough to drive off any volatile constituents. The 
plaster mass is then spread evenly on chamois skin, kid skin or muslin. 
The constituents of the following-named 17 official Plasters may be found 
in the section on Materia Medica under their appropriate headings. 

Emplastrum Ammoniaci. Emplastrum Hydrargyri. 

Emp. Ammoniaci cum Hydrargyro. Emplastrum Ichthyocollae. 

Emplastrum Arnicae. Emplastrum Opii. 

Emplastrum Asafoetidae. Emp. Picis Burgundicae. 

Emplastrum Belladonnas. Emp. Picis Canadensis. 

Emplastrum Capsici. Emp. Picis cum Cantharide. 

Emplastrum Ferri. Emplastrum Plumbi. 

Emplastrum Galbani. Emplastrum Resinae. 
Emplastrum Saponis. 

Of the foregoing only two are directed to be spread, viz. — Emp. Cap- 
sici upon muslin, and Emp. Ichthyocollae upon taffeta, the others having 
no pharmacopceial prescription for the material to be used. Plasters after 
being spread should remain soft, pliable and adhesive, without melting at 
the heat of the body. To soften the surface, if old, it should be brushed 
with a small portion of Tincture of Camphor. 



442 EXTEMPORANEOUS PHARMACY. 

Chartae, Papers, — consist of strips of paper medicated by impregna- 
tion of its fibres with medicinal substances, or by being coated therewith. 
Of the 3 official Papers 2 are made with sized paper, and are intended for 
external application as vesicants or counter-irritants ; the third (Charta 
Potassii Nitratis) is unsized paper impregnated with Nitre and intended 
for the inhalation of its fumes while burning. Those officially recognized 
are — 

Charta Cantharidis. Charta Sinapis. 

Charta Potassii Nitratis. 



EXTEMPORANEOUS PHARMACY. 

This is the most important division of the whole subject of Pharmacy, 
embracing as it does the preparation and dispensing of those medicines 
which are designed for immediate use and which are compounded on the 
prescriptions of physicians. Hence it comprises the chief portion of the 
daily work of the pharmacist, and can only be learned at the dispensing 
counter and under the personal supervision of a competent master. In 
the following pages are given the most important of the general directions 
pertaining to this subject, with the object of enabling the young medical 
practitioner to familiarize himself with the compounding and dispensing 
of drugs so far as the limits of the book will admit of. The drug-store of 
the present day has degenerated so far from its legitimate business that ere 
long physicians will be compelled in self-defence to dispense their own 
medicines, thereby protecting themselves and their patients from the 
patent-medicine vending, the counter-prescribing, and the many other 
nefarious methods which have degraded the pharmacist from his old pro- 
fessional position to that of a mere trader in drugs and nostrums. The 
first outfit of every young doctor should include a few pharmaceutical 
instruments and a small stock of drugs. By daily handling of these, the 
tools of his profession, he will insensibly become .familiar with the tech- 
nique of the art, and even if he does not continue to dispense his medi- 
cines in after years he will never regret the practical knowledge which 
such a course will give him. 

Compounding means the mixing or preparing of the drugs ordered 
in a prescription, and comprises all the operations of official pharmacy 
together with many other manipulations which will be described in their 
appropriate places. 

Dispensing is the operation of putting up and issuing the drugs 
ordered in a prescription, and may apply to the already compounded prepa- 
rations of official pharmacy as well as to those prepared extemporaneously. 



WEIGHTS AND MEASURES. 



443 



WEIGHTS AND MEASURES. 

The working formulae of the U. S. Pharmacopoeia are constructed on 
the system of parts by weight for all articles, whether solids or fluids, ex- 
cept in the case of fluid extracts, for which the metric weights and measures 
are employed. On this system it really makes no difference what unit 
of weight is adopted in official pharmacy. However, the weights and 
measures referred to by physicians in prescribing and used by pharmacists 
in dispensing medicines are, in the United States, those of the Apothe- 
caries' or Troy System of Weights (having 480 grains to the ounce and 
5760 grains to the pound) and the Wine Measure, or those of the Metric 
System. On the other hand, the British Pharmacopoeia recognizes only 
the Imperial Standard (Avoirdupois) weights, having 487^ grains to the 
ounce and 7000 grains to the pound. The drachm (60 grains) and the 
scruple (20 grains) are intermediate units which are still used but are rap- 
idly becoming obsolete. The units of the Wine Measure are the minim 
(t^), which in water at its maximum density equals gr. 0.95 ; the flui- 
drachm (60 minims), and the fluidounce (8 fluidrachms or 480 minims). 
The signs used to denote these units are ttt, minim, 9 scruple, 3 drachm, 
g ounce, and in the case of liquids an f to denote fluid is often placed 
before the sign, thus f5 for fluidrachm, fg for fluidounce. The relations 
between these units of weight and measure are as follows : — 



Measure. 
TTL j, One minim 
f^j, One fluidrachm 
f Jj, One fluidounce 



Pound. 
Libra. 

ft 



Weight. 




Weight. 


Measure. 


= 0.95 grains, 
m = 56.96 " 
:e =455-69 " 


grain j = 


1.05 minims 
63.20 " 
505.60 " 


Table of Troy or Apothecaries' Weight. 




Ounce. 


Drachm. Scruple. 


Grain. 


Uncia. 


Drachma. Scrupulus. 


Granum. 


O 

12 = 


96 = 288 


g r - 
= 576o 


I = 


8 


= 24 
= 3 


= 480 
= 60 



Pound. 
Libra. 



Table of British Pharmacopceial Weight. 
Troy grain, Avoirdupois ounce and pound. 



Ounce. 

Uncia. 

oz. 

16 

I 



Grain. 
Granum. 

g r - 
7000 

437^ 



The Troy ounce contains 42^ grains more than the avoirdupois ounce, 
but the Troy pound contains 1240 grains less than the avoirdupois pound. 
The grain is the only unit common to both. 



444 WEIGHTS AND MEASURES. 

Table of Apothecaries' or Wine Measure. 



\ 



Gallon. Pint. 


Fluidounce. 


Fluidrachm. 


Minim. 


Congius. Octarius. 


Fluiduncia. 


Fluidrachma. 


Minimum. 


C. 0. 
1=8 = 
i = 


128 = 
16 = 


1024 = 

128 = 

8 = 


61440 

7680 

480 

60 


Table of British Imperial or Pharmacopceial Measure. 


Gallon. Pint. 


Fluidounce. 


Fluidrachm. 


Minim. 


Congius. Octarius. 


Fluiduncia. 


Fluidrachma. 


Minimum 


c. o. 

1 = 8 = 


floz. 

160 = 

20 = 
I = 


fldr. 

1280 = 

160 = 

8 = 

1 = 


min. 

76800 

9600 

480 

60 



The Metric, or Decimal System of Weights and Measures, 

is generally used on the continent of Europe, and also by French and 
German physicians in the United States. Its three standard units are 
the following, viz. : — 

A Meter, the standard unit of linear measure and also of the whole system, is the ten- 
millionth part of the quadrant of the earth, i. e., the forty millionth part of the earth's 
circumference around the poles. One-tenth of the meter is the Decimeter, one-hundredth 
is the Centimeter, and one-thousandth is the Millimeter. 

A Liter, the unit of measure of capacity, is the cube of a decimeter. One-thousandth 
of a liter is. the Cubic Centimeter, which measure of pure water at its maximum density 
weighs one Gramme. 

A Gramme, the unit of weight, is the weight of the one-thousandth part of a liter of 
water at its maximum density. Its tenth is the Decigramme, its hundredth is the Centi- 
gramme, and its thousandth part is the Milligramme. 

The metric measures above noted are those used chiefly in pharmaceu- 
tical practice, but the system embraces many other terms of increase which 
are set forth in the following table : — 



0000 Myriameter. 


1 0000 




Myrialiter. 


1 0000 




Myriagramme 


1000 Kilometer. 


1000 




Kiloliter. 


1000 




Kilogramme. 


100 Hectometer. 


100 




Hectoliter. 


100 




Hectogramme 


10 Dekameter. 


10 




Dekaliter. 


10 




Dekagramme. 


1 Meter. 


1 




Liter. 


1 




Gramme. 


.1 Decimeter. 




.1 


Deciliter. 




.1 


Decigramme. 


.01 Centimeter. 




.01 


Centiliter. 




.01 


Centigramme. 


.001 Millimeter. 




001 
or 


Cubic Centimeter. 
Milliliter. 




001 


Milligramme. 



The relations between the Metric Weights and Measures and the Apothe- 
caries' are as follows, viz. : — 

1 meter = 39.370432 inches. 

I liter == 2.1 13433 pints. 

I gramme = 15.43234874 grains. 

I grain = 7.06479895 grammes. 

I minim = 0.0161613 cubic centimeter. 



WEIGHTS AND MEASURES. 445 

The Metric System is making way but slowly in this country although 
its progress is aided by every process of forcing which scientific bodies 
can bring into action, and it remains to be seen how much its adoption in 
the last edition of the U. S. Pharmacopoeia will influence the medical 
profession in its favor. 

With all the influence brought to bear in its favor it certainly has not 
yet been adopted by any considerable proportion of native-born and 
home-educated physicians and pharmaceutists. Its chief disadvantage is 
one which is inherent to any decimal system, viz. — that the number ten 
cannot be divided more than once without producing a fraction. This is 
partly compensated for by the practice of dividing five into the three 
parts of 2, 2 and i, and on this principle metric weights are usually con- 
structed. In writing or reading prescriptions it is sufficiently accurate to 
consider a gramme as equivalent to 15 Troy grains, and a cubic centi- 
meter (milliliter) as equivalent to 15 minims, or one-fourth of a flui- 
drachm. All other terms, units or prefixes belonging to the metric 
system may be wholly ignored by the physician and the pharmacist. The 
decimal point after the gramme or the cubic centimeter should always be 
replaced by a line, so as to avoid errors which in many cases might prove 
serious, from the misplacement of a point, the dropping of a spot of ink 
or the intrusion of a fly-speck. The simplest method of writing a metric 
prescription for one not practiced in the system is to first write for one 
dose of the medicine in grains and minims, then by substituting the same 
number of grammes and cubic centimeters (fiuidgrammes) we get 'fifteen 
doses in metric tenns. Of course, when a mixture or solution is desired 
the proper quantity of vehicle must be added to give the dosage in such 
measures as may be deemed convenient for administration. For ex- 
ample : — 

One dose. 15 doses metric. 

R . Quininae Sulphatis, gr. j, I 

Strychninse Sulph., § r - 6? or °- OI 6, 016 

Ext. Glycyrrhizae Fl., nyv, 4 

Syrupi, . \r\lx, 60 

This gives a two-ounce mixture approximately, of which the dose would be " a tea- 
spoonful thrice daily." 

One dose. 15 doses metric. 

R. Quininae Sulph atis, gr. j, I 

Massae Ferri Carb., gr. ij , 2 

Ext. Nucis Vomicae, gr. y£ or 0.25, 25. 

Ft. pil. No. xv. Sig. — One pill thrice daily after meals. 

The above rule will answer for all liquids except those which are very 
heavy (as Syrups and Chloroform), or very light (as Ether). Measures 
may be entirely discarded, and all fluid quantities expressed in grammes. 
The average drop of water may be considered equivalent to 0.05 cubic 
centimeter (or gramme), the average teaspoonful to 5 c. c, the tablespoon- 



Water. 


Tinctures. 


Syrup. 


Chloroform. 


Ether. 


(Grammes.) 


(Grammes.) 


(Grammes.) 


(Grammes.) 


(Grammes.) 


29.52 


28.OO 


38.OO 


43-70 


22.14 


59-04 


56.OO 


76.OO 


84.40 


44.28 


I18.08 


II2.00 


I52.OO 


174.80 


88.56 


236.16 


224.OO 


304.OO 


349.60 


177.12 



446 WEIGHTS AND MEASURES. 

ful to 20 c. c, the Troy g to 30 grammes, the fluidounce to 30 c. c, and 
8 fluidounces to 250 c. c. 

In prescribing Syrups or Chloroform, each Troy fluidounce should be 
reckoned at something more than 30 grammes — say 40 ; and if this be 
done, the difficulty of converting one scale into the other will be obviated. 
As to Syrups, Chloroform, etc., the following table shows the actual 
weight in grammes of each fluidounce of the substances named : — 

Fluid Oz. 

Z viii. = 

A table of equivalents between Apothecaries' and Metric Weights and 
Measures will be found in the Appendix. 

Approximate or Domestic Measures become necessary in appor- 
tioning doses for a patient, when liquid medicines are used. Of these 
the measure most commonly employed is the teaspoonful, which is gener- 
ally taken as equivalent to a fluidrachm, though in most cases as now 
manufactured the teaspoon contains about 75 minims, or 25 per cent, 
more than the theoretical quantity. The dessertspoonful is about equal 
to 2 teaspoon fuls, and the tablespoonful to about 4 teaspoon fuls or f t ^ss, 
while the wineglass is supposed to contain about fgij. The use of gradu- 
ated medicine glasses is strongly recommended instead of the above 
approximate measures. They may be obtained at a trifling cost in any 
well-stocked drug-store. 

Drops (Guttse) are very variable in size, though popularly supposed to 

equal minims, the variations in their relative dimensions being due to the 

viscidity of the liquid, the shape and surface of the orifice from which 

they escape, and sundry other circumstances. The Syrups and Mucilages 

produce large drops while Bromine, Chloroform and other heavy mobile 

liquids produce very small ones-. These differences are well illustrated in 

the following table, which gives the number of drops in a fluidrachm of 

several liquids of certain classes. [See the Appendix for a fuller table.] 

Syrupus Acaciae, 44. Oleum Ricini, 77. 

Syrupus Scillae, 75. Oleum Copaibae, 123. 

Aqua, 60. Oleum Juniperi, 148. 

Liquor Potassae, 62. Spiritus Camphorae, 143. 

Liquor Hydrargyri Nitrat., 131, Spiritus Chloroformi, 150. 

Acetum Opii, 90. Ext. Digitalis Fluid., 134, 

Vinum Opii, 100. Ext. Ipecac. Fluid., 120. 

Tinct. Opii Deodorat., no. Ext. Cinchonas Fluid., 138. 

Tinct. Opii Camph., no. Ext. Zingiberis Fluid., 142. 

Tinct. Opii, 130. Ext. Buchu Fluid., 150. 

Tinct. Iodi, I48. Ext. Hyoscyami Fluid., 1 60. 

Tinctura Aconiti, 146. /Ether Fortior, 176. 

Alcohol Dilutum, 137. Bromum, 250. 

Alcohol, 146. Chloroform Purif., 250. 



PRESCRIPTIONS. 447 

Specific Gravity is the relative weight of equal bulks of different 
bodies. The specific gravity of water at a certain temperature (generally 
59 F.) is taken as i, and that of all other substances is expressed in terms 
of this unit. The Pharmacopoeia gives very complete tables of percentages 
and specific gravities of Alcohol, Acetic, Hydrobromic, Hydrochloric, 
Nitric, Sulphuric and Phosphoric Acids, and of aqueous solutions of Po- 
tassa and Soda. The specific gravity of any substance is expressed by the 
quotient obtained by dividing the weight of a given measure of the sub- 
stance by the weight of an equal measure of water. In pharmacy the 
specific gravity of solids is not of any importance, but that of liquids is a 
matter of constant value, and is determined in most cases by means of a 
specific gravity bottle or by a hydrometer, instruments which are described 
in any standard work on chemistry or physics. Modifications of the 
hydrometer with scales adapted to particular work are the urinometer, 
saccharometer, lactometer, etc. 

Specific Volume is the relative bulks of equal weights of different 
bodies. In pharmacy it means the volume of the weight of a liquid com- 
pared with the volume of an equal weight of water at 59 F. The specific 
volume of a body is therefore inversely as its specific gravity, and is ex- 
pressed by the quotient obtained by dividing unity by the specific gravity, 
^^r = sp. vol. and therefore sp. gr. X sp. vol. = 1. 

[A table of the specific gravity and specific volume of several liquids 
will be found in the Appendix.] 



PRESCRIPTIONS. 

Extemporaneous Prescriptions are formulae written by the phy- 
sician on the instant (ex tempore) to meet the requirements of individual 
cases. A prescription should begin with the name of the person for whom 
it is designed, and the date on which it is written. Then follows the 
Latin word Recipe, usually abbreviated to the sign R, and signifying 
"Take," or " Take thou;" next the names and quantities of the ingre- 
dient to be used, which are also expressed in Latin ; then the directions 
to the compounder, followed by the directions to the patient, the last 
being now usually expressed in English ; and finally the signature of the 
prescriber. 

A prescription then consists of four parts, viz. ; — the 

Superscription, — 'Consisting of the name of the party, the date and the sign & . 
Inscription,— the body of the prescription, which may consist of the — 

Basis, — or chief, active ingredient. 

Adjuvant, — to assist the action of the basis. 

Corrective, — to correct some injurious quality of the other ingredients. 

Vehicle or Excipient, — -giving it a suitable form. 



44-8 PRESCRIPTIONS. 

Subscription, — the directions for the compounder, usually expressed in contracted Latin. 
Signature, — the instructions for the guidance of the one administering the medicine, in 
English, followed by the signature of the prescriber. 

A prescription may, however, contain the base alone, or the base with 
the adjuvant, or the base with a simple vehicle or diluent, etc. A single 
ingredient may serve a double or treble office, as the Syrupus Rhei Aro- 
maticus with Quinine, in which case the syrup serves as an adjuvant to 
increase the action of the quinine, as an excipient to cover the taste, and 
as a vehicle to facilitate the administration of the dose directed. The 
basis may not need any aid in doing its work, and may require no correc- 
tive of its action nor any special vehicle. On the other hand there is no 
limit to the number of ingredients which may be used, provided the 
prescriber has a clear idea of something to be accomplished by each one, 
and also provided that there is no chemical or medicinal incompatibility 
between them. In olden times prescriptions were very complex, and 
contained a great many curious and incongruous ingredients. As Dr. 
Piffard well says " the tendency of the present age is toward mono- 
rather than poly-pharmacy, and prescriptions with the orthodox adjuvans 
and corrigens are less frequently seen than formerly." There is danger, 
however, in carrying this simplicity too far, for there is no doubt but that 
proper combinations of medicines will often produce effects for the 
patient's good, which could not be obtained from the use of any one 
remedy. 

An example will perhaps make the foregoing analysis more comprehen- 
sive, and at the same time serve to indicate the style of abbreviation 
usually employed. The following formula is that of the Pharmacopoeia 
for the Compound Infusion of Senna, or the old-time "Black Draught," 
except that approximate weights and measures are substituted for the 
pharmacopceial parts: — 

For Mrs. Steele. July 6th, 1886. ~» 

Recipe, Take, — j 

(" Sennce, semiunciam, "| 

/Ti ■ \ ' Of Senna, half an ounce ; 

^ '' 1 Magnesii Sulphatis, 

I Magnesium Sulphate ; 
, . ,. n J Mannce, ana tinciam unam, 

(Adjuvant.) | Manna, of each an ounce ; [-INSCRIPTION. 

ir ^ N f Fceniculz, drachmam unam, 

(Corrective.) j Of Fennel, one drachm ; 

(\T V 1 , \ J Aqua Bullientis,fluiduncias octo, 

^vemcie.j ^ Qf Boiling Waterj eight fluid ounces< 

Macera per horam in vase clauso, deinde cola. 

Macerate for an hour in a closed vessel, then strain. 

Signa, Mark, or Write thus — A wineglassful every four hours till it \ 

operates. \ SIGNATURE. 

T. F. Wood, M. D. ) 



Superscription. 



V 



Subscription. 



Abbreviated in the style usual with physicians the above prescription 
would read as follows, viz. : — 



PRESCRIPTIONS. 449 

For Mrs. Steele. July 6th, 1886. 

Senna, ^ ss 

Magnes. Sulph., 

Manna, aa ^ j 

Funiculi, 3 j 

Aq. Bull., fj§viij 

Mac. per hor. in vase clauso, deinde cola. 
Sig. — A wineglassful every four hours till it operates. 

Wood. 

The above is given as an example of an ordinary compound prescrip- 
tion, but as the result is nearly identical with an official preparation, we 
might write the prescription simply as follows : — 

B. lnfusi Sennoz Compos., §viij. 

and this is the manner of prescribing the official compound preparations. 
It will be noticed that the term "basis" in the analysis of the formula 
covers two ingredients ; but either of the two might be considered the 
principal agent, and the other one classed as an adjuvant. 

As Pareira says, " These four parts of a formula are intended to accom- 
plish the object of Asclepiades, curare cito, tute et jucunde ; in other 
words to enable the basis to cure quickly, safely, and pleasantly. 

The Principles of Combination are so well laid down by Dr. H. 
C. Wood, that his words are appended verbatim, as follows : — 

The art of combining medicines is not a difficult one ; but in practice certain principles 
should not be lost sight of. Chief of these are, to prescribe as few remedies as possible, 
and to use no powerful drug without a very distinct idea of what it is intended to do. 
Whenever it is desired to give a powerful remedy in increasing doses until its physiotegical 
effect is produced, it should always be given by itself. Thus, it may be necessary to give 
arsenic so as to impress the system, at the same time that iron is indicated ; but the two 
remedies should be given separately, so that the dose of either can be increased or dimin- 
ished independently of the other. 

The principles of combination formulated below were long ago enunciated by Dr. Paris, 
but are to-day as imperative as ever. Medicines are combined — 

First. To augment, correct, or modify the action of a medicine. Thus, purgatives act 
much more kindly when a number of them are united together. The chief reason of this 
probably is, that as different remedies affect different portions of the gut, the whole intes- 
tine is best reached by a union of the diverse substances. It may take an intense irrita- 
tion of the mucous membrane to purge as actively as does a mild irritation of both the 
mucous membrane and the muscular coat. In the case of neurotics the principle has a 
very limited action, because so many of this class of remedies are physiologically more or 
less antagonistic ; yet sometimes the principle can be advaniageously applied ; thus, the 
anaesthesia of Chloroform or Ether may be prolonged by a hypodermic injection of Mor- 
phia ; and Chloral and Morphia certainly make a mixture which is much more powerfully 
hypnotic than is either of the substances separately. 

Second. To obtain the joint action of two or more diverse remedies. Thus, in a cough 
mixture Morphia may be included to quiet the cough, whilst Ipecacuanha and Squill (in 
accordance with the first principle) are added to affect the mucous membrane. The 
application of this principle requires caution, or the practitioner will be led into that chief 
abomination — polypharmacy. It is worse than futile to attempt to prescribe for every 
symptom. It is the underlying cause of the disorder or the under-stratum of bodily con- 
dition which must be sought out and prescribed for simply. 

Third. To obtain a special combination, which is really a new remedy, or which expe- 
29 



450 PRESCRIPTIONS. 

rience has shown acts almost as a new remedy. Thus, when to Iodide of Potassium in 
solution Corrosive Sublimate is added, a new chemical compound is formed, which expe- 
rience has shown to be of great value in syphilitic diseases. Griffith's antihectic mixture 
is another instance of the use of chemical changes, the Proto-carbonate of Iron being 
formed out of the Sulphate of the metal and the Carbonate of Potassium. In the famous 
Dover's powder no chemical change occurs, but the ordinary action of Opium upon 
the skin is so enhanced that the combination may be looked upon almost as a new 
remedy. 

Fourth. To afford a suitable form. Thus, Acacia is added to make an emulsion, or 
Confection of Rose to make a pill. In the choice of excipients care should be exercised 
to select a substance free from medical properties, having no chemical incompatibility with 
the medicinal agent, and of suitable physical character. Bread crumbs often make a good 
basis for pills ; but with Nitrate of Silver they are chemically incompatible, on account of 
the chlorides in them. When writing a prescription, the utmost care should be taken to 
use such excipients that the combination should not only be attractive to the eye, but also 
as little repulsive to the palate as may be. Whenever possible, the pill-form should be 
employed with bitter or disagreeable medicines. The pill may be readily coated with 
silver-foil; tonic pills may be coated with Iron by shaking or rolling them in Ferri Pulvis 
whilst soft and sticky. Sugar-coated pills and "compressed pills" are apt to get so hard 
and insoluble that their use requires caution. In regard to mixtures, flavoring oils should 
be freely used, and the power of Glycerin to conceal the disagreeable taste of many sub- 
stances should be remembered. 



In Writing an Extemporaneous Prescription, the first step is 
to put down the superscription, consisting of the name, date, and the 
sign R. Next the name of each ingredient should be written in Latin 
and in the genitive case, each one on a separate line. Then the quantity 
of each article sufficient for one dose should be mentally determined and 
multiplied by the number of doses which the mixture is to contain, arid 
the result set down in signs and Roman numerals. The directions to 
pharmacist and to patient being added, and the preserver's name or 
initials affixed, the prescription is completed; but when very active agents 
are used, it is a good plan to go over the calculations a second time before 
letting it leave the hands of the person most responsible for its action. 
For pills or powders the same process should be employed, slightly varied 
according to the requirements of each case. Frequently the ingredients 
and quantities for but one pill, powder or suppository are named, with 
instructions to make a certain number after the formula. When an 
unusually large dose of any poisonous drug is prescribed, it is cus- 
tomary to underline the quantity, so as to call the attention of the 
compounder to the fact that the prescriber is aware that the dose is above 
the average. 

There is no royal road to prescription-writing; practice, care and 
knowledge of the whole subject is necessary to enable one to turn out 
habitually those elegant prescriptions which are properly termed " magis- 
tral," being the work of a magister, or master of his business. A fair 
knowledge of the Latin language is a sine qua non to every professional 
man, but especially to the physician. It is pitiable to see a Doctor write 
ignorantly of even the genitive case-endings of the drug-names which he 
uses. The teaching of Latin is not within the scope of this work, and 



PRESCRIPTIONS. 



451 



hence this part of the subject will be dismissed with the advice, to the 
physician who is ignorant of that language to write his prescriptions 
wholly in English if he cannot write them in decent Latin. 

Abbreviations, though very commonly used by physicians in pre- 
scribing, are a source of much annoyance to the compounder, and fre- 
quently one of great danger to the patient. Physicians who never knew 
anything of the Latin grammar, or those who have forgotten its rules, 
are very apt to use abbreviations to conceal their ignorance of case-end- 
ings. Many others use them through sheer laziness, and some from force 
of habit. The educated and conscientious man will take pride in turning 
out a full and clear prescription, free from cabalistic letters and all ele- 
ments of uncertainty. In the Appendix will be found a list of the Latin 
terms used in prescriptions, with the abbreviations in vogue, and the 
English meaning. Ambiguous contractions may result fatally to the 
patient, as is readily seen by studying the following list, which gives a 
few examples of the dangers of careless abbreviation : — 



Aconit. 
Amnion. 
Aq. Chlor. 
Aq. Fontis. 

Chlor. 
Hyd. Chlor. 



Acid. Hydroc. — may mean 

f Aconitine. 
\ Aconitum. 

( Ammonia. 
\ Ammoniacum. 
j Aqua Chlori. 
\ Aqua Chloroformi. 

f Might easily be read 
\ Aqua Fortis. 

{Chlorine. 
Chloral. 
Chloroform. 
Calomel. 

Corrosive Sublimate. 
Hydrate of Chloral. 



f Acidum Hydrochloricum. 
( Acidum Hydrocyanicum. 



Hydr. 



Sod. Sulph. 



C Hydrargyrum. 



Sulph. 



Zinci Phos. 



Hydras. 

Hydriodas. 
j Hydrochloras. 
[ Hydrocyanas. 
\ Sodium Sulphate. 
{ Sodium Sulphite. 
L Sodium Sulphide. 
[ Sulphur, 
j Sulphide. 
] Sulphate. 
[ Sulphite, 
f Zinc Phosphate. 
( Zinc Phosphide. 



Prescription Blanks. After many years' experience in prescribing 
on blanks furnished by druggists, the writer has come to the conclusion 
that it is much better, for many reasons, for the physician to have his own 
blanks, without the address of any drug-store thereon. These blanks 
should be furnished with stubs on which to write the prescription at first 
in rough, afterwards copying it out cleanly on the main blank. A care- 
ful prescriber always writes a formula twice before letting it go out of his 
hands. If he does the first writing on the stub of a book of blanks he 
will always have a copy of such prescription in his possession, for which 
he will often be thankful. The blank used by the writer measures 4^ 
inches by 3^, joined by a perforated edge to a stub 3^ inches by 2^ 
inches. On the main blank the physician's name and address are printed, 
together with his office hours, and a place for number and date, also the 
sign R., and a line for signature. On the stub there are printed the 



452 PRESCRIPTIONS. 

words, " Copy of Prescription No 189. . For . . . . , " 

and on the back of the main blank occurs the following printed legend 
in red ink : 

A Prescription written on this side 

OF THE SHEET MUST NOT BE RENEWED 
UNDER ANY CIRCUMSTANCES WHATEVER, 
WITHOUT MY ORDER. 

, M. D. 

These blanks are bound up in books of 100 each, with a flexible morocco 
cover, from which the book of stubs may be slipped and a fresh book in- 
serted as required. The size is ample for all ordinary requirements, and 
permits of the book being carried in the breast-pocket. 

Renewals. — It would be advisable for physicians to always write the 
words " Non Repetatur, " or some similar direction, on all prescriptions 
which should not be repeated without their sanction. By so doing they 
would doubtless cut off a good many renewal charges from the receipts 
of druggists who would fear the legal consequences of disobeying the 
mandate. This inconvenience to the drug-seller would -be more than 
compensated for in the protection to the drug-taker, who too frequently 
carries in his pocket-book a stock of recipes for his various complaints ; 
and in protection to the physician, who by giving up the dispensing of 
his own medicines has placed it in the power of the druggist to connive 
at a direct robbery of the just reward of professional skill and knowledge. 

It is doubtless a fact familiar to every observer, that the old-time con- 
fidential relations between the professions of physician and pharmacist 
have almost passed into oblivion. In fact, the tendency of pharmacy 
now-a-days is towards the position of a mere money-making trade, instead 
of in the exalted direction of a profession. The indiscriminate renewing 
of prescriptions, the open sale of quack nostrums and homoeopathic pel- 
lets, the readiness with which counter-prescribing is indulged in, the 
insinuations too frequently made over the drug-counter in reflection 
on physicians, and many other similar practices, have caused the non- 
combatant profession to regard the average druggist with suspicion. If 
physicians boldly took the dispensing of medicines more into their own 
hands many of these evils would soon eliminate themselves from the drug- 
stores. Right here, it may be said that there is nothing unprofessional or 
derogatory in the dispensing of his own medicines by the physician. In 
England it has been the universal practice for centuries in all places 
except the largest cities, and it has only been given up by a part of the 
medical profession as a matter of convenience, not as a right. The homoeo- 
paths fought for the reclamation of this practice as a right belonging to 
the medical profession, and succeeded in its legal establishment, but not 
from a worthy motive. They dispense their own medicines in order to 



PRESCRIPTIONS. 453 

cover up the many frauds of which they are daily guilty, and to give them 
the power of administering full doses of powerful drugs in a form which 
is apparently "homoeopathic, " with no tell-tale prescription on file in a 
drug-store to give mute but dangerous evidence against their honesty. In 
this way they administer several grains of Calomel or eighth-grain doses 
of Morphine, or correspondingly large quantities of active alkaloids, 
triturated with sugar of milk, or dissolved, as many of the latter may be, 
in alcohol. Chemistry, by isolating the active principles of plants, and ' 
furnishing them to commerce in the form of soluble salts, has enabled the 
homoeopath to practice this fraudulent method of dispensing drugs, which 
the innocent and ignorant patient, who believes in the power of the mini- 
mum dose, supposes to be infinitesimal in amount. But the physician of 
the regular profession is too apt to think that if he adopts a practice which 
charlatans have appropriated to themselves, he may be classed with them 
by his professional competitors. Hence, many regular physicians are 
absolutely afraid to use such drugs as Aconite, Belladonna, Gelsemium, 
Arnica, Rhus, etc., all of which are official, and most of which are older 
than homoeopathy in medicine ; and avoid pocket-cases, drachm-vials 
and triturations, as badges of charlatanism. It is high time that we 
asserted our independence in all these matters, and made use freely of 
those means which are recommended by our individual judgments as pro- 
motive of the best results to our patients and to ourselves. With a small 
stock of reliable fluid extracts, such as are manufactured by Parke, Davis 
& Co., of Detroit, or Dr. Edward R. Squibb, of Brooklyn, — an equally 
moderate supply of gelatin-coated pills and compressed tablets from the 
best houses, such as McKesson & Robbins, Schieffelin & Co., Warner & 
Co., Wyeth & Co., physicians could check-mate the unscrupulous prac- 
tices of many druggists to a great extent, save their patients many dollars, 
and retain many a dollar for their own pockets, which under the present 
system goes to their enemies. The homoeopaths understand the money 
part of the argument well. When their patients' medicine is exhausted, 
the doctor must be seen for a fresh supply, meaning of course another 
consultation about symptoms, a change perhaps from Mercurius Dulcis 
to Mercurius Vivus, and another fee. The expense is nothing, sugar 
of milk being cheap, and there is no prescription in the patient's pocket- 
book, to be renewed scores of times (paying toll however every time 
to the druggist), and finally to be copied- by aunts, mothers and friends, 
as a sovereign remedy for a cough, or a really wonderful receipt in a 
case of croup. 

Filling a Prescription means a combination of operations which 
requires great care, undivided attention, and a special practical appren- 
ticeship at the dispensing desk. In the following discussion of extempo- 



454 PRESCRIPTIONS. 

raneous preparations such hints are incorporated as are particularly 
applicable to the compounding of each article under consideration \ and 
they may be prefaced by a few general suggestions which will serve to 
point out the most approved method of dealing with this important part 
of the druggist's work. 

The prescription should first be slowly read over in a critical spirit, but 
no word or action of unfavorable criticism should reach the ears or eyes of 
the messenger. To shrug the shoulders while scanning the items, to 
laugh or even smile at the phraseology, to question the person offering it 
as to whom it is for, or what complaint it is given for, are instances of 
such flagrant treason to the prescriber as would justify the most complete 
professional ostracism of the offender. The compounder has no business 
whatever with the propriety of the recipe for its purpose. It might have 
been given as a placebo for reasons eminently wise and judicious ; or if 
not so constituted it has at least been ordered by one who is in possession 
of facts which the druggist knows nothing about, even if by education 
and experience he were competent to judge in the matter, which he sel- 
dom is. His criticism should be directed only to the dosage and the 
pharmaceutical compatibility of the ingredients. Even in the latter case 
he must remember that incompatibles are often prescribed with the view 
of forming another agent from the chemical reaction produced. If he 
thinks that there is any mistake, and the drugs ordered are in any degree 
poisonous, it is his duty to make an excuse for delay to the messenger and 
at once communicate with the physician. This course, in these days of 
telephones, is nearly always practicable. 

After reading the prescription, it is well to number it and write the 
label. This gives time for the label to dry, and avoids the use of blotting 
paper, which often mars the writing and renders the directions all but 
illegible. 

A clearly defined method should next be decided on by which to 
compound the prescription. Directions for such plans of procedure will 
be found in the succeeding pages under the titles of the various prepara- 
tions. Next, the ingredients should be carefully weighed or measured 
out, each one being checked off so as to avoid the danger of its being 
duplicated. In many cases the excipient is not specified, its choice being 
left to the druggist ; but in all such a note should be made on the pre- 
scription to show the article used, in order that in the event of a renewal 
there may be no difference perceptible. No alteration or addition should 
ever be made which would in any degree affect the medicinal action of 
the prescription, or interfere with the obvious intention of the prescriber. 

The labelling of the package and the numbering and filing of the pre- 
scription are matters of mechanical detail which are best learned at the 
counter. Various devices for simplifying these operatidns are in vogue 



PRESCRIPTIONS. 455 

and may be seen in any well-appointed drug-store. Poisonous articles 
sold by the druggists should always be labelled " Poison," and the trans- 
action entered in a book usually required by law to be kept for that pur- 
pose ; but in the case of prescriptions the word "Poison" should not 
appear on the package or label unless so directed by the prescriber. 



Stock Solutions of the salts most frequently prescribed are kept in 
many establishments for convenience in dispensing. Those most gener- 
ally used are the following : — 

Alum, — ^ ijss in a quart of distilled water. Of this solution each fluidounce represents 
gss of the salt. 

Potassium Bicarbonate, — ^j in f^iv of distilled water; of which ^ ss contains gj of 
the salt. 

Potassium Chlorate, — I in 24^of distilled water, will not crystallize as the temperature 
changes. 

Potassium Bromide, — I in 3 of distilled water, makes a very convenient solution for 
dispensing purposes. 

Chloral Hydrate, — I in 1 of distilled water ; of which each minim contains a grain of 
chloral. 

Morphine Sulphate, — gr. xvj in %'} of distilled water, with a grain of Salicylic acid or 
3 drops of Carbolic Acid to prevent change. Of this solution, known as Magendie's, each 
minim contains gr. J^ of the salt, and Tn^x contain gr. i. A safer solution is the Liquor 
Morphiae Sulphatis of the U. S. P., 1870, which had one grain of the salt in each fluid- 
ounce. 

Carbolic Acid, — 3J in f^iv of glycerin, makes a convenient solution which will mix 
with water in all proportions, mjvss represent gr. j of the acid. 

Tannic Acid, — ^j in f ^iv of glycerin, dissolved by the aid of a gentle heat, mjvss 
represent gr. j of the acid. 



The following rules for the pharmaceutical student are quoted from the 
Chemist 's and Druggist 's Diary for 1885. They are well worth remem- 
bering. 

1. Read through a prescription, rapidly and in a manner suggesting no suspicion or 
doubt. 

2. Write directions invariably before dispensing. Avoid thus the use of blotting- 
paper ; a good dispenser uses almost none. 

3. If a mixture contains readily soluble ingredients, never use a mortar. 

4. Avoid effecting solution by heat, for fear of recrystallization. 

5. With syrups and also ingredients not water, arrange in dispensing to rinse out the 
measure and leave it clean ; a skilled dispenser shows very little traces of his work. 

6. Carefully clean and put away weights and scales after each operation. 

7. Jloldthe scales firmly by the left hand, never lift them high above the counter, and 
judge of the weight as much by the indicator as by the position of the scale. 

8. Select glass pans for scales, preferably of heavy make, and discard flimsy brass 
material, which corrodes speedily and becomes inaccurate. 

9. Learn to judge of the quantity to be weighed with tolerable accuracy ; train the eye 
as well as the hand. 

10. If in doubt, always begin with that about which you have no doubt. 

11. Be rapid in manipulation. Finish wrapping, tying, or sealing quickly. Slow dis- 
pensing is bad dispensing, and arises either from deficient practice or want of knowledge. 

12. Never, when in a shadow of doubt, hesitate to ask advice from a fear of compro- 
mising your own dignity. 



45 6 INCOMPATIBILITY. 

INCOMPATIBILITY. 
Incompatibility may be Chemical, Pharmaceutical or Therapeutical, 
according to the prescribed combination results in chemical decomposi- 
tion, physical disassociation or antagonistic action. In the first case the 
incompatibility may be unintentional or intentional on the part of the 
prescriber, for in many cases the result of the chemical action affords the 
substance desired. 

Instances of intentional incompatibility are the mixtures of Calomel and Corrosive Sub- 
limate with Limewater, producing the Black and Yellow Oxides of Mercury respectively, 
and commonly known as " Black Wash " and " Yellow Wash." Such combination 
should not be filtered (as a novice might suppose), but should be dispensed with a 
" Shake-label," that the precipitate may be uniformly distributed before using. 



Chemical Incompatibility generally results from neglect on the 
part of the prescriber of the most common chemical reactions, such as — 
i. Acids tend to combine with bases and to form salts. 

2. Weak acids or bases are displaced from their combinations by 
stronger ones, so that salts in solution when brought together generally 
exchange their radicles, especially if by doing so an insoluble compound 
can be formed. 

3. A salt in solution is easily decomposed by a strong alkali if the salt 
is one having a weak or volatile base. 

4. A substance in solution may be decomposed by another without pre- 
cipitation, the product being soluble in the solution. 

5. Alkaloidal salts are precipitated from their solutions by the addition 
of fixed alkalies, their salts or salts which produce insoluble compounds. 
Oxides of the fixed alkalies decompose salts of the metals proper, and 
those of the alkaloids, precipitating their bases; but the base may be 
soluble in an excess of the alkali. 

6. Tannic or Gallic Acids and vegetable substances containing them 
precipitate albumen, alkaloids and most of the metallic oxides, and form 
inky solutions when brought into contact with the persalts of Iron. 
Tannic Acid precipitates gelatin. 

7. Glucosides are incompatible with free acids or Emulsin. 

Examples of the neglect of these principles are seen in the prescribing of Quinine Sul- 
phate in mixture with Potassium Acetate, resulting in a voluminous precipitate of Quinine 
Acetate which could not be poured from the bottle; — Vinegars or Syrups containing 
Acetic Acid (Syr. Allii, Syr. Scillse) added to a solution of alkaline carbonates, causing 
decomposition of the latter with evolution of C0 2 ; — the addition of Liquor Potassae to a 
solution of Ammonia-alum, setting free gaseous ammonia; — the mixing of Strychnine 
Sulphate and Potassium Bromide in solution, causing the decomposition of the alkaloid 
sulphate and precipitation of Strychnine; — preparations of Cinchona with salts of Iron, 
forming an inky tannate of Iron ; Elixir of Chloral with alkalies, causing the elimination 
of Chloroform and its subsequent evaporation, etc., etc. 

The following table shows the most important instances of solutions 



INCOMPATIBILITY 



which mutually precipitate each other, the letter P meaning 
precipitate with" : — 



457 
forms a 



Table of some Mutually Pre- 
cipitant Solutions. 


c 
.2 

"o "£ 

cos 

T3 C 

rt — ' 
< 


a 

.2 

.sS 

lis 


o 
"o 

CO 

u 


c 

CO 
V 

J> 

CO 


c 
.2 

J3 

"o 

CO 

.2 
U 


c 

.2 

"o 

CO 

u 
e 
be 

3 


_o 

"o 
CO 

o 

c 

a 

s 

< 


■J) 

a 
.2 

"o 

CO 

3 
O 

O 




P 
P 
P 

"P 
P 

P 


P 
P 
P 

"p 

P 

"P 

P 
P 


P 
P 
P 
P 
P 
P 
P 
P 
P 
P 
P 
P 


p 
p 
p 
p 
p 
p 
p 
p 
p 
p 
p 
p 


P 

"P 

P 
P 


p 
"p 
"p 


p 


P 


Tannic Acid, .... 

Carbonic Acid and Sol. of Carbonates, . . . 
Sulphuric Acid and Sol. of Sulphates, . . . 
Phosph. Acid and Sol. of Phosphates, . . . 

Boric Acid and Sol. of Borates, 

Hydrochloric Acid and Sol. of Chlorides, . 
Hydrobromic Acid and Sol. of Bromides, . 
Hydriodic Acid and Sol. of Iodides, .... 













( 



The following more or less insoluble salts will be formed whenever the 
materials of which they are composed are brought together in solutions: 
the Hydrates, Carbonates, Phosphates, Borates, Arseniates and Tannates 
of most earthy and heavy metals and alkaloids, and the metallic Sulphides ; 
the Sulphates of Calcium and of Lead, and the subsalts of Mercury ; the 
Chlorides, Iodides, and Bromides of Bismuth, Silver, Lead, and subsalts 
of Mercury ; the Iodides of Quinine, Morphine, and most alkaloids. 

Instances are — Limewater or Aromatic Spirit of Ammonia with Tincture of Chloride 
of Iron, or solutions of Mercury salts, or neutral solutions of Quinine or Morphine salts. 

Ammonium, Potassium, and Sodium carbonates or bi-carbonates with Limewater. 

Solutions of Magnesium Sulphate, Alum, Zinc Acetate, or Sulphate with solutions of 
salts of Iron, Manganese, Bismuth, Antimony, Lead, and of most alkaloids. 

Ammonium or Sodium Phosphates with solutions of Iron salts, with Limewater, solu- 
tion of Magnesium Sulphate, of Alum, etc. 

Liquor Potassii Arsenitis with Limewater, with solutions of basic salts of Iron, and of 
neutral salts of Quinine and Morphine, etc. 

Solutions. Decoctions, Tinctures, and Extracts containing Tannic Acid with solutions 
of salts of Iron, Mercury, Antimony, Lead (as also with solutions containing albuminous 
substances and Gelatin). 

Limewater with solutions of Quinine and Morphine Sulphates. 

Solutions of Lead Acetate with Zinc Sulphate or Alum. 

Sodium Chloride with Silver Nitrate. 

Morphine Hydrochlorate with Lead Acetate. 

Alkaline Iodides or Bromides with Bismuth Carbonate or Sub-nitrate, with Lead Ace- 
tate, with Subchl-oride of Mercury, or with neutral solutions of Quinine, Morphine, and 
Strychnine salts. 



Explosive Compounds result from the admixture of powerful oxid- 
izing agents with substances which are readily oxidizable. The most 
important members of these two classes are as follows : — 



, 



458 INCOMPATIBILITY. 

Oxidizers. Oxidizable or Combustible. 

Nitric Acid. Chromic Acid. Glycerin, Sugar, Alcohols. 

Free Hydrochloric Acid. Oils and Ethers. 

Nitro-hydrochloric Acid. Sulphur and Sulphides. 

Potassium Chlorate. Dry Organic Substances. 

Potassium Permanganate. Phosphorus. 

Explosions have resulted from mixing Fluid Extract of Uva Ursi with certain samples 
of Spirit of Nitre, Chromic Acid with Glycerin, Permanganate of Potassium with Glycerin, 
Nitric Acid with Glycerin, Nitrate of Silver with Creasote, Oxide of Silver in pill with 
Extract of Gentian, Potassium Chlorate with Glycerin and Tincture of the Chloride of 
Iron. Chloride of Lime triturated with Sulphur in a mortar has exploded, so also has 
Calcium or Sodium Hypophosphite when triturated alone. Tincture of Iodine with 
Ammonia forms the Iodide of Nitrogen, which is highly explosive, especially if triturated 
in the presence of water. Catechu and Potassium Chlorate in a dentifrice have exploded 
in the mouth from the friction produced by a dry tooth-brush. 



Poisonous Compounds may be formed by the admixture of many 
substances in solution, such as — 

Potassium Chlorate with Potassium Iodide, in solution together do not 
react at ordinary temperatures, but in the system they evolve a poisonous 
agent, probably the Iodate of Potassium. 

Potassium Chlorate with Syrup of Iodide of Iron, liberates Iodine from 
the Iodide in the warm stomach, causing severe gastric irritation,. perhaps 
gastritis of dangerous degree. 

Dilute Hydrocyanic Acid or Potassium Cyanide, with Calomel, forms 
the Bichloride and Bicyanide of Mercury, both virulent poisons; — with 
metallic hydrates, carbonates, sub-nitrates, or sub-chlorides, cyanides of 
the metals are formed which are even more poisonous than the acid itself 
in its usual diluted form. 

Pharmaceutical Incompatibility differs from chemical incompati- 
bility in the absence of chemical action, and is generally produced by 
adding one substance to another which, through differences in solubility, 
causes a precipitation of solid matter or a separation of part of the liquid. 
The constituents separated may be active and hence important, or inert 
and therefore unimportant. 

Instances of this are — the addition of an acid to a Quinine and Liquorice mixture, result- 
ing in precipitation of the Glycyrrhizin (relied on to cover the taste of the Quinine) by the 
acid; — or the use of Quinine, Tincture of Ferric Chloride and Liquorice together; — or 
the prescribing of solutions of Chloral and Potassium Bromide with an alcoholic prepara- 
tion, the Chloral separating to the top as an alcoholate, and therefore dangerously in 
excess for the first few doses ; — or the neglect to prescribe Acacia or some other emulsifier 
in mixtures of an alcoholic fluid extract of a resinous body with an aqueous preparation, 
which would result in the separation of the resin to the surface and an overdose with the 
first teaspoon ful. 

When the fluid extracts are diluted with liquids differing in composition 
from those used in the fluid extracts, the gum, albumen, resin, and mucil- 
age are often separated. In such a case as Fluid Extract of Cannabis 



INCOMPATIBILITY. 459 

Indica the active resin would be thrown out of solution, and floating on 
top might cause serious symptoms ; but in many other instances the pre- 
cipitate would be inert and filtration would be in order. Water is the 
solvent for albuminous, gelatinous, gummy, and saccharine bodies and for 
a large number of inorganic salts ; while Alcohol is the solvent for vola- 
tile oil and resins, gum-resins, resinoids, balsams, and all drugs contain- 
ing these as their active principles. The solvent power of either Alcohol 
or Water for their particular substances decreases in proportion to the 
amount of the other added. 

Instances of Pharmaceutical Incompatibility. 
Resinous tinctures of Fluid Extracts with aqueous solutions. 
Tincture of Guaiac with spirit of nitric ether. 
Compound Infusion of Gentian with infusion of wild cherry. 
Compound Infusion of Cinchona with compound infusion of gentian. 
Essential oils with aqueous liquids in quantities exceeding I drop to J;j. 
Fixed oils and Copaiba with aqueous liquids (except excipients). 
Tinctures made with Alcohol with those made with diluted alcohol. 
Alcoholic tinctures and fluid extracts with aqueous preparations. 
Spirit of Nitric Ether with strong mucilages. 
Infusions generally with metallic salts. 



Therapeutical Incompatibility arises when two agents are admin- 
istered together which oppose each other in their action on the human 
system,— as for instance Belladonna in any form with Physostigma. But 
in many cases physiological antagonists are designedly prescribed together, 
one as a guard against the action of the other, as in the hypodermic ad- 
ministration of Morphine guarded by Atropine. The antagonists to each 
of the active medicinal agents may be found in the section on Materia 
Medica under their various titles ; but they may be well summarized, as 
to the most important ones in the following list. 

Physiological Antagonists. 

Aconitine, — Atropine, Digitalin, Strychnine. 

Alcohol, — Strychnine. 

Ammonium Chloride, — Chloral hydrate. 

Atropine, — *Aconitine,*Bromal-hydrate, Chloral-hydrate, Hydrocyanic Acid, Jaborandi, 

Muscarine, ^Morphine, Physostigmine, Phytolacca, Pilocarpine, Quinine. [Those 

marked * will not prevent death from a lethal dose of Atropine, though the latter will 

prevent death from a lethal dose of either of them.] 
Barium, — Sodium Sulphate, Potassium salts. 
Bromal-hydrate, — Atropine. 
Brucine, — Chloral-hydrate. 
Calabarine, — Chloral- hydrate. 
Carbolic Acid, — Chloral-hydrate. 
Chloral- hydrate, — Ammonium Chloride, Atropine, Brucine, Calabarine, Carbolic Acid, 

Codeine, Physostigma, Picrotoxine, Strychnine, Thebaine. 
Chlorofortn, — Amyl Nitrite. 
Cocaine, — Morphine. 
Codeine, — Chloral-hydrate. 
Digitalin, — Aconite, Muscarine, Saponin. 
Gelsemium, — Opium, Atropine. 



, 



460 INCOMPATIBILITY. 

Morphine, — Atropine, Caffeine, Chloroform, Cocaine, Daturine, Hyoscyamine, Nicotine, 

Physostigma. 
Muscarine, — Atropine. 

Opiutn, — Atropine, Gelsemium, Veratrum Viride. 
Physostigma, — Atropine, Chloral, Morphine. 
Saponin, — Digit alin. 

Strychnine, — Alcohol, Chloral, Hydrocyanic Acid, Nicotine, Nitrite of Amyl. 
Thebaine, — Chloral-hydrate. 



The Dangers of Incompatibility may in a great measure be 
avoided by the use of the utmost simplicity in prescribing. The subject 
can only be glanced at within these pages, but the following simple rules 
may help the burdened memory of the student and the practitioner. 

(1). Never use more than one remedy at a time, if one will serve the 
purpose. 

(2). Never use Strong Mineral Acids with other agents, unless you 
know exactly what reaction will ensue. They decompose salts of the 
weaker acids, and form ethers when combined with alcohol. Never com- 
bine free acids with hydrates or carbonates. 

(3). Select the simplest solvent, diluent or excipient you know of, re- 
membering that the solvent power of alcohol and of water for their 
respective substances decreases in proportion to the quantity of the other 
added. 

(4). Generally do not combine two or more soluble salts ; for such 
salts in solution, when brought together, usually exchange their radicles, 
thereby forming an insoluble compound. 

The following more or less insoluble salts will be formed whenever the materials of 
which they are composed are brought together in solutions : the Hydrates, Carbonates, 
Phosphates, Borates, Arseniates and Tannates of most earthy and heavy metals and alka- 
loids, and the metallic Sulphides ; the Sulphates of Calcium, of Lead, and the subsalts of 
Mercury ; the Chlorides, Iodides, and Bromides of Bismuth, Silver, Lead, and Mercury ; 
the Iodides of Quinine, Morphine and most alkaloids. 

(5). Never order a drug in combination with any of its Tests or Anti- 
dotes. 

(6).. Never prescribe a Glucoside, (as Santonin, Colocynthin, etc.), in 
combination with free acids or with a substance containing Emulsin, as 
these agents will decompose it. 

(7). Aconite should be ordered in water alone, Mercuric Chloride by 
itself in water or in simple syrup. The latter drug is incompatible with 
almost everything, even the Compound Syrup of Sarsaparilla being said 
to decompose it. 

(8). Iodide of Potassium decomposes most of the metallic salts, and is 
one of the drugs which are best administered alone. 

(9). The following named substances are incompatible with so many 
others that it is best to always prescribe them alone ; they are best given 
in simple solution : — 



EXTEMPORANEOUS PREPARATIONS. 46 1 

Dilute Hydrocyanic Acid. Morphine Acetate. 

Dilute IS ltro- hydrochloric Acid. Morphine Hydrochlorate. 

Sulphuric Acid. Quinine Sulphate. 

Mercuric Chloride (Corr. Sub.). Liquor Calcis. 

Iodine and Iodides. Liquor Potassse. 

Syrup of the Iodide of Iron. Liquor Potassii Arsenitis. 

Potassium Permanganate. Liquor Ferri Nitratis. 

Potassium Acetate. Tinct. Ferri Chloridi. 

Potassium Bromide. Zinc Acetate. 

Tartar Emetic. Citrate of Iron and Quinine. 

Tincture of Guaiac. Free Chlorine in Solution. 
Tannic and Gallic Acids. 

(10). Silver Nitrate and the Acetate and Sub-acetate of Lead, though. 
incompatible with almost everything, may be combined with Opium, the 
latter forming with Opium a compound, which, though insoluble, is 
therapeutically active as an astringent and anodyne lotion. Silver Ni- 
trate with Creasote forms an explosive compound. 

(11). Tannic and Gallic Acids, and substances containing them (as the 
Astringent Bitters), precipitate albumen, alkaloids and most soluble 
metallic salts. They may be prescribed with the proto-salts of Iron, but 
not with its per-salts. Calumba is the best vegetable tonic to use with 
ferric salts, as it contains neither tannic nor gallic acids. Tannic Acid 
precipitates gelatin. 

(12). Iodine and the soluble Iodides are incompatible with the alkaloids 
and substances containing them, also with most metallic salts. 

(13). Alkalies neutralize free acids, and precipitate the alkaloids and 
the soluble non-alkaline metallic salts. Oxides of the Alkalies decompose 
salts of the metals proper, and salts of the alkaloids, precipitating their 
bases; but the base may be soluble in an excess of the alkali. 

(14). Resinous Tinctures or Fluid Extracts, {e. g., Tinct. Cannabis 
Indicse) when combined with aqueous solutions, should always have Aca- 
cia or some other emulsifying agent added, to prevent the separation of 
the resin, which otherwise will be deposited on the sides of the bottle or 
will float on top of the mixture. 

(15). Tincture of Digitalis should not be mixed with aqueous or syrupy 
solutions, for in such cases a decomposition of the active principles may 
occur, forming new and poisonous ones. 



LIQUID EXTEMPORANEOUS PREPARATIONS. 
Mixtures (Misturae), — in official pharmacy are aqueous preparations 
containing some insoluble ingredients held in suspension by an appropri- 
ate vehicle. In extemporaneous pharmacy, however, the term Mixture is 
applied to every fluid compound intended for internal use, except a few 
which bear distinctive titles, such as Emulsions, Draughts, Enemas, Elixirs 
and Drinks. The simplest form of mixture in this extended sense is that 



462 



EXTEMPORANEOUS PREPARATIONS. 



in which two or more liquids are mixed together ; but a great variety of 
substances may be prescribed in this form, chief among which are most 
of the soluble salts, light insoluble powders, salts which may be diffused 
by agitation, extracts, gum-resins, and the fixed essential oils. They are 
generally ordered in 2, 3, 4, 6, 8, 10 and 12-ounce vials. 

The substances suitable to the mixture-form, properly so called, are 
those which, though more or less insoluble in water, will mix with it by 
agitation, trituration, etc. Those most frequently ordered are as 
follows: — 



Diffusion by Agitation : — 
Calcii Phosphas Prsecip. 
Cinchonas Pulvis. 
Ipecacuanhas Pulvis. 
Magnesia. 
Quininas Sulphas. 
Sulphur Praecipitatum. 

Suspendible by Viscid Excipients . 
Essential Oils. 
Oleum Amygdalae. 
Oleum Morrhuae. 
Oleum Olivae. 
Oleum Ricini. 
Copaiba. 
Ferri Carbonas Saccharatus. 



Miscible only by Trituration 
Ammoniacum. 
Asafoetida. 
Confectio Rosas. 
Confectio Sennae. 
Extractum Aconiti. 
Ext. Belladonnas. 
Ext. Conii. 
Ext. Hyoscyami. 
Ext. Stramonii. 
Ext. Glycyrrhizae. 
Ext. Krameriae. 
Ext. Taraxaci. 
Guaiacum. 
Scammonium. 
Myrrha. 



Best suspended by the aid of a fixed oil or yolk of egg:— 

Ext. Cannabis Indicae. Oleum Terebinthinas. 

Camphora. Chloroformum. 

Solutions intended for internal administration are classed as Mixtures 
in extemporaneous pharmacy, for the reason stated above. The follow- 
ing list of acids and salts comprises most of the solids which are best 
adapted for use in liquid form, by reason of their solubility in water. 



Acidum Citricum. 

Acidum Tannicum. 

Acidum Tartaricum. 

Alumen. 

Ammonii Chloridum. 

Antimonii et Potassii Tartras. 

Barii Chloridum. 

Calcii Chloridum. 

Calcii Hypophosphis. 

Ferri Pyrophosphas. 

Ferri Sulphas. 

Ferri et Ammonii Citras. 

Ferri et Potassii Tartras. 

Ferri et Quininae Citras. 

Magnesii Sulphas. 

Mangani Sulphas. 

Potassii Acet&s. 

Potassii Bicarbonas. 



Potassii Carbonas. 
Potassii Citras. 
Potassii Chloras. 
Potassii Hypophosphis. 
Potassii Tartras. 
Potassii et Sodii Tartras. 
Potassii Bromidum. 
Potassii lodidum. 
Morphinae Acetas. 
Morphinae Hydrochloras. 
Morphinae Sulphas. 
Sodii Bicarbonas. 
Sodii Boras. 
Sodii Carbonas. 
Sodii Chloridum. 
Sodii Hypophosphis. 
Sodii Phosphas. 
Sodii Sulphas. 



A few require the use of viscid substances as vehicles or correctives. 
They are as follows : — 



EXTEMPORANEOUS PREPARATIONS. 463 

Ammonii Carbonas. Potassa. 

Plumbi Acetas. Potassii Cyanidum. 

Hydrargyri Chloridum Corrosivum. 

Certain salts are best ordered by prescribing such agents as will when 
in solution together react upon each other and produce the desired salt. 
Instances of this may be found in the pharmacopceial processes for most of 
the official Liquores ; the salts so produced being the following : — 

Ammonii Acetas. Ferri Nitras. 

Magnesii Citras. Ferri Phosphas. 

Potassii Citras. Potassii Arsenis. 

Ferri Citras. Potassii Hydras. 

Ferri Acetas. Sodii Hydras. 

Ferri Chloridum. Soda Chlorata. 

Hydrargyri Nitras. Zinci Chloridum. 
Arsenii et Hydrargyri Iodidum. 

Certain other substances require the addition of other agents in order 
to form eligible solutions. Such are the following: — 

Quinines Sulphas, — requires acidulated water for its solution, the acid used being gen- 
erally Sulphuric diluted, or the Aromatic Sulphuric. This method of prescribing this salt 
develops its bitter taste to the utmost, and is often avoided by ordering the drug to be sus- 
pended in a viscid liquid, such as Pulv. Acacias in Syrup of Ginger. In such a case an 
officious dispenser anxious to show his smartness may add some dilute Sulphuric Acid to 
dissolve the Quinine and thus defeat the object of the prescriber. 

Sulphate of Quinine may be prescribed with Aromatic Spirit of Ammonia, Spirit of 
Nitrous Ether, Tinctures or other alcoholic preparations together with Glycerin or Syrup 
and Water. In such cases the salt should be first dissolved in the alcoholic portion of the 
prescription ; then the glycerin or syrup, and finally the aqueous portions should be added 
gradually. It may also be ordered with dilute Sulphuric Acid and some vegetable infusion 
containing Tannin, in which case a precipitate of Tannate of Quinine will be produced. 
This of course should not be filtered, but should be dispensed with a " Shake-label." 

[For the use of " Veloutine " as a vehicle for the use of Quinine Salts, see ante, pages 

l87 ' 2I 3-] 

Chinoidin, Cinchonine Sulphate and Quinidine Sulphate, — also require the addition of 

dilute mineral acid for their solution in aqueous mixtures. 

Iodine, — requires the addition of Iodide of Potassium for its solution in a convenient 
quantity of water, as in the case of the official Liquor Iodi Compositus. 

Red Iodide of Mey-cziry, — requires the addition of Iodide of Potassium or Mercuric 
Chloride for its aqueous solution. 

Potassii Bitartras, Cream of Tartar, — requires the addition of Borax or Boric Acid for 
its solution in water. 

Benzoic Acid, — requires the addition of Borax to aid its solubility in water, an equal 
part of the latter making it 5 times more soluble than when alone. 

Lime, — is more soluble in sweetened water than in plain water, the sugar aiding its 
solution. 

Excipients are substances which give form and consistence to prescrip- 
tions, and serve as vehicles for the exhibition of the other ingredients. 
Some of the excipients are diluents, or agents which effect the dilution or 
division of the active ingredients ; while others act in the double capacity 
of diluents and flavoring agents. The excipients most generally used in 
mixtures may be tabulated as follows, viz. : — 

Diluents. True Excipients. 

Water (Aqua). Acacia (Pulv.). 

Medicated Waters (Aquae). Tragacanth (Pulv.). 



464 EXTEMPORANEOUS PREPARATIONS. 



Diluents. 




True Excipients. 


Syrup*. 




Sugars. 


Mel Rosae. 




Confections. 


Elixir Aurantii. 




Some Extracts. 

Yolk of Egg (Vitellus). 

Flavoring Agents. 


Oleum Cari. 




Tinct. Gentianae Comp. 


01. Caryophylli. 




Tinct. Aurantii Dulcis. 


Ol. Cinnamomi. 




Tinct. Vanillae. 


01. Gaultheriae. 




Spiritus Anisi. 


Ol. Sassafras. 




Spiritus Limonis. 


01. Amygdalae Amarae. 


Spiritus Myristicae. 


Tinctura Tolutana. 




Spiritus Menthae Piperitae 


Tinct. Zingiberis. 




Spiritus Menthae Viridis. 


Tinct. Cinnamomi. 




Spiritus Lavandulae. 


Tinct. Cardamomi. 




Syrupus Limonis. 


Tinct. Cardamomi 


Comp. 


Syrupus Tolutanus. 
Syrupus Zingiberis. 



Compounding the Mixture is a matter of no slight importance, and one 
which is best learned at the dispensing counter, though a few directions 
may not be out of place. In the case of the simplest form of mixture, 
where two or more fluid preparations are prescribed together, the only 
operations required are the measuring of the several ingredients and pour- 
ing them into the designed vial. In doing this the compounder should 
pursue a regular and definite order of procedure. Taking in his left hand 
a graduate of sufficient capacity to hold the whole quantity prescribed, he 
should walk along the shelves, and with the right hand pour from the 
stock-bottles the requisite quantity of each ingredient in the order in which 
they are entered on the prescription. A skillful clerk will hold the 
graduate between the thumb and first finger, the prescription between the 
second and third fingers, and the stopper of the stock-bottle between the 
little finger and the hand, leaving his right hand free for the manipula- 
tion of the bottles containing the ingredients. 

When an actively poisonous agent is ordered it should always be the last 
thing put into the mixture. Attention to this rule will prevent the danger 
of the toxic substance being put in twice. 

The order in which the ingredients are put together is not of so much 
importance in compounding a simple mixture as in the case of an emul- 
sion, and the order of the prescription can usually be followed, with the 
exception noted in the preceding paragraph. Still, when several alcoholic 
preparations, syrups and waters are ordered together, it is good practice to 
first mix the alcoholic fluids, then to add the syrups and finally the water, 
so as to avoid the precipitation of resinous principles which would occur 
if the alcoholic solutions were added to the water. Distilled water should 
always be used, in order to insure uniformity in taste and appearance, 
and also as a matter of purity and cleanliness. All mixtures should be 
well shaken before being labelled. 



EXTEMPORANEOUS PREPARATIONS. 465 

Solids which are comparatively insoluble or only slowly soluble require 
to be rubbed up in a mortar with one or more of the fluid ingredients. 
Glass mortars are much employed for this purpose, and many compounders 
mix all the ingredients in such a mortar before transferring them to their 
vial. Vegetable powders (as Rhubarb, Ipecac, etc.), or finely pulverized 
inorganic substances, are often ordered in intimate mixture with water, 
thickened with mucilage or syrup. In such cases the mixture should be 
made in a porcelain or wedgewood mortar, enough mucilage or syrup 
being added at first to make a thick paste, and after this is rubbed smooth 
the water may be gradually added during the continued process of mixing. 
This process will answer for all inorganic substances in powder, except 
Magnesia, which is best mixed by being thrown on the surface of the 
water, and after it has sunk to the bottom as a uniform sediment the other 
ingredients may be added, and the whole well shaken. Froth upon the 
surface of the liquid, which often arises after agitation, and may prevent 
the corking of the bottle, will quickly subside on the addition of a few 
drops of alcohol. 

The following are samples of prescriptions for medicines to be admin- 
istered in mixture form : — 



Bismuth Mixture for Children. 

R. Bismuthi Subcarbonatis, gij. 
Syrupi Acaciae, 
Aquae Cinnamomi, aa ^ij. 
Misce. Signa. — A teaspoonful every 
hour in choleraic diarrhoea. 



Quinine Mixture for Children. 

R. Quininae Sulphatis (pulv.), £ss. 

Pulveris Acacias, . . . . sjss. 

Syrupi Zingiberis, . . . ^ iv. 
Fiat mistura. Signa. — A teaspoonful 
thrice daily. 



Emulsions (Emulsiones), — are mixtures containing an oil or a resin- 
ous substance in a state of minute subdivision, and suspended in water by 
the aid of some viscid excipient, as gum, soap, alkali, or yolk of egg. 

Natural Emulsions comprise two classes of substances, — (i) those 
emulsions which exist ready formed in nature, as milk, yolk of egg, the 
milky juices of plants, etc. ; and (2) the mixtures formed by rubbing up 
gum-resins (as Ammoniacum, Myrrh, Asafetida) with water. Each of 
the latter substances contains, together with its resin, enough gum to make 
a perfect emulsion when triturated with water. The manufactured emul- 
sions are simply imitations of the natural ones, sufficient gum being added 
in case of a resinous substance to cause its suspension in the aqueous 
diluent. 

Emulsification consists in the division of the oily or resinous substance 
into very minute globules, and surrounding each globule with a thin envel- 
ope of the excipient. If properly done the globules will remain mechan- 
ically suspended in the water, without any tendency towards recombination. 
Milk is the best illustration of a natural emulsion, its butter existing in 
the aqueous portion as very minute globules, each surrounded by a thin 
30 



466 EXTEMPORANEOUS PREPARATIONS. 

film of casein. Yolk of Egg is a dense emulsion, consisting of oil sus- 
pended in water by means of albumen. 

The Excipients which may be used for emulsification are the follow- 
ing, arranged in the order of their most frequent employment, viz. : — 

Mucilage of Acacia, — used for oils and resins. Powdered Acacia is even better, being 
made into a mucilage by the process of emulsification; such a mucilage having the advan- 
tage of being perfectly fresh when incorporated with the other ingredients. To give 
uniformly good results the following proportions in parts by weight should be used, viz. : — 

Gum Acacia. Water. 

I part of Fixed Oils or Copaiba requires, y 2 % 

I " " Balsam of Peru " 2 \% 

I " " Oil of Turpentine " I 1 

Mucilage of Tragacanth, — may also be used for oils and resins, but it has not proved 
so satisfactory as the preceding. The same may be said of powdered Tragacanth. 

Vitellus, Yolk of Egg, — is an excellent agent for emulsifying oils, but mixtures made 
with it must be used within a few days, as they will not keep long. One yolk will emul- 
sionize an ounce of fixed oil, and is about equal to half an ounce of Acacia. It is best 
suited to emulsions of cod-liver oil intended for immediate administration. The official 
Mistura Chloroformi is an emulsion made with yolk of egg. Glyceritum Vitelli or Gly- 
conin is an official preparation consisting of glycerin and yolk of egg. (See ante, page 
408). One ounce of it will emulsify three ounces of fixed oil. 

Liquor Potassce, — may be used for oils, the resulting compound being however a soap 
rather than an emulsion. Copaiba is usually emulsified by using both a gum and an alkali; 
a similar process being employed for many of the fixed oils. 

Tincture of Senega, — will emulsify fats and oils very efficiently, and even in very small 
quantities, IT^x emulsifying an ounce of fixed oil. 

Tincture of Quillaia (Soap-bark), — is a good emulsifier for oils, and is much used in 
Europe for this purpose. 

Milk, — is used to emulsify Scammony in the Mistura Scammonii, which is official in 
the British Pharmacopoeia. 

Syrups, Confections and Extracts, — may be used in making emulsions, but are rarely 
so employed. 

Soap, — is occasionally used for emulsifying Oil of Turpentine. 

The Method of preparing an emulsion which experience has shown to 
be the best, is as follows: — Add the oil, resin, etc., to a proper quantity 
of the excipient, and mix both thoroughly in a wedgewood mortar. Then 
add enough water to equal one-half the weight of the previous mixture, 
and triturate the whole rapidly and unceasingly until the emulsion is homo- 
geneous and of a whitish color. Next, add the remainder of the water 
slowly, with continual stirring ; finally incorporating the other ingredients, 
if any. 

Emulsions are sometimes flavored and at the same time colored, with 
such a preparation as the Compound Tincture of Cardamom ; but they 
present a better appearance when perfectly white. Alcoholic preparations 
should not be added in large quantity to emulsions made with Acacia or 
Yolk of Egg, as alcohol will precipitate the emulsifying agent. Volatile 
Oils require admixture with a fixed oil before being made into an emul- 
sion. Soluble salts should never be prescribed with emulsions of oils. 
Acids are incompatible with mixtures which have been emulsified by an 
alkali. Mucilage used for emulsions should always be freshly prepared. 



EXTEMPORANEOUS PREPARATIONS. 



467 



The following examples of prescriptions for emulsions will represent 
those generally met with : — 



Cod-Liver Oil Emulsion 
R. Olei Morrhuse, 
Vini Albi, . . 
Ac. Phos. Dil., 
Syrupi, . . . 
Vitellum, . . 
Aq. Amygd. Amar. ad., . 
Misce, et fiat emulsio. 
Sig. — Tablespoonful doses 



J- 



Alkaline Emulsion of Copaiba. 
& . Copaibae, 

Liq. Potassse, aa £ij. 

Misce, et adde — 
Pulv. Acacise, 

Pulv. Sacchari, . ■ . . . aa 55 ij_ 
Aq. Menth. Viridis, «</, . . %'\v. 
Misce, et fiat emulsio. 

Sig. — Tablespoonful doses. 



Elixirs (Elixiria), — are mixtures containing alcohol, water and sugar, 
with certain medicinally active ingredients, and supposed to be so pre- 
pared as to be particularly palatable, which is seldom true. There is one 
official elixir, Elixir Auranlii (see ante, page 124), which may be used as 
a basis for the extemporaneous prescribing of these preparations. The 
manufacturers have put on the market a great variety of elixirs, and most 
druggists keep a stock of them on hand prepared in the shop ; but they 
may be ordered by prescription just as any other mixture would be. The 
substances generally used in this form are as follows : — 



Arsenic. 

Bismuth. 

Bromide of Ammonium. 

Bromide of Lithium. 

Bromide of Potassium. 

Calisaya Bark. 

Chloral Hydrate. 

Coca. 

Gentian. 



Guarana. 

Iron, Tincture of the Chloride. 

Iron, Phosphate. 

Iron, Pyrophosphate. 

Liquorice. 

Pepsin. 

Quinine. 

Strychnine. 

Taraxacum. 



Valerianate of Ammonium. 

Many of these agents are combined with each other, as in the Elixir of Bismuth and 
Strychnine ; Elixir of Calisaya, Iron and Strychnine ; Elixir of Gentian with Tincture of 
Chloride of Iron ; Elixir of Iron, Quinine and Strychnine, etc., eic. 

A Draught (Haustus), — is an extemporaneous mixture consisting of 
a single dose, and usually ordered in a vial containing from one to two 
fluidounces. 

Effervescing Draught is one of the best known. It is prepared by' neutralizing a 
watery solution of Potassium Bicarbonate with Lemon-juice or Citric Acid, and may be 
drunk during effervescence. When the C0 2 has escaped it is a solution of Potassium 
Citrate in water, and corresponds to the official Mistura Potassii Citratis, or Neutral 
Mixture. (See ante, page 330.) 

Black Draught is another well-known preparation of this class. It is official as In- 
fusum Sennse Compositum. (See ante, page 372.) 



A Drink (Potus), — is a solution or a mixture intended to be used ad 
libitum, and generally consists of a Potassium or Sodium salt ; or a min- 
eral acid, in dilute solution, sweetened and flavored. 



468 EXTEMPORANEOUS PREPARATIONS. 

The " Imperial Drink" is made after the following formula: R. Potassii Bitartratis, 
3 ij ; Olei Limonis, tt\v ; Aquae Bullientis, q. s. ad % xx. M. Fiat potus. Sig. — Use as 
a drink. 



A Gargle (Gargarysma), — is a mixture or solution for application to 
the pharynx or the mouth (mouth-wash). It should never contain any 
active drug, which would produce dangerous symptoms if swallowed ; 
nor any agent which would injure the teeth or the mucous membrane. 
Gargles are ordered and compounded in the same manner as mixtures. 
They usually contain astringent or disinfecting salts (Alum, Borax, Sul- 
phate of Zinc, Chlorate of Potassium), with a vegetable astringent, and 
often Honey. The following formulae will illustrate prescriptions of this 
class: — 



R . Tr. Guaiaci Ammoniatae, 

Tr. Cinchonae Comp., . . aagij. 

Mellis Despumat, . . . . gvj. 
Bene simul agita, et adde — 

Potassii Chloratis, . . . . gr. lxxx. 

Aquas, q. s., ad Jiv. 

Fiat gargarysma. Sig. — Gargle. 



R. Aluminis, sjij. 

Granati Corticis, sjiv. 

Petal Rosae Rubr., . . . . ^j. 
Mellis Despumat., . . . . sj. 
Aquae Bullientis, . . . \ . J vj. 
M. Sig.— Gargle. 

(Goddard.) 



A Lotion (Lotio) or Wash, — is a solution or mixture of medicinal 
agents, intended for external application ; and usually consists of some 
soluble, astringent salt, dissolved in water, with perhaps some glycerin or 
alcohol. A Fomentation (Fotus) is a similar preparation used hot. A 
Collyrium is an eye-wash, and generally contains a soluble astringent salt 
dissolved in rose-water or distilled water, in the proportion of gr. j-iv to 
the ]|. The only official preparation suitable for a lotion is the Liquor 
Plumbi Subacetatis Dilutus, or Lead- water. A well-known anodyne, re- 
frigerant and astringent lotion is that represented by the first two of the 
following prescriptions. 



Lead-water and Laudanum. 
R. Liq. Plumbi Subacetatis, . . gj. 

Tinct. Opii, ^j. 

Aquae, q. s. ad . . > . . . . ^ viij. 
M. Fiat lotio. Sig. — Lotion. 

Gross. 



B 



gr. x. 



Collyrium. 
Sodii Boratis, .... 
Aquae Camphorae, . . 
Mucil. Cydonii, 

Aquae Destil., aa^ss. 

M. Fiat collyrium. Sig. — Eye- water; 
a few drops to be put into the eye three or 
four times daily. 



Lead and Opium Wash. 
U . Liq. Plumbi Subacetatis, 

Tinct. Opii, aa^j. 

Aquae, q. s., ad J; viij. 

M. Fiat lotio. Sig. — Lotion. 

Sturgis. 



Collyrium of Four Sulphates. 
R . Zinci Sulphatis, 
Ferri Sulphatis, 
Cupri Sulphatis, 

Aluminis, aa gr. j. 

Aquae Destillatae, ^j. 

M. Fiat collyrium. Sig. — For use with 
brush to palpebral conjunctivae, and to be 
washed off with clean water. 



Liniments (Linimenta), — are mixtures intended for external applica- 



EXTEMPORANEOUS PREPARATIONS. 



469 



tion to the skin with friction. The official liniments are solutions of 
various substances in oily liquids or in alcoholic liquids containing fatty 
oils, and are enumerated on page 435. Extemporaneous liniments may 
correspond to the official ones or they may be simple mixtures of fluids 
without either fat or soap. A prescription for each kind is appended. 
The official Linimentum Saponis (Soap Liniment) is a good basis for 
extemporaneous preparations of this class. 



R 



Compound Chloroform Lini??ient. 
Extract! Belladon. Fl., . . Sss. 



Extracti Aconiti Fl., 
Chloroformi Venalis, 
Spiritus Camphorse, 
Alcoholis Diluti, ad . 

M. Fiat linimentum. 

Sig. — Poison. To be 
painful part. 



■ • • 3 vii J- 
rubbed on the 



Anodyne Liniment. 

& . Tinct. Aconiti, 5 ij. 

Tinct. Opii, % iv. 

Tinct. Arnicse, ^j. 

Chloroformi, gij. 

Linim. Saponis, ad . . . . ^ iv. 
M. Fiat linimentum. 
Sig. — Poison. Liniment. 



Stokes 1 Liniment. 



R. 



Olei Terebinth. iiij. 

Acidi Acetici, ...... 3 ss. 

Olei Limonis, gj. 

Vitellum, j. 

Aquae Rosae, ^"j- 

M. Fiat linimentum. 
Sig. — Liniment. 



R 



Army Medical Wagon Liniment. 

. Liq. Ammonias, 

Ol. Terebinthinse, 

Ol. Olivae, 

aa, partes sequales. 
M. .Fiat linimentum. 
Sig. — Liniment. 



An Embrocation is a similar preparation, but of thinner consistence. 
The term is almost obsolete. 



Injections (Injectiones), — are liquid preparations intended for intro- 
duction into the cavities of the body by means of a syringe. When 
thrown into the rectum they are termed Enemas (Enemata), or Clysters, 
and are usually prepared at the bedside. Enemata may be demulcent, 
laxative, nutritive, stimulant, or vermifuge in character ; and always have 
warm or tepid water as their diluent, with which are incorporated such 
medicaments as may be desired. They may consist simply of water to 
act as a wash for the cleansing of the bowel. Injections are termed vagi- 
nal, urethral, vesical, nasal, hypodermic, etc., according to the locality in 
which they are employed. A special form of syringe is employed in each 
case, the discussion of which belongs rather to the domain of surgery 
than that of medicine. Those used for the nasal cavities are often 
arranged with small holes or an atomizing attachment, so as to deliver 
the injection in the form of a fine spray. A Colhtnarium is a nasal 
douche or wash. In the Appendix will be found a list of formulae for 
hypodermic injections ; a few prescriptions for other forms are appended 
below. 



4/o 



EXTEMPORANEOUS PREPARATIONS. 



Enema for Stricture of the Rectum. 

R. Bismuthi Subcarb., . . . . sjj. 
Extracti Opii Aquosi, . . . gr. ij. 
Glycerini, Aquae, . . . aa 25 ij. 
M. Fiat enema. Sig. — Two tablespoon- 
fuls to be injected thrice weekly. 

Demulcent Enema. 

R . Tincturse Opii, TT\xx. ^ 

Decocti Amyli, ;jiv-vj. 

M. Fiat enema. 



Vermifuge Enema. 

R. Extr. Quassiae Fl., .... ,-|jss. 
Aquae, 3 ijss. 

M. Sig. — A tablespoonful with an equal 
quantity of warm water, as an enema, to be 
retained as long as possible. 



Nasal Injection [DobelVs). 



R 



Ac. Carbolici, 3J SS - 

Sodii Bicarb., 

Sodii Boratis, aa 3 iv. 

Glycerini, gxivss. 

Aquae, q. s. ad J v "j- 

M. Sig. — A tablespoonful diluted with 
an equal quantity of tepid water to be used 
thrice daily with a nasal sprayer. 



Injection for Gonorrhoea. 
(Injection Brou.) 

R . Zinci Sulphatis, gr. viij. 

Plumbi Acetatis, gr. xv. 

Tincturae Opii, % ij. 

Tinct. Catechu, gj. 

Aquae Rosae, q. s. ad . . . 3j vj. 
M. Fiat injectio. Sig. — Use with 
urethral syringe. 



Injection for Chronic Urethritis. 



R 



Hydrarg. Chi. Corrosivi, . gr. %. 

Zinci Chloridi, gr. ss. 

Aquae Destillatae, . . . . Bj viij. 
M. Sig.— A teaspoonful to be injected 
well down into the urethra thrice daily, 
through a gum-catheter. 



Vaginal Injections for Leucorrhcea. 

R. Aluminis, gj. 

Zinci Sulphatis, . . . . . gss. 

Sodii Boratis, gr- iv. 

M. Sig.— Dissolve in half-a-pint of 
warm water, and use with a vaginal sy- 
ringe. 

R. Acidi Tannici, j|j. 

Glycerini, Hjiv. 

M. Sig. — One-half with an equal quan- 
tity of water to be injected twice daily. 



Baths (Balnea), are often medicated, and then become medicinal 
preparations. The ingredients only are ordered in a prescription, as per 
the following examples, each of which is intended for a bath of 25 to 30 
gallons : — 



Balneum Acidi Nitrohydrochlorici. 

R . Acidi Nitrici, 

Acidi Hydrochlorici, . . aaBjj. 
M. Sig. — Use with 30 gallons of hot 
water, as a bath. 



Balneum Sulphuris Compositum. 

R . Sulphuris Praecip., . . . . 25 ij. 
Sodii Hyposulphitis, . . . 5 j. 
Acidi Sulphurici Dil., . . . Jss. 

Aquae, Oj. 

M. Sig. — For a 30-gallon bath. 



SOLID EXTEMPORANEOUS PREPARATIONS. 
Pills (Pilulse), — are described on page 438, where also the official 
pills are enumerated. They constitute a form of medicine very much used 
in extemporaneous pharmacy, and one with the preparation of which the 
compounder should be perfectly familiar, for it will constitute fully one- 
third of his work at the dispensing counter. Pills should not exceed 5 
grains in weight, unless the ingredients are very heavy, as Bismuth, Calo- 
mel, Hydrargyrum cum Creta, etc., of which 6, 8, or 10 grains may be 
made into a pill which may be readily swallowed. 



EXTEMPORANEOUS PREPARATIONS. 47 I 

A Bolus is a similar mass, but larger than a pill, while the names 
Granule and Parvule are given to masses smaller than the average pill. 

The Process of Pill-making is briefly as follows : The ingredients 
ordered in the prescription are separately weighed out in the order of 
their bulk, commencing with that one of which the smallest quantity is 
to be used. If any require pulverization they should first be placed in 
the mortar, and reduced to powder; then the other dry ingredients, next 
the soft extracts and the excipient selected, and the whole is worked up into 
a mass, the Pill-mass, by the aid of the mortar and pestle. The perfect 
pill-mass should be uniform throughout, should not show any particles of 
any one ingredient, should have such a consistence that the pills made 
from it will retain their shape, should not be too hard, nor too dry, nor 
should it stick to the fingers. The mortar should be large and shallow, 
of unpolished wedgewood ware ; having a thick, smooth and well-formed 
bottom, and a pestle which fits it. The operation of working up the 
mass is one of kneading it between the end of the pestle and the side of 
the mortar, and if proper ingredients and excipient are used, and if the 
work is well done, the mass will eventually loosen itself from both mortar 
and pestle. If it does not do so it should be removed with a spatula 
when sufficiently worked, and may then be kneaded for a few minutes 
between the fingers. It should then be placed upon the tile or slab pre- 
viously dusted with a little Lycopodium or Starch in fine powder, and 
rolled into a long cylinder by the aid of a broad-bladed spatula, until the 
mass is of a length corresponding to the divisions on the tile-scale which 
represent the number of pills to be made. The mass should then be 
placed along the scale, and a cut made through it with the spatula at each 
division of the scale, the pieces being at once rounded separately into pills 
by the thumb and two fingers of each hand. A pill-machine is often 
employed, consisting of two metal plates having semi-cylindrical grooves 
on one side, and set into wooden boards, the whole forming a convenient 
apparatus for rolling the mass and then cutting it into the required num- 
ber of pills by one movement. The pills are then left to dry upon the slab 
while the label is being written, after which they are placed in a pill-box, 
or in a wide-mouthed bottle if they contain volatile ingredients, and sur- 
rounded by a conspergative powder (Lycopodium, powdered Chalk, 
dusted Talc), to prevent their adhering together or losing their shape. 

Excipients used in pill-making are seldom mentioned in the prescrip- 
tion, but are usually left to the choice of the compounder. Some sub- 
stances need no excipient, but may be made at once into pills; such 
being the softer Extracts and some Gum-resins, the former if too hard 
only needing a little water, and the latter a few drops of spirit to soften 
them to the required degree of plasticity. Every druggist has his favorite 
pill-excipient,many using a paste made of powdered Tragacanth i, Glycerin 



( 



47 2 EXTEMPORANEOUS PREPARATIONS. 

31^ and Water 1 part, while others use Extract of Malt, or a mixture of 
Syrup and powdered Acacia, for general use. Powdered Tragacanth to 
give tenacity, Glycerin to keep the mass soft, and Water to develop the 
adhesive qualities of many ingredients, will answer for fully nine-tenths 
of all the cases which occur in practice. These three excipients should 
stand on the dispensing counter ready for use, and -all ready-made pastes 
or mixtures should be discarded, as being slovenly, dirty, and liable to 
change. The excipients described below are those in general use, and are 
arranged in the order of their comparative importance, viz. : — 

Liquid Excipients. 

Glycerin, — is a very valuable excipient, as it continually attracts moisture from the 
atmosphere, and pills made from it do not get hard. It should be used always for Qui- 
nine pills. Glycerites of Starch or Tragacanth are generally useful excipients. The 
former is official, the latter is made in the proportion of 3 ss to the % . 

Glucose, — is a good excipient, being colorless, adhesive, and not readily volatilized at 
ordinary temperatures. Since its introduction by Mr. Lascheid for this purpose it has 
steadily grown in favor. 

Honey, — may be used for dark-colored substances. It should be evaporated to one-half 
its bulk, and then if mixed with a little Tragacanth, it makes an excellent excipient for 
insoluble powders. 

Extract of Malt, — is a pretty fair excipient, but has the disadvantage of its dark color. 

Syrup, — is a fair excipient for powders, but it should not be used for metallic salts, espe- 
cially Calomel, which it reduces in a short time. Syrup of Acacia is good where there 
is little room left for the excipient, but if kept too long, pills made with it become very 
hard and insoluble. 

Mucilage of Acacia, — is very adhesive, but not a good excipient for the same reason 
as given for the syrup. 

Water, — is only used alone as an excipient when the ingredients possess sufficient adhe- 
siveness to be developed by the water. Such are the following powders : Aloes, Rhubarb, 
Kino, Tannic Acid, Opium, Squill, Asafetida, — also Citrate of Iron, Sulphate of Ber- 
berine, etc. 

Alcohol,— is used to soften Camphor, Compound Extract of Colocynth, Guaiac, resinous 
extracts, gums, etc. 

Solid Excipients. 

Tragacanth, — is an excellent excipient, especially for substances which are too soft, 
giving them body and elasticity. 

Acacia, — is added to give more adhesiveness than can be obtained from viscid liquids 
alone. Pills made with it are generally very hard. It is used for Nitrate of Silver, which 
may explode if mixed with vegetable extracts or glucose. 

Soap,— is the best for resinous and fatty substances, increasing the solubility of the former. 
It is more employed in the official pills than any other excipient, but should not be used 
for substances which are decomposed by an alkali, nor for Tartar Emetic. 

Bread-crumb (Mica Panis), — is an excellent excipient for Croton Oil, or other powerful 
liquid substances, as Volatile Oils. 

Confection of Rose, — is too bulky for general use, but is a good excipient for very active 
agents, like Strychnine, which are used in small quantity. 

Althaa, — is good for absorbing and adhesive purposes, but is too bulky for general use. 

Petrolatum, Cacao Butter, and Resin Cerate, — are used for oxidizable substances, as 
Potassium Permanganate. 

Kaolin, — is well adapted for Nitrate of Silver, and other substances which are easily 
decomposed. 

Liquorice, — is an old excipient, but not much employed now. In powder it may be 
used for oils. 

Conspergatives, — are absorbent powders which are dusted upon the 



EXTEMPORANEOUS PREPARATIONS. 473 

finished pills and put around them in the box or vial in which they are 
dispensed, to keep them from sticking together and losing their shape. 
Powdered Liquorice was formerly much used for this purpose, but the best 
conspergatives are Lycopodium, Talc, Althcea, and Rice Flour, the latter 
especially for white pills. 

Substances Suitable for the pilular form of medicine are the follow- 
ing:— 

Those acting in small doses. Heavy, insoluble substances. 

Those intended to act slowly. Fetid substances. * 

Those to act on the lower bowel. Vegetable extracts. 

Gum-resins, Balsams, Turpentine. 

When the basis is an unadhesive substance, one of the other ingredients 
should be an extract or a vegetable powder, which will form a mass by 
moisture alone. Attention to this rule in prescribing pills will often pre- 
vent the increase of their size by inert excipients. 

Difficult Substances to combine, except by peculiar treatment, are 
met with frequently. The following notes will cover most of the cases : — 

Aloes, — is best treated on a heated slab with alcohol in very small quantity. Soap is 
the excipient in the official Pilulae Aloes. 

Butyl Chloral Hydrate, — should be treated with a little Confection of Rose and thick 
mucilage. 

Calcium Sulphide, — should be well triturated with an equal quantity of Sugar of Milk, 
and then worked up with a little powdered Liquorice-root and Tragacanth Mucilage. 

Camphor, — should be powdered with a little alcohol, and may be worked into a pill- 
mass with Glycerite of Tragacanth after the evaporation of the alcohol. 

Carbolic Acid, — requires nearly an equal part of wheaten flour or bread crumb, with a 
very minute quantity of Glycerite of Tragacanth. Creasote may be made into a mass by 
the addition of powdered Liquorice with a very little bees' wax. If made into a pill with 
Oxide of Silver it will explode unless the silver salt be first diluted by trituration with 
Liquorice, Gentian, or some other inert powder. 

Citrate of Iron and Quinine, — is very deliquescent with most excipients. Canada Bal- 
sam is the best for it. 

Copaiba, — may be made into pill-mass by the addition of a little Carbonate of Magne- 
sium or Wax. 

Croton Oil, — is best worked up with bread-crumb, though powdered Liquorice and 
mucilage may be used. 

Ferrum Iodide, — in pill form requires special manipulation and protection to remain 
unoxidized. The official Pil. Ferri Iodidi is prepared with Iodine and Reduced Iron, has 
Liquorice, Sugar, and Acacia as excipients, and is protected by a coating of Balsam of 
Tolu (see ante, page 221). In other formulae, Acacia, Althaea, Cocoa-butter, Elm-bark, 
and Liquorice are used as excipients. 

Ferri Sulphas, — is used in Blaud's Pill and in the official Pil. Ferri Compositae, with 
Carbonate of Potassium, to form by mutual decomposition Ferrous Carbonate, which 
quickly passes into the ferric salt by exposure. Myrrh in powder and Syrup are the 
excipients used for the official pill. 

Gallic Acid, — makes a good pill with a very small quantity of Glycerin. Tannic Acid 
requires about one-fifth its weight of Glycerin and one-tenth of Mucilage. 

Phosphorus, — presents the problem of combining it in pill without letting it oxidize. 
This is believed to be accomplished by the pharmacopceial directions for the Pil. Phos- 
phori, according to which the Phosphorus is dissolved in Chloroform in a test-tube, then 
quickly worked into a mass with Althaea, Acacia, Glycerin and Water, and finally the 
pills are coated by shaking with an Ethereal solution of Balsam of Tolu. Carbon Bisul- 
phide is a better solvent, but when it is used the pill-mass retains its disgusting odor. 



( 



474 



EXTEMPORANEOUS PREPARATIONS. 



Potassium Acetate, — requires Canada Balsam to secure its stability in pill form. Potas- 
sium Iodide is best manipulated by rubbing into a smooth paste with a very little water, 
then adding a small quantity of Liquorice powder. Potassium Permanganate should be 
worked up with kaolin and a very little water. Resin Cerate, Soft and Hard Paraffin 
and Cacao butter are also used as its excipients. 

Quinine, — requires very clean hands and tools, and a colorless excipient, as Glycerin 
or Glucose, to make a nice-looking pill. If one part of Tartaric Acid is added to four of 
the Quinine salt, the mass will be less likely to crumble and will be of less bulk. Sul- 
phate of Quinine may be made into small and soluble pills by simply triturating it with 
Aromatic Sulphuric Acid n\iij to each 5 grains of the salt. The moulding into pills 
should be done at the moment when the mass has begun to dry. A drop of syrup or 
honey, added at this time, will prevent the too rapid hardening of the mass. 

Rhubarb, — in powder makes a good mass with one-fifth of its weight of Glycerin; but 
Soap is the excipient ordered for the official Pilulae Rhei. 

Substances Unsuited to the pilular form are : — 
Those requiring large doses, and those which are volatile. 
Emetics, and other agents administered for immediate effect. 
Essential Oils in quantity exceeding half a drop to each pill. 
Oils and other bodies which require much solid matter to make a mass ; 

except those having a very small dose, as Croton Oil. 
Deliquescent Salts, unless intended to be used immediately. 
Efflorescent Salts, unless deprived of their water of crystallization. 



Deliquescent Salts. 

Ammonii Iodidum. 

Nitras. 

Valerianas. 

Auri Chloridum. 

Calcii Chloridum. 

Chinoline Salts, except the Tartrate, which 

is stable. 
Lithii Citras. 

Bromidum. 

Salicylas. 

Magnesii Citras. 
Potassa. 

cum Calce. 

Potassii Acetas. 

Carbonas. 

Citras. 

: — Cyanidum. 

Hypophosphis. 

Sulphis. 

— Tartras. 

Sodii Hypophosphis. 

Iodidum. 

Zinci Bromidum. 
Chloridum. 

Iodidum. 



Efflorescent Salts. 

Alumen (slightly). 
Ammonii Carbonas. 

Phosphas. 

Ant. et Potass. Tartras (slightly). 
Cupri Acetas. 

Sulphas. 

Magnesii Sulphas (slightly). 
Potassii et Sodii Tartras (slightly). 

Ferrocyanidum (slightly). 

Quininse Bisulphas. 

Sulphas (after a time). 

Soda. 

Sodii Acetas. 

Arsenias (slightly). 

Benzoas. 

Boras (slightly). 

Carbonas. 

Hyposulphis. 

Phosphas. 

Santoninas (slightly). 

Sulphas. 

Sulphis. 

Strychnine Sulphas. 
Zinci Acetas. 
Sulphas. 



Coated Pills are manufactured upon a large scale by the large drug 
houses, extensive machinery being employed for the purpose. The coat- 
ing material used is either Sugar or Gelatin. The U. S. Pharmacopoeia 
directs that two of the official pills shall be coated by being shaken with 
a solution of Balsam of Tolu in Ether, viz. — Pil. Ferri Iodidi and Pil. 



EXTEMPORANEOUS PREPARATIONS. 



475 



Phosphori. In extemporaneous pharmacy it is rarely practicable to coat 
pills with anything except gold or silver leaf, and this is sometimes directed 
by the prescriber, the word " Deaurenter — let them be gilded" being 
used in the subscription. To do this neatly the pills should have no trace 
of powder on them, but should be first coated with a trifle of fresh mucilage 
by rolling between the mucilage-moistened fingers, each pill being then 
dropped directly on to a sheet of gold or silver leaf, until a dozen or more 
are so deposited. The leaf and its pills are then allowed to slide into a 
globular boxwood shaker, or the leaf may be first placed in the shaker and 
the pills dropped on it there. A cautious circular movement being given 
to the shaker the pills are caused to travel around its walls, and when the 
cover is removed they will be found to have each received an even coat- 
ing of the metal used. Gold leaf should always be employed for pills of 
Blue Mass or Asafetida, as silver is amalgamated with the former and 
turned black by the latter. 

Albumen may be used for coating small numbers of pills, which should be of very firm 
consistence before the coating is applied.' Each pill is rolled between two fingers with a 
little white of egg, and then revolved in a warm pan. Another method of finishing them 
is, after coating with albumen, to rotate them in a tray with powdered French chalk until 
their surfaces become smooth and shiny. When carefully done this process gives a very 
nice finish. 

Compressed Pills, as now largely manufactured by several reliable 
firms, consist of various medicinal powders pressed into pill or tablet shape 
by machinery. They are extremely convenient preparations for the phy- 
sician's use, as quite a variety can be carried in a pocket-case, and as slight 
pressure is sufficient to reduce them to powder, they can be dispensed with 
facility and accuracy of dosage. Messrs. John Wyeth & Brother, of Phila- 
delphia, manufacture a very extensive line of these pills, including nearly 
all those put up in the sugar-coated or gelatin-coated form by other houses. 
The trade-list of this firm should be in the hands of every physician who 
keeps a small stock of medicines in his office, or who carries a pocket-case 
of drugs. The following list includes the most important of these prepa- 
rations, the figures representing the number of grains in a pill in each 
case : — 



i 



Acid, Arsenious, fa fa fa fa 

Benzoic, 5. 

Gallic, 5. 

Salicylic, 2)4, 5- 

Salicylic, 2)4, and Morphine, fa 

Tannic, 2, 5. 

Aconitina, fa 

Aloes, 2. Aloes et Ferri (U. S. P.). 

Aloes, 2, et Myrrh, I. 

Aloes, %, et Rhei, ij£, et Gentian, %. 

Aloin, i_, %,}4. 

Ammonium Bromide, 5, 10. 

Ammonium Chloride, 3, 5, 10. 



Atropine, fa 
Bismuth Subcarb., 5. 

Subnitrate, 5, 10. 

Borax, 5. 

Caffeine Citrate, I. 

Calcium Sulphide, fa }£, )4, I- 

Calomel, %, ^, I, 2, 3, 5. 

Calomel, 2, Opium, 1. 

Camphor, Monobromated, 2, 3, 5. 

Cathartic Comp. (U. S. P.) and Imp'ved. 

Cerium Oxalate, 2. 

Cinchona Alkaloids (Mixed). 

Cinchonine Sulphate, 2, 3, 4, 5. 



476 



EXTEMPORANEOUS PREPARATIONS. 



Cinchonidine Sulphate, 2, 3, 4, 5. 




Pepsin Sacch., 2, 5. 


Codeine, Y- 




Podophyllin, T L Y,Y> K> I, 


Digitaline. fa 




Potassium Bromide, 5, 10. 


Extract of Cannabis Indica, Y- 




Chlorate, 5. 


Extract of Ignatia Amara, Y-> l A- 




Iodide, 5. 


Extract of Nux Vomica, %, %. 




Nitrate, 5. 


Ferrum (Quevenne's), 1, 2. 




Permanganate, ^, I, 2. 


Ferrum Arseniate, }i, }(. 




Quinine Bisulphate, j^, 1, 2, 3 


Proto-carb., 3, 5. 




Salicylate, 2. 


Lactate, I. 




— -Sulphate, #,1,2,3,4,5 


Pyrophosphate, 2. 




Quinquinine, 2, 3. 


and Quinine Citrate, 2, 3, 5. 




Rhubarb, 3. Rhei Co. (U. S. 


Hydrargyrum, I, 3, 5. 




Rhei, 2, et Magnesiae, 2. 


Chlor. Corros., fa fa fa T \ 




Salicin, 2#, 5. 


Iod. Rub., fa fa 




Santonin, I. 


Proto-Iodide, fa y 8 , y 6 , X, 


%- 


Santonin, 1, et Calomel, 1. 


Ipecac, et Opii, 2, 3, 5. 




Sodium Bicarbonate, 5. 


Morphine Sulphate, fa Y$> *A> %> 


%- 


Salicylate, 3, 5. 


Opium Deodorized, 1. 




Strychnine, T fa fa up to fa 


Opium %, and Lead Acetate, ij4- 




Zinc Phosphide, fa up to ^ . 



4,5. 



P.). 






The following prescriptions represent the composition of a few unoffi- 
cial pills in general use. A complete pill formulary is easily obtained, 
being published annually by each of the principal manufacturers. 



R 



Pills of Iron. 

. Ferri Reducti, gr. 1. 

Mannaa, gr. x 

Glucosi, q. s. 
Fiat massa, et div. in pil. xxv. 
Sig. — One after each meal. 



R 



Emmenagogue Pill (Olio). 

. Ferri Sulph. Exsic, . . . gr. xlviij. 

Pulv. Aloes, gr. xij. 

Terebinthinse, ... gr. xxvij. 

01. Terebinth., TT\x. 

Fiat massa, et div. in pil. xxx. 
Sig. — Two, three times a day. 



Hooper's Female Pills. 

R . Pulv. Aloes Socot., . . . gr. xlviij. 

Ferri Sulph. Exsic, . . . gr. xxiv. 

Ext. Hellebori Nig., 

Pulv. Myrrhse, 

Saponis, aa gr. 

Pulv. Canellae Alb., 

Pulv. Zingiberis, . . . . aa gr. 

Aquae vel Syrupi, q. s. 
Fiat massa, et div. in pil., quisque pondo 
gr. ijss. 

Sig. — One to three at a dose. 



Xlj. 



V J- 



R 



Anaphrodisiac and Sedative. 

. Camphorse, gr. xxx. 

Lupulini, gr. xx. 

Fiat massa, et div. in pil. xx. 
Sig. — One thrice daily. 



Astringent Pill. 

R . Plumbi Acetatis, . . . 

Pulv. Camphorse, . . 

Pulv. Opii, 

Bismuthi Subcarb., . . 

Ext. Gentianae, q. s. 
Fiat massa, et div. in pil. xij. 
Sig. — One thrice daily. 



R 






gr. xvj. 
gr. xij. 
gr. nj. 
gr. xij. 



R 



Astringent Pill. 




. Argenti Nitratis, gr. 


xx. 


Pulv. Cretse (Gallicae), . . gr. 
Petrolati, q. s. 


lxxx. 


Fiat massa, et div. in pil. xl. 




Cholagogue Pills (Squibb). 




. Resinae Podophylli, . . . gr. 
Ext. Belladon. Alcohol, . . gr. 


lij. 


Pulv. Capsici, 

Pulv. Sacch. Lactis, . . aa gr. 


xxiv. 


Pulv. Acacias, gr. 


V J- 


Glycerini Syrupi, q. s. 
Fiat massa, et div. in pil. xxiv. 




Sig. — One or two as required. 





R 



Aperient Pills. 

. Pulv. Aloes Socot., . . . . gr. xxiv. 

Pulv. Rhei, gr. xlviij. 

Hydrarg. Chlor. Mitis, . . gr. iv. 

Ant. et Potas. Tart., . . . gr. ij. 
Fiat massa, et div. in pil. xxiv. 
Sig. — One or two as needed. 



EXTEMPORANEOUS PREPARATIONS. 477 

Tonic Pill for Women. Anti-bilious Pills. 



R. Strychninae Sulph., 

Ac* Arseniosi, . . . . aa gr. j. 

Ext. Belladonnse, . . . . gr. v. 

Quininse Sulph., gr. xxxv. 

Massse FerriCarb., . . . . gr. xc. 
Fiat massa, et "div. in pil. xxxv. 
Sig. — One three times daily. 



R. Pulv. Scammonii, 
Pulv. Aloes Socot., 
Pulv. Gambogise, 
Hydrarg. Chlor. Mitis, 
Potass. Bitart., . . . . aa gr. xx. 
Ext. Taraxaci, q. s. 
Fiat massa, et div. in pil. xx. 



Gelatin Capsules are to be obtained from the drug stores, of various 
sizes from o to 10. They are a convenient means of administering oils or 
nauseous solids, and when filled may be swallowed as easily as a large pill. 
By some of the manufacturers Soluble Elastic Capsules are prepared, each 
containing an ordinary dose of such medicines as Castor Oil, Cod-liver 
Oil, etc. The largest of these capsules makes a bolus which may be swal- 
lowed with a little effort, as it is quite compressible and changes its shape 
to suit the calibre of the passage. The ordinary capsules are easily filled 
by the aid of a paper funnel, and the end of a pen-holder as a packer ; 
but simple devices {capsule-fillers) may be obtained for the purpose of 
facilitating the operation. 



R . Pulv. Opii, gr- x. 

Pulv. Camphorae, . . . . gr. xx. 
Sacch. Alb., q. s. 
Trit., et riant capsulse x. 
Sig. — One at bedtime for chordee ; re- 
peat in two hours if necessary. 



R. Copaibse, £iss. 

Oleo-resinse Cubebse, . . . gss. 

M., et fiant capsule xij. 

Sig. — Two capsules three times daily, 
soon after meals, for gonorrhoea. 



< 



Troches (Trochisci), — also named Tablets, Pastilles, Lozenges, etc., 
and Compressed Pills, are not readily compounded at the dispensing 
counter, but may be obtained in all first-class shops, being prepared in 
great variety by the manufacturers. Besides the official Troches (see 
ante, page 439), those named in the following list are generally for sale : — 



Troches {Lozenges). 



Alum, gr. ij. 

Alum, gr. 1^, Catechu, gr. ij. 

Ammonium Chloride, gr. ij, and Cubebs, 

g r - j- 
Amnion. Chlor., gr. ij, Liquorice, gr. viij. 
Benzoic Acid, gr. y z . 
Borax, gr. iij. 

Bismuth, gr. ij, and Charcoal, gr. v. 
Bronchial, — 01. res. Cubebs, gr. i, Tolu, 

gr. A, Ol. Sassafras, gr. T ^, and . Ext. of 

Liquorice, gr. vij. 
Brown Mixture. 
Carbolic Acid, gr. j. 



Ginger and Sodium Bicarb. 

Guaiac, gr. ij. 

Kino, gr. ij. 

Lettuce, gr. j. 

Lime-juice. 

Logwood, gr. ij. 

Magnesia, gr. iij. 

Pellitory, gr. j. 

Pepsin, gr. iij, Charcoal, gr. iij, Magnesia, 

gr. ij,and Ginger, gr. j. 
Potassium Bitartrate, gr. iij. 
Potassium Citrate, gr. iij. 
Santonin, gr. x / 2 , and Calomel, gr. y 2 . 



478 



EXTEMPORANEOUS PREPARATIONS. 



Compressed Tablets. 

Ammonium Chloride, gr. iij. 
Charcoal, gr. x. 
Cocaine Hydrochlorate. 
Dover's Powder. 
Mercury, Yellow Oxide, gr. ^^. 
Pepsin and Pancreatin. 
Potassium Bicarb., gr. v. 
Potassium Chlorate, aa gr. v. 
Potas. Chlorate and Borax, gr. 2^. 
Potas. Chi. and Ammon. Chloride. 
Spencer's Chloramine Pastilles. 
Sodium Bicarb., gr. iv, Ammon. Carb., gr. 
X, 01. Menth. Pip., gtt. j/ 6 . 



Compressed Tablets. 

Sodium Salicylate, gr. iij. 

Antiseptic. Hydrarg. Chlor. Corr.,^r. vijss. 

Fehling's Test for grape-sugar in the urine. 

Hypodermic Tablets. 

Morphine Sulphate, gr. fa to y^. 
Morph. Sulph. and Atropine Sulph. 
Atropine Sulphate, gr. -fa-fa. 
Strychnine Sulphate, gr. - t \-§. 
Apomorphine Muriate, gr. -fa, fa. 
Pilocarpine Muriate, gr. fa,, ]/ z . 
(And several others.) 



Confections (Confectiones), and Electuaries (Electuaria), — are 
very seldom prescribed; and therefore can have but little place in extem- 
poraneous pharmacy. They are medicinal powders, etc., beaten up with 
sugar, honey or molasses, to the consistence of a thick paste, and are 
administered with a spoon like preserved fruits. The two official con- 
fections are described on page 439, and a few old formulae for similar 
preparations are given below as pharmaceutical curios. The first is a 
meritorious prescription. 



Electuary for Piles. 
R . Potassii Bitartratis, 
Potassii Nitratis, 

Pulv. Jalapae, aa % ss. 

Confectio Sennge, . . . . Jj. 
Syrupi Zingiberis, q. s. 

M. Fiat electuarium. 

Sig. — A piece the size of a marble" to be 
taken thrice daily. 



The Chelsea Pensioner. 

IJ. Sulphuris Loti, 5ij. 

Potassii Bitart., ^j. 

Pulv. Rhei, gij. 

Guaiaci Resinge, . . , . 55 j. 

Mellis Despum., Bbj. 

Myristicam Pulv., . . . . j. 
M. Fiat electuarium. 
Sig. — A dessertspoonful twice daily, 
a laxative in chronic rheumatism. 



Confectio Damocratis. 

[An ingredient of Warburg's Tincture.] 

This preparation was official in the London Pharmacopoeia of 1745. It contained I 
grain of Opium in ^ ss, and consisted of 45 ingredients, as follows, viz.: Cinnamon, 14 
parts; Myrrh, 1 1 parts; — White Agaric, Spikenard, Ginger, Spanish Saffron, Treacle, 
Mustard Seed, Frankincense and Chian Turpentine, of each 10 parts ; — Camel's Hay, 
Costus Arabacus, Zedoary, Indian leaf, Mace, French Lavender, Long Pepper, Seeds of 
Harwort, Juice of ripe Cistus, strained Storax, Opponex, strained Galbanum, Balsam of 
Gilead, Oil of Nutmeg, Russian Castor, of each 8 parts ; — Water Germunder, Balsam-tree 
Fruit, Cubeb, White Pepper, Seeds of Cretian Carrot, Poley Mont, strained Bdellium, of 
each 7 parts ; — Gentian-root, Celtic Hard, Leaves of Dittany of Crete, Red Rose, Seeds 
of Macedonium, Parsley, Sweet Fennel Seeds, Seeds of Lesser Cardamom, Gum Arabic, 
Opium, of each 5 parts; — Sweet Flag, Wild Valerian, Anise seed, Sagapenum, of each 
3 parts; — Spigrul, St. John's Wort, Juice of Acacia, Catechu, Dried Bellies of Skunk, of 
each 2^/ 2 parts; — the roots finely powdered and the whole mixed thoroughly into a paste 
with Clarified Honey. 



Powders (Pulveres), — as prepared extemporaneously are generally 
compound, and may be mixed on a slab with a spatula, but a much better 



EXTEMPORANEOUS PREPARATIONS. 479 

method of mixing them is by trituration in a mortar. The latter should 
always be employed except in the case of substances which may explode 
if so treated, as Potassium Chlorate with oxidizable substances. (See 
ante, page 457.) The Diluent best employed in powders is Sugar of Milk, 
on account of its hardness, its density and its comparative insolubility. 
A coloring agent, as Carmine in minute quantity, is a useful ingredient, 
enabling the eye to judge of the degree of mixing and subdivision ob- 
tained. Powders containing soluble salts, extracts, volatile oils, camphor, 
or any other hygroscopic or volatile substances, should be dispensed in 
waxed paper. For ordinary powders the plain white paper of the drug 
stores will answer, but a better paper for small powders is one having a 
high surface finish and made very thin,. as the white glazed French demy. 
Powders are often ordered in Wafers (Cachets), to be swallowed without 
unfolding. The division of powders into the number of papers (Char- 
tulce) ordered, and folding them neatly, requires a considerable amount 
of practice. A small machine is used over which the ends of the papers 
are bent, in order to have them of the proper size for the box in which 
they are usually dispensed. If they are to be put into an envelope less 
exactness of folding is required, and the mechanical contrivance may be 
dispensed with. 

Substances suitable to administration in the form of powders are those 
which are insoluble, those which would be chemically incompatible in fluid 
form, and certain pulverizable extracts. Those which are unsuited to this 
form are such as have a very nauseous taste or odor, substances of which 
the dose is large, those which are deliquescent, efflorescent or very vola- 
tile, and those which liquefy on mixing. A list of deliquescent and efflo- 
rescent salts is found on page 474, while the following named, though 
dry alone, become moist when triturated together, viz : — 

Sodium Sulphate and Potassium Carbonate. 
Zinc Sulphate and Lead Acetate. 
Camphor and Chloral Hydrate. 

Many substances cannot be powdered without the intervention of another 
body : thus Opium requires a hard substance like Sugar of Milk or Potas- 
sium Sulphate, Camphor requires a minute quantity of Alcohol, Myrrh 
needs Sugar or Gum, etc. Substances, as the alkaloids and their salts, 
which are very active and are used in very small doses, require some 
inert substance to give them bulk enough for division and handling. 
Sugar of Milk will be found the best agent for this purpose. Prescrip- 
tions may order the ingredients for a single powder, with directions to 
dispense a certain number of the same composition ; or they may give the 
quantities for the whole number of powders ordered, with instructions to 
divide into a certain number. The dispenser should carefully scan the 
prescription in order to avoid the multiplication of quantities where divi- 



< 



43o 



EXTEMPORANEOUS PREPARATIONS. 



sion is intended. The official powders are enumerated on page 439 ; and 
the following formulae will serve to illustrate those generally prescribed : — 



R. 



Astringent Powder for Infants. 
Plumbi Acetatis, gr. ij. 



Pulveris Opii, gr. ss. 

Camphorse, gr. j. 

Sacchari Lactis, gr. iij . 

Trit., et div. in chartulas xij. 
Sig. — One every 2 or 3 hours in diar- 
rhoea of infants. For an adult the above 
represents one dose. 



Gastric Sedative. 



R. Bismuthi Subnitratis, . . . 3J. 

Pulveris Rhei, 
» Pulveris Aromat., . . . aa 3 ss. 

M., et div. in chartulas vj. 

Sig. — One before each meal. 



Laxative Powder. 



B . Hydrarg. Chlor. Mitis, . . gr. 

Sacchari Lactis, gr. 

M., et fiant pulv. x. 

Sig. — One powder twice daily. 



x. 

XX. 



B 



Bismuth and Soda. 

. Bismuthi Subnitratis, 

Sodii Bicarb., aa ,^ij- 

Pulv. Zingiberis, gr. xl. 

M., et div. in chartulas xij. 

Sig. — One after each meal. 

Corrective in dyspepsia,acne and eczema. 



Antipruritic Powder. 

B. Pulveris Camphorae, . . . ^j. 

Zinci Oxidi 5 iv. 

Pulv. Amyli, g j. 

M., et fiat pulvis. 

Sig. — Use locally as a dusting powder to 
relieve itching. 



Catarrh Powder 



B 



. Bismuthi Subnitratis, 

Pulv. Acaciae, . . . 

Pulv. Talc, .... 

Morphinae Muriatis, 
M. Sig. — Use by insufflation. 



3«J- 
8 r - j- 



Compressed Pills are really powders which have been compressed into 
pill shape by machinery. A little pressure from the blade of a spatula will 
restore them to powder form. (See ante, page 475.) 



Triturations (Triturationes), — are powders containing minute doses 
of very active agents diluted with Sugar of Milk, and possessing a definite 
relation between the active ingredient and the diluent, namely, 1 in 10, 
according to the general formula of the U. S. Pharmacopoeia, which, as 
well as the one official trituration, is described on page 440. Sugar of 
Milk is employed as the diluent because of its hardness and its compara- 
tive insolubility. The first of these qualities secures the fine comminu- 
tion of the active ingredient whereby the action of the medicine is 
increased and better distributed. Its insolubility makes it the best 
diluent for powders or triturations administered from a spoon or glass 
with fluid, as is so often done, for unlike cane sugar it is not readily dis- 
solved and does not leave the active substance behind on the surface of 
the utensil. Triturations are excellent forms for the administration of 
powerful alkaloids, which may thus be divided with great accuracy into 
the minute quantities required. Mercury and its salts are especially 
adapted to this method of preparation, being more uniformly divided 
and hence more active than when administered in any other form. 
Triturations of mercury with sugar were commonly used in England a 



EXTEMPORANEOUS PREPARATIONS. 



48l 



hundred years ago, and triturations of many substances were employed 
by the Arabian physicians of the 13th century. But the subsequent 
adoption of these preparations by the homoeopathists produced such a 
prejudice against them in the ranks of the regular profession that until 
recently any one using them stood in danger of being stigmatized as a 
homoeopath. Their recent recognition by the U. S. Pharmacopoeia 
under their proper title does away with any such implication, though it 
is much to be regretted that the compilers of the last revision of the 
British Pharmacopoeia should have shown their fear of a name by con- 
tinuing the title " Pulvis Elaterini Compositus " to designate a prepara- 
tion which in every respect is a trituration. The preparations of Pepsin 
daily prescribed by physicians all over the country are really sugar-of- 
milk triturations of that ferment, and not pure Pepsin as many suppose. 
Prof. H. G. Piffard, Med. Dept. Univ. of the City of New York, in his 
treatise on the Materia Medica and Therapeutics of the Skin (N. Y., 
1881), after detailing several microscopical examinations of pills and 
triturations, uses the following language : — 



'* It is to be expected, therefore, that the protoiodide trituration will prove, ceteris 
paribus, more active than the pill, and such we have found it. . . . Iodides of Mercury 
.... Since we have used the triturations, however, in preference to the ordinary pills, 
patients more rarely complain of disagreeable sensations. We have been enabled to 
materially reduce the size of the dose in order to obtain the desired effect. In other 
words, a larger proportion of the drug is utilized for specific purposes, while but a small 

amount remains to give rise to local irritation I have nothing to add to this, 

except that I continue to use triturations of Mercury and other substances with increasing- 
satisfaction. Beside those mentioned I employ Calomel, Cyanide of Mercury, Black 
Oxide of Mercury and Corrosive Sublimate in this form." 



The following examples will illustrate the mode in which Triturations 
may be prescribed : — 



R. Hydrarg. Oxidi Flavi, . . . gr. ss. 

Sacchari Lactis, gr. 1. 

Trit., et div. in chartulas xxiv. 
Sig. — One twice daily. 



B 



. Hydrarg. Chlor. Mitis, . 

Sacchari Lactis, q. s. 
Trit., et div. in chartulas x. 
Sig. — One powder daily. 



gr. x. 



R. Morphinse Sulph., . . . . gr. j. 

Sacchari Lactis, gr. xvj. 

Trit., et div. in chartulas viij. 
Sig. — One every six hours. 



R 



. Acidi Arseniosi, gr. ss. 

Sacch. Lactis, gr. xl. 

Trit., et div. in chartulas xx. 
Sig. — One powder thrice daily. 



Suppositories (Suppositoria), — are small, conical, medicated bodies 
intended for introduction into the rectum, uterus, or urethra (bougies), 
occasionally into the vagina. No official suppositories are enumerated, 
but a general formula is prescribed by the Pharmacopoeia for their prepa- 
ration (see ante, page 440). The basis is usually Cacao-butter, but for 
those intended for the urethra or uterus a mixture of Gelatin and Glycerin 
31 



482 EXTEMPORANEOUS PREPARATIONS. 

is considered the best excipient, being firmer and more plastic than 
cacao-butter, and more easily handled. Hollow cones of cacao-butter, 
or some composition resembling it, are kept in the shops, and will be 
used by the average druggist in filling prescriptions for rectal supposito- 
ries unless prohibited, as they save him considerable labor ; the active 
drug being simply placed in the centre of the cone which is then sealed 
with a plug fitting in its. base. These contrivances are by no means so 
efficient as the regular suppository, in which the medicinal agent is 
thoroughly incorporated with the excipient, for the former smear the 
rectum with a quantity of melted grease before the active portion of the 
preparation is permitted to come in contact with its walls. The agents 
used in suppositories are chiefly extracts and alkaloids ; some few powders, 
and a few metallic salts are occasionally employed. Those for the adult 
rectum should contain from 15 to 30 grains of the excipient, for the 
vagina a drachm of cacao-butter is the average quantity. Those for the 
uterus and urethra are made of cylindrical instead of conical form, and 
about the diameter of a No. 9 catheter. 

The methods of compounding suppositories are two, viz. : — that by 
the use of moulds (the official method), and that by hand. The former 
process is described on page 440, but many prefer the hand method, 
which is as follows : The medicament is mixed with finely shaved Cacao- 
butter by the aid of a spatula on a board or tile lightly dusted with 
Lycopodium or Starch. After a smooth and uniform mixture is thus 
obtained, the mass may be rolled into cylindrical form, cut into the 
required sizes and with the spatula given the required shape. When 
dispensed, they should be placed in a powder-box, between layers of 
cotton. 

Bougies or Pencils, as urethral and uterine suppositories are often 
termed, may be prepared by melting together White Gelatin 3, Glycerin 
1, and Distilled Water 1 part by weight, then adding the medicament, 
and drawing the. mass into a glass tube previously oiled inside. When 
cold the bougie may be pushed out and cut into suitable lengths. 

The Br. Pharmacopoeia describes 8 official suppositories, as follows, 
viz. : — 



Suppositoria Acidi Carbolici cum Sapone, — Carbolic Acid, 12 grains; Curd Soap, in 
powder, 180 grains; Glycerin of Starch, 40 grains; to make 12 suppositories, each 
containing I grain of Carbolic Acid. 

Suppositoria Acidi Tannici, — Tannic Acid, 36 grains; Oil of Theobroma, 144 grains ; 
to make 12 suppositories, each containing 3 grains of Tannic Acid. 

Suppositoria Acidi Tannici cum Sapone, — Tannic Acid, 36 grains; Glycerin of Starch, 
30 grains; Curd Soap, in powder, 100 grains; Starch, in powder, q. s. ; to make 12 
suppositories, each containing 3 grains of Tannic Acid. 

Suppositoria Hydrargyria — Mercurial Ointment, 60 grains; Oil of Theobroma, 120 
grains ; to make 12 suppositories, each containing 5 grains of Mercurial Ointment. 

Suppositoria Iodoformi, — Iodoform, 36 grains; Oil of Theobroma, 144 grains; to 
make 12 suppositories, each containing 3 grains of Iodoform. 



EXTEMPORANEOUS PREPARATIONS. 



483 



Supposiloria Morphince> — Morphine Hydrochlorate, 6 grains; Oil of Theobroma, 174 
grains; to make 12 suppositories, each containing ]^ grain of the Morphine salt. 

Suppositoria Morphines cum Sapone, — Morphine Hydrochlorate, 6 grains ; Glycerin 
of Starch, 30 grains; Curd Soap, in powder, loo grains; Starch, q. s. to make 12 sup- 
positories, each containing % grain of the Morphine salt. 

Suppositoria Plumbi Composita, — Acetate of Lead, 36 grains; Opium, in powder, 12 
grains ; Oil of Theobroma, 132 grains; to make 12 suppositories, each containing 3 grains 
of Lead Acetate and 1 grain of Opium. 



Suppositories and Bougies may be prescribed in the manner illustrated 
by the following formulae : — 

Wade's Bougies. 

H . Iodoformi, ^j. 

Bismuthi Subnitrat., . . . gj. 

Chloralis gr. viij. 

MorphinaeSulphat., . . . gr. iij. 

01. Rosae, ff\x. 

Gelatini, et Glycerini, q. s. 
M. Fiant bougia xij. 
Sig. — One into urethra thrice daily. 



Anodyne Suppository 




R . Ext. Opii 

Ext. Belladonnse, .... 


g r - V J- 

gr. ss. 


Ext. Hyoscyami, .... 
Olei Theobromae, q. s. 


g r - !J- 


M. Fiant suppositoria vj. 
Sig. — One into the rectum morning and 
night. 


Anthelmintic. 




R . Santonini, 

Olei Theobromse, .... 


gr. xij. 
3»j- 


M. Fiant suppositoria vj. 
Sig. — One into the rectum as 


directed. 


Quinine Suppository. 




R . Quininae Sulphatis, . . . 


. gr. v. 



Olei Theobromae, . . . . gr. x. 
Fiat suppositorium unum, mitte tales sex. 



Bougie for Gleet. 



R. 



Zinci Sulphatis, gr. vj. 

Ac. Carbolici, TT\_iij . 

Pulv. Hydrastis, gr. xij. 

Ext. Belladonnae, . . . . gr. xij. 

Gelatini, et Glycerini, q. s. 
M. Fiant bougia xij. 
Sig. — One into urethra night and morn- 
ing. 



Ointments (Unguenta) and Cerates (Cerata), — are frequently ordered 
on extemporaneous formulae, though the 34 official preparations of these 
classes (see ante, pages 440, 441) would seem to give the physician a 
sufficiently wide field for selection. The basis used is usually either the 
official Ceratum or Unguentum, but Petrolatum, Lard, Lead Plaster with 
a fixed oil, etc., may be used. Lard is probably the best basis for all oint- 
ments, as it softens the skin better than any other similar substance. Its 
disadvantage is that it soon becomes rancid, so that preparations made 
with it must be quickly used. Cerates only differ from ointments in their 
firmer consistence, melting at temperatures above 104 F., while the latter 
melt below the ordinary temperature of the body. Oleates are described 
fully on page 72. 

The process of compounding an ointment or a cerate is sufficiently sim- 
ple, being generally a mere matter of triturating the ingredients together 
in a mortar, or of their incorporation on a slab by means of a spatula. 
Rarely will melting be required in the compounding of extemporaneous 
ointments. When extracts, powders or gritty substances are ordered, the 
ingredients should be first pulverized into a fine powder, then triturated 
with a small quantity of the basis into a smooth, impalpable paste ; the 



4§4 



EXTEMPORANEOUS PREPARATIONS. 



remainder of the basis being added gradually, until the whole is thoroughly 
incorporated. A warm mortar may be required for hard extracts. Soluble 
salts should be triturated with a little water before adding the excipient. 
Camphor needs a little alcohol to enable it to be pulverized ; and Iodine 
should be rubbed to a fine powder, then a little alcohol added and finally 
the excipient by degrees. Iodide of sulphur requires persevering work 
with a small portion of olive oil. Borax should be triturated with glycerin 
and Red Oxide of Mercury with distilled water. A bone or horn spatula 
should be used for all ointments, as steel or iron blades will injure many 
substances, particularly alkaloids, free acids, tannin or iodine, and several 
of the mercurial salts. Volatile substances should be added last, and 
quickly worked in, so that their evaporation may be as slight as possible. 
Ointments are dispensed usually in amber-colored glass pots with wooden 
or metallic covers, or in porcelain jars called Gallipots. In hospital and 
dispensary practice the common chip pill-box is used, but soon becomes 
excessively dirty and disagreeable to handle. 



Ung. Iodoformi Compos. 

R . Iodoformi, 5jj. 

01. Anisi, n\xx. 

01. Rosae, 

01. Ylang ylang, . . . . aa n^v. 

Ung. Aquae Rosae, . . . . ifj. 
M. Fiat unguentum. 
Sig. — Ointment. 



Unguentum Anti-pruriticum. 

R . Camphorae, 

Chloralis Hydrat, . . . aasjj. 
Tere una ad liquorem, dein 

adde cum tritu — 
Unguenti Aquae Rosae, . . ^j. 
M. Fiat unguentum. 
Sisr. — Ointment. 



Plasters (Emplastra), — are rarely prepared extemporaneously, the 
official and many other ones being produced on a large scale by the manu- 
facturers, and kept in stock by all druggists. As a consequence the com- 
pounding and spreading of a plaster by the pharmaceutist has become a 
lost art. The official plasters are enumerated and described on page 441, 
and may be ordered by prescription in the manner illustrated below. 
Blisters may be produced by the application of any preparation of Can- 
tharides sufficiently strong for the purpose. Either of the official Cerates 
of Cantharides (see page 155), may be spread on Adhesive Plaster (Em- 
plastrum Resinae), making a blistering plaster ; or Cantharidal Collodion 
(see page 155), may be painted over the surface. Plasters are usually 
ordered by the square inch, but a model of the shape and size may be 
drawn on paper, and the plaster be directed to conform thereto, as in the 
first of the following prescriptions. Two of the official Papers (Chartas) 
are practically plasters, viz. — Charta Cantharidis and Charta Sinapis. 



Emplastrum Vesicatorium. 

R . Cerati Cantharidis, q. s. 

Extende supra Emplastrum Resinse hujus 
formae et magnitudinis. 

Sig. — Blistering Plaster, to be applied 
over the region of the heart. 



Counter-irritant and Anodyne. 



R 



Chartae Sinapis, 

Emplas. Belladonnae, aa 3 // x 6 // . 
Sig. — Apply the mustard paper first, to 
be followed by the plaster when the surface 
has been well reddened. 



GASEOUS PREPARATIONS. 



485 



Poultices (Cataplasmata), — are usually prepared at the residence of 
the patient, the ingredients only being ordered from the druggist. They 
are generally employed as a means of applying heat and moisture to a cer- 
tain portion of the body, but are sometimes medicated with anodyne, 
counter-irritant or disinfectant agents. Poultices are not official in the 
U. S. Pharmacopoeia, but are in the British, the following list including 
all so recognized : — 

Cataplasma Carbonis, — Wood Charcoal 1, Crumb of Bread 4, Linseed Meal 3, Boiling 
Water 20 parts. 

Cataplasma Conii, — Hemlock-juice 1, evaporated to half its volume, Linseed Meal 4, 
Boiling Water 10 parts. 

Cataplasma Fermenti, — Beer Yeast 3, Wheaten Flour 7, Water at 100 F., 3 parts. 

Cataplasma Lini, — Linseed Meal 2, Boiling Water 5 parts, mixed with constant 
stirring. 

Cataplasma Sinapis, — Mustard, Linseed Meal, Boiling Water and Water, of each a 
sufficiency. 

Cataplasma Sod<z Chlorinate, — Solution of Chlorinated Soda 1, Linseed Meal 2, Boil- 
ing Water 4 parts. 



Paints (Pigmenta), — are preparations for external use, which cannot 
be classed with the preceding. They are generally prescribed in skin- 
diseases, for use over inflamed joints, or for application to the throat with 
a camel's-hair brush. 



R . Tinct. Iodi, . , 
JEtheris Fort., 
Tinct. Aconiti, 
Ext. Belladon. Fl 
Morph. Sulph., 
Iodi, .... 
M. et fiat pigmentum. 
Sig. — Paint 4 or 5 coats freely over the 
inflamed and painful parts. 



fa 

3 SS - 

g r - ij- 
3jss. 



R . Alcoholis, Saponis Viridis, 

Olei Cadini, .... aa ^j. 
M. et fiat pigmentum. 
Sig. — Paint over the part. 

R. Olei Tiglii, jj. 

^Etheris Fort., ^ij. 

Tinct. Iodi, gv. 

M. Sig. — Paint on once in 3 days. 



GASEOUS PREPARATIONS. 
Vapors (Vapores) and Inhalations (Inhalationes), — are medicines 
in the form of a vapor, a gas or an atomized spray, to be inhaled by the 
patient for their local action on the respiratory tract. The well-known 
steam-atomizer is the agent by which most of these preparations are 
administered, though many substances may be inhaled from the surface of 
hot water, from a sponge in a bottle surrounded by a hot cloth, or from a 
heated shovel. They are prescribed in the usual manner, as follows : — 



Stimulant Inhalation. 

R. Olei Cubebse, gij. 

Magnesii Carbonat., . . . 2jj. 

Aquae, ^ iij. 

M. Sig. — A teaspoonful in a pint of 
water at 150 F., for each inhalation. 



Carbolized Inhalation. 

R . Acidi Carbolici, n\xlviij. 

Aquae, q. s ad ^ij. 

M. Sig. — Use one-half in the cup of 
steam-atomizer for each inhalation. 



486 



GASEOUS PREPARATIONS. 



Oil of Pine. 
R . 01. Pini Sylvestris, , . , 3 ij, 

Magnesii Carb., zj. 

Aquse, Jiij. 

M. Sig. — A teaspoonful in a pint of 
hot water for each inhalation. 



Tar and Turpentine. 
R . 01. Picis Liquidse, 

01. Terebinth., .... aa 25 ij. 
M. Sig. — Pour slowly in a hot shovel in 
the sick-room, keeping the vapor confined 
therein. 



The official Charta Potassii Nitratis, Nitre-paper (see ante, page 330), 
is a preparation intended for use as an inhalation, its vapors while burning 
being taken into the lungs. 



PART III. 



SPECIAL THERAPEUTICS. 



Applied Therapeutics may be studied either with the various thera- 
peutic agents as the objects of chief consideration, as in the first part of 
this work; or with the different diseases and morbid conditions forming 
the objects of study in respect to their modification and treatment by 
medicines. In the following pages the latter method is followed, the 
therapeutics of each affection being exhibited in the form of an Analyti- 
cal Index to the recognized text-books of the day. Every indication for 
the use of a drug, or statement regarding its value, is followed by the 
initial (in parentheses) of its author : these references enabling the book 
to be used as an index to the authorities, for more strict differentiation 
between indicated remedies, — while the brief analyses given include 
enough to make each section a complete synopsis of the most advanced 
therapeutics of the disease forming its title. 

The principal authors to whom references are made, and the various 
initials indicating them, are comprised in the following list : — 

References and Bibliography. 

(A.) Aitken. — The Science and Practice of Medicine. 

(Ag.) Agnew. — The Principles and Practice of Surgery. 

(B.) Bartholow. — Materia Medica and Therapeutics. 

(Br.) Brunton. — Pharmacology, Therapeutics and Materia Medica. 

(C.) Carter. — A Practical Treatise on Diseases of the Eye, edited by Green. 

(CI.) Clarke. — A Manual of the Practice of Surgery. 

(D.) Druilt. — A Manual of Modern Surgery. 

(E.) Emmet. — Principles and Practice of Gynaecology. 

(El.) Ellis. — A Practical Manual of Diseases of Children. 

(F.) Fothergill. — The Practitioner's Handbook of Treatment. 

(G.) Goodell. — Lessons in Gynaecology, Philadelphia. 

(H.) Hamilton. — Nervous Diseases, their Description, etc. 

(L.) Leishman. — A System of Midwifery. 

(M. & P.) Meigs and Pepper. — Diseases of Children. 

(N.) Niemeyer. — A Text-book of Practical Medicine. 

(P.) Phillips. — Materia Medica and Therapeutics. 

(Pf.) Piffard. — Materia Medica and Therapeutics of the Skin. 

(R.) Ringer. — A Handbook of Therapeutics. 

(Ros.) Rosenthal. — Diseases of the Nervous System. 

487 



l 



488 



ABDOMINAL PLETHORA — ABORTION. 



- (S.) Stille. — Therapeutics and Materia Medica. 

(St ) Sturgis. — The Student's Handbook of Venereal Diseases. 

(T.) Tanner. — An Index of Diseases and their Treatment. 

(Tr.) Tronsseati and Pidoux. — A Treatise on Therapeutics. 

(Tt.) Tait. — Diseases of Women, by Lawson Tait. 

(W.) Wood, H. C. — Therapeutics, Materia Medica, etc. 

(Wa.) Waring. — Practical Therapeutics, edited by Buxton. 

Besides the above-named, occasional references are made to other works by the 
same authors. References will also be found, with names in full, to Anstie, Brown- 
Sequard, Clymer, Cohen, Da Costa, Fordyce-Barker, Gross, Hammond, Hilton, Lister, 
Mitchell, Nelaton, Noyes, Nussbaum, Ricord, Roosa, Simpson, Thomas, and others. 
When a statement is not followed by any reference it is to be understood as coming from 
the writer of this book. 






Abdominal Plethora. 

Cathartics. The saline and hydragogne cathartics are of value in congestion 
of the portal circulation (B.). Saline Mineral Waters, especially the purgative 
saline waters, as Vichy and Saratoga, in plethora of the abdominal viscera (B.). 
Grape-cure has helped many cases, particularly those of hepatic engorgement 
and sluggish portal circulation ; is best used after a preliminary course of power- 
ful mineral waters (P.). Aliment is very important. A dry diet is particu- 
larly indicated in cases of dyspepsia and hepatic enlargement due to excessive 
beer-drinking. Avoid much bread, also salted or twice-cooked meats, rich 
sauces, solid vegetables, especially cucumbers, soups and fruits. Biscuits, 
fresh meat, lemons, fish, fowl and game, may be used. [Compare Hepatic 
Congestion, Obesity.] 



Prescriptions. 



R 



Potassii Bicarbonatis, 

Sodii Sulphatis aa ^iv. 

Dissolve in i^ pint of Water, and add 

Acidi Tartarici (cryst.), 3 ij. 

Cork quickly and firmly. %d to be taken 
thrice daily. 



R. Resinse Podophylli, . . . . gr. vj. 

Ext. Colocynthidis Co., . . gr. xij. 

Ext. Belladonnse, gr. iij. 

Fiat massa, et div. in pil. no. xij. 
Sig. — One pill every night. 



Abortion. 

Opium, cautiously in threatened abortion, is often very valuable (Wa.) ; — the 
tincture, nLxx-xxx by rectum (Parvin) ; — Opium to check uterine action and 
Ergot to restrain hemorrhage (B.). Ergot, small tonic doses give excellent 
results in threatened abortion (P.). Tannin, combined with Opium and Ipecac 
(W.). Cimicifuga, to prevent miscarriage when uterus is irritable and prolapsed 
(R.). Savine, the dried powder of the leaves, gr. xv-xx, thrice daily, one of the 
most powerful remedies against the hemorrhage indicative of approaching 
abortion (Wa.) ; — the tincture in doses of 5 to 10 drops, every }£ to 3 hours, 
useful against the hemorrhage (P.). Viburnum Prunifolium, in threatened and 
habitual abortion, has a very high reputation. Aurum Chloride, to avert the 
tendency to habitual abortion (B.). Iron, with Potassium Chlorate, throughout 
the pregnancy, when fatty degeneration the cause of habitual abortion 
(McLane). Tamponade, of the cervix uteri, with cotton or sponge, dipped in 
vinegar or glycerin, when abortion is inevitable and it is desirable to hasten it 
and restrain hemorrhage. Empty uterus thoroughly with the finger, placenta- 
forceps liable to do harm (Barker). Abortifacients, see pages 48 and 236. 
Quinine and Ergotin, of each gr. ij in pill every 3 hours, the routine abortifacient 
of many irregular practitioners. Only by the production of such violent irrita- 
tion of the abdominal and pelvic organs as generally endangers life, can the 
pregnant uterus be stimulated to expel its contents (P.). The abortifacient 
effect of Savine and other drugs cannot be obtained unless by the administra- 
tion of a quantity sufficient to endanger life (B.). 



ABSCESS — ACIDITY. 



489 



R . Ext. Ergotae Fluidi, 3 v. 

Tinct. Opii Deodorat., . . . . giij. 

Syrupi Limonis, ,f j. 

M. Sig. — A teaspoonful tlmce daily. 



Prescriptions. 

R. Acidi Tannici, gr. xv. 

Pulv. Ipecacuanhas, . . . gr. xij. 

Extracti Opii, gr. iij. 

Ft. pil. xij. Sig. — One every six hours. 



Abscess. 

Poultices to check or to assist in maturation, may be smeared with Belladonna 
or Opium (R.). Belladonna, as plaster to subdue (B.) ; painted around areola 
(Wa.) ; internally often successful in aborting (R.). Sulphide of Calcium, half- 
grain doses frequently repeated, to abort abscess or to hasten formation of pus 
(B.) ; gr. y 1 ^ every hour or two, gives striking results in healing large abscesses 
(R.). Phosphate of Calcium, in large abscesses (R.). Mercury and Morphine, 
the Oleate locally, diminishes induration due to old abscesses and prevents the 
formation of new ones (R.). Carbolic Acid, a weak solution as injection after 
evacuation, also as a dressing (Lister). Silver Nitrate, a strong solution in 
Nitrous Ether if applied early to adjacent surface will check inflammation (B.). 
Blisters or Iodine, as counterirritants around or adjacent to seat of disease (R.). 
Potassium Permanganate, 3j to the pint of water, to correct fetor (B.). Iodine, 
the tincture injected after opening large abscesses (R.) ; especially in scrofulous 
abscess (Wa.). Salicylic or Boracic Acid, as dressings (B.). Sarsaparilla, a 
very useful remedy in chronic abscess with profuse discharge (P.). Cod-liver 
Oil, improves and lessens discharge from scrofulous abscesses (Wa.). Surgical. 
Opening necessary in all deep abscesses, or when on face, near anus, mammary, 
or if danger of its opening into an internal cnvity. Open with grooved director 
and forceps (Hilton). Never open a deep abscess with a plunge. Drainage- 
tube may be required, also irrigation of the cavity and pressure (Agnew). 
Weaning of child necessary in chronic mammary abscess (Gross). Psoas abscess 
may result from strain or laceration of muscle, as by heavy lifting, effort to re- 
cover balance when skating, etc., as well as from spinal disease. Symptoms 
often obscure and simulating those of chronic malaria. Early opening by 
lumbar incision necessary ; then tonics, good food, and daily irrigation of the 
cavity with an antiseptic solution. [Compare Suppuration, Carbuncle.] 



R. 



Syrupi Ferri, Quininae et 

Strychninae Phosphatum, . ^ vj. 
Sig. — A teaspoonful in water thrice daily. 
To repair waste from suppuration. 



Prescriptions. 



U . Syrupi Hypophosphitum, . . ^vj. 
Sig. — A dessertspoonful thrice daily. 



5t • Quininae Sulph., 5jj. 

Ferri Pyrophosphatis, . . . gj. 

Strychninae Sulph., gr. j. 

Ac. Phosphor. Dil., . . . . £ij. 

Syrupi Zingiberis, ^ij. 

Aquae, q. s ad ^iv. 

M. ft. mistura. Sig. — A teaspoonful 
thrice daily. 



Acidity. 

Acids, Hydrochloric or Phosphoric before meals ; acid wine, a genuine Rhine 
wine best; Sulphurous Acid Tt^v-xxx well diluted; for acid fermentation of 
starchy foods (R.) ; acids after meals for alkaline pyrosis (R.). Tannic Acid, 
useful in pill, gr. iv with Try of Glycerin (B.). Carbolic Acid, often arrests 
eructations (B.). Alkalies, after meals for immediate relief, effects only tem- 
porary, bicarbonate best (R.) ; frequent use of alkalies enhances the mischief 
(B.). Nux Vomica, gtt. ij-iij of tincture before meals, excellent in small doses 
(B.) ; especially in acidity of pregnancy (R.). Pulsatilla, gtt. v of tincture 
every 4 hours in acid dyspepsia (P.). Silver Oxide, extremely useful (B.). Man- 
ganese Oxide, gr. x-xx of the purified black oxide relieves (B.). Kino, a favorite 
remedy (B.). Ipecacuanha, in acidity of pregnancy (R.)- Mercury, gr. ss of 
gray powder ter in die, when acidity with clayey stools (R.). Bismuth, gives 



490 



ACNE. 



excellent results, combined with Opium or Morphine, sometimes with Magnesia 
(R.). Diet. Use lemon-juice, aerated or old bread, plain biscuits. Avoid new 
bread, pastry and ( vegetables. 

Prescriptions. 



R. Bismuthi Subnitrat., . . . ^iij. 

Acidi Carbolici, . . . pr. ij-v. 

Mucil. Acaciae, J;j. 

Aq. Menth. Pip., .... |iij. 
M. Sig. — A teaspoonful 3 or 4 times 
daily for adults. 



R. Sodii Bicarb., gij. 

Spt. Ammonige Aromat., . 5jij. 
Tinct. Zingiberis, . . . . |jj. 
Infus. Gentianae Co. (U. S. 
P., 1870), q. s. . . .ad ^viij. 
M. Sig. — A tablespoonful or two. 



Acne. 

Alkalies, internally yield the best results in a number of cases (Bulkley) ; 
alkaline lotions for cases with seborrhcea (B.). Borax, a weak solution in rose- 
water (-5.H|viij), of great benefit locally in acne simplex (Wa.). Potassium 
Bromide, in moderate doses has proved curative in some obstinate cases (R.). 
Sulphur, internally and as a lotion. In severe forms an ointment of the iodide 
or hypochlorite, Z\] ad ^j (R.). Belladonna locally, is of some service, check- 
ing the abundant secretion from the sebaceous follicles (R.). Arsenic, in old 
cases, especially in acne indurata, but often disappoints. Given with bromides 
it prevents the bromic acne (R.). Phosphorus, is an excellent substitute for 
arsenic (B.) ; the compound syrup of the hypophosphites in acne indurata (R.). 
Mercury, in lotion is much employed (B); a weak lotion of the bichloride to 
the face two or three times daily (R.). The iodo-chloride (gr. v-xv ad ^) as 
irritant application (Fox) ; or ointments containing the bichloride or biniodide 
may be employed instead of the green soap application (Pf.). Glycerin, in- 
ternally, has been used with success (B.). Berberis, tt\, v of a fresh tincture 
thrice daily for the acne of girls at puberty. Bromide of Arsenic is adapted to 
the majority of cases of acne vulgaris (Pf.). Calcium Sulphide is indicated in 
cases characterized by a tendency to pustulation (Pf.). Bismuth, locally as a 
cosmetic (B.). Magnesium Sulphate, as a purgative daily before breakfast, in, 
cases of acne vulgaris depending on derangement of stomach and bowels 
(Duhring); the salt, finely triturated, is an excellent dusting-powder for cases 
of acne rosacea. Water, hot sponging for 1 5 or 20 minutes several times a day, 
followed by glycerite of starch to allay irritation (R.) ; the local use of very hot 
water is of the greatest benefit in all inflammatory forms of acne (Bulkley). 
Puncturing each papule with a lancet point, followed by very hot water, and 
ointments of sulphur iodide, ammoniated mercury, etc., diluted (Pf.). Ergot 
is well used in acne rosacea and other forms of acne ; a good fluid extract with 
glycerin and water, giving £ss internally per diem (B.). Diet and Hygiene, 
require careful attention (B.) ; powerful tonics are often required (Bulkley). 
Sapo Viridis, as an active irritant in subacute cases, applied every night as long 
as bearable, then emollients until irritation subsides, when the green soap 
should be removed (Pf.). [Compare Seborrhcea.] 



Prescriptions. 



R. Potassii Acetatis, ^ ss_ j' 

Tinct. Nucis Vomicae, . . . . £ij. 
Ext. Rumicis Fluidi, . . . ^iv. 
Misce. Sig. — A teaspoonful, largely di- 
luted, half an hour before meals. 



R. Potassii Acetatis, %]. 

Spt. Ether is Nitrosi '^j ss - 

Ac. Acetici Dil., %]. 

Ext. Taraxaci Fl., gij. 

Misce. Sig. — A teaspoonful, well di- 
luted, on an empty stomach. 



R . Sulphuris, gj. 

Glycerini, %}. 

Aquae Rosae, ^ vij. 

M. Sig. — Lotion. 



gr. x. 



R . Hydrarg. Chlor. Corr., . 

Alcoholis, q. s. 

Aquae Destil., . £ ij. 

M. Fiat. sol. Sig. — A teaspoonful in 
}{ pint of water as a lotion, twice daily. 



ADDISON S DISEASE ADYNAMIA. 



49 1 



R . Magnesii Sulphatis, . . . . J, jss. 

Ferri Sulphatis, gf-xvj. 

Acidi Sulphurici, £ij. 

Aquae, q. s. ad Jjviij. 

M. Sig. — A tablespoonful in a glass of 
water before breakfast. 



R. Potassii Acetatis, ^iv-^j. 

Tinct. Nucis Vom., . . . . £ij. 

Infusi Quassise, vel 

Tinct. Cinchonae Co., . ad % iv. 
M. Sig. — Teaspoonful in water after 
meals, as an antacid tonic. 



R. Liq. Potassae, pjj. 

Aquae Rosas ad ^ iv. 

M. Sig. — Apply with a soft sponge 
twice daily. 

R. Bismuthi Subnit., gj. 

Ung. Hydr. Ammoniat., . . % ij. 

Ung. Aq. Rosae, . . . . ad £]. 
M. et fiat unguentum. 



R. Hydrarg. Iodo-chlor., . . . gr.v-xv. 
Adipis, ...•-.• 3J- 

Fiat unguentum. An irritating applica- 
tion, requiring care. 



Addison's Disease. 

Arsenic, with cod-liver oil, gives the best results (Da Costa). Iron, and other 
tonics are useful, especially a combination of the chloride, glycerin and chloro- 
form (Greenhow). Phosphorus, has seemed to exert a beneficial influence 
(Wilks). Treatment must be symptomatic, and is of little use, the disease 
being always fatal (H.). 

Prescriptions. 



R. Tinct. Ferri Chloridi, . . . gj. 

Spt. Chloroformi, ;f j. 

Glycerini, ^ vj. 

M. Sig. — A dessertspoonful in water 
thrice daily. 



R. Quininae Sulph., %]. 

Ferri Reducti, 3J SS - 

Ac. Arseniosi, 

Strych. Sulph., aa gr. iij, 

Confect. Rosae, q. s. 
M. et div. in pilulas Ix. 



Adynamia. 

Cinchona or Quinine, with arsenic, for pale, badly-fed town-dwellers (R.) ; 
as a general tonic when flesh flabby, skin perspiring (P.). Arsenic, for swelled 
feet of old or weakly persons, and breathlessness from weak heart (R.) ; tonic 
in continued doses of gr. ^ to -^ (Wa.). Nux Vomica, in adynamia of drunk- 
ards. R. Tinct. Capsici gvj ; Tinct. Nucis Vom. 3ij ; gtt. xx in water every 
four hours (B.). Lime Salts, the phosphate, when from prolonged town-life or 
overwork, gr. j, with grain j each of Phosphate of Iron and Carbonate of Lime, 
for a dose (R.) ; Hypophosphites, of Lime or Soda, in nervous or general debility 
(R.). Iron, promotes appetite and digestion ; gr. j — iij of the Sulphate, or the 
official iron and aloes pill, or with manganese (B.) ; anaemic subjects (R.). 
Hydrastine, as substitute for Quinine, to promote appetite and digestion and 
improve assimilation (B.). Digitalis or Eucalyptus, in debility with weak heart- 
action (B.). Bitters, especially Calumba and Gentian, useful for a short time 
(B.). Sanguinaria, when stomach needs stimulation (P.). Sarsaparilla, broken- 
down, syphilitic constitutions (P.). Alcohol is of great value, but has been 
abused; hurtful when it increases temperature and pulse, dryness of tongue, 
etc. (B.) ; a wine with much ether in debility of old age, especially where sleep- 
lessness, indigestion and stomach cramps (R.). Aliment, sugar and saccharine 
fruits, vegetables, oil, milk, cod-liver oil, wine of good body and strength (B.). 
Porter or rum-and-milk for town-living women (R.). Sea-bathing, is useful in 
chronic illness, with much debility (R.). Turkish Baths, when debility is 
caused by the tropics, but caution necessary. When town-dwellers become 
stout and flabby, are easily tired, suffer from a lack of energy and from mental 
depression, a course of baths is beneficial (R.). [Compare Anaemia, Conva- 
lescence.] 



492 



AFTER-PAINS AGALACTIA ALBUMINURIA. 



Tonic Prescriptions. 



B 



. Quininae Sulph., gr. xxx. 

Ac. Sulph. Dil., q. s 

Tinct. Ferri Chlor.,. . . . Sjij. 

Aquae, ad Jij. 

M. Sig. — A teaspoonful thrice daily. 



R. Tinct. Ferri Chlor., . . . . ^iv. 

Ac. Phosphor. Dil., . . . . sjvj. 

Sp. Limonis, gij. 

Syrupi, q. s. ad J vj. 

M. Sig. — A dessertspoonful in water 
after each meal. 



R. Quininae Sulph., gj. 

Strychninae Sulph., . . . . gr. j. 

Tr. Ferri Chloridi, . . . . ^v. 

Ac. Phosph. Dil., % ij. 

Syr. Limonis, .... ad ^vj. 
M. Sig. — A teaspoonful in water thrice 
daily, in nervous debility. 



R. 



Ac. Arseniosi, gr. j. 

Quininae Sulph., gr. xl. 

Ferri et Pot. Tart., .... gr.lxxx. 
M. Fiant pil. no. xl. 
Sig. — One after each meal. 



After-pains. 

Opium, more certain in action than any other remedy (Wa.) ; Morphine and 
Atropine (gr. \ and gr. xiyo)> combined (B.), hypodermically (Wa.). Belladonna, 
as ointment, much used in France (L.). Camphor, gr. x with gr. y% of mor- 
phine, an effective remedy (B.) ; ^j in gvj of mucilage, tablespoonful doses 
every hour or two (Wa.). Chloral, will stop the pains, but large doses, gr. 
xx-xl, are necessary (R.). Chloroform, the linimentum chloroformi, 5jj with 
linim. Saponis :§vj, applied on flannel to the abdomen (Barker). Quinine, gr. 
v-x night and morning, with the above chloroform liniment locally, in neuralgic 
after-pains which do not yield to opiates, the uterus being tender on pressure 
(Barker). Gelsemium, suspends them, large doses (n\,xx) necessary (B.). Cimi- 
cifuga, relieves the pains, and allays general nervous excitement (P.). Ergot, 
is better than cimicifuga (R.). Poultices, warm, over the hypogastrium, with 
soothing injections into the vagina (L.). 



Agalactia. 

Ricinis Communis, gr. v of extract, or 3j-ij of strong decoction, daily in 
water ; also the leaves, or an infusion, locally to mammae (T.). Gossypium, 
an emulsion of the seeds has repute in India, as a galactagogue. A wineglass 
of the decoction every 20 or 30 minutes (P.). Pilocarpus, remarkably increases 
the secretions (B.). Tea, a good black tea promotes the milk-supply. [Com- 
pare Lactation.] 

Albuminuria. 

Aconite, in incipient, high body temperature (R.). Lead, diminishes the 
albumen (R.). Turpentine, gtt. ss-j, every 2 to 4 hours, or one to two drop 
doses night and morning, of great value in chronic albuminuria without marked 
symptoms of Bright's disease (P.). Gallic Acid, the most efficient agent in the 
acute form to restrain loss of albumen (B. P.). See Aitken's formula below. 
Cannabis Indica is indicated when bloody urine (R.). Chimaphila, has un- 
questioned power over albuminuria (P.). Cantharis rnj every three hours, of 
the tincture, after the subsidence of acute symptoms, especially when bloody 
urine (R.). Fuchsine, in doses of gr. j-iij, completely arrested albuminuria in 
many cases with oedema (Bouchut). Alkalies, the citrates and acetates as 
diuretics (R.) ; the Buffalo Lithia Water of Virginia is highly recommended 
Nitro-glycerin, rr\j of a one per cent, solution to dilate the peripheral vessels, 
relieving the heart and lessening the renal congestion (B.). Turkish Baths, 
benefit by relieving the kidneys of work (R.). Milk-cure, with buttermilk, 
has proved very efficient in many cases (B.). Chalybeate "Waters, especially 
those having purgative qualities, are beneficial (B.). [Compare Bright's 
Disease.] 



ALCOHOLISM. 



493 



R 



Acidi Gallici , . 
Ac. SulphuriciDil. 
Tinct. Lupuli, . 
Infusi Lupuli, 



ad 



M. Sig. — Tablesp. thrice daily. 



3HJ- 

3 V J- 



Prescriptions. 

R 



[Ait ken. 



Mist. Ferri et Ammonii Acetatis 

(U.S. P.), . . gyj. 

Sig. — Teasp. to a tablesp. according to 
age, well diluted, thrice daily. 

[Basham.) 



Alcoholism. 

Arsenic, for distressing vomiting, one drop of liquor arsenicalis before break- 
fast (R.). Capsicum, in dyspepsia of chronic alcoholism, and to induce sleep ; 
also as a substitute for the alcohol. Gr. x, with honey (B.). With bromide or 
arsenic and bitters to assist in overcoming habit, by removing the distress at 
pit of the stomach. The tinct. in io-minim doses should be taken shortly 
before meals, or whenever there is depression or craving for alcohol. It obvi- 
ates the morning vomiting, and promotes appetite and digestion (R.). Ammo- 
nia, a full dose (oSs) of the spirit will often sober a drunkard speedily (R.); — 
a few drops of liquor ammonias, diluted, have prompt action (S.) ; — 3j of the 
aromatic spirit with capsicum, see formula below. Ammonium Chloride, of 
high value (see ante, page 97). Quinine, especially the cinchona rubra, for 
gastric catarrh of drunkards (B.); gr. ij-vj daily to raise the nervous tone (P.). 
Nux Vomica, for after stomachal disorders (B.) ; in tremor of chronic alcohol- 
ism, of much value (P.) ; the tinct. in 5-minim doses with 15 of tinct. capsici, in 
water every 4 hours, is exceedingly effective in diminishing the craving for spirits 
and sustaining the nervous system. Strychnine, the Nitrate, gr. •gV'TF hypoder- 
mically thrice daily for ten days, is an absolute cure for dipsomania (Luton) ; 
a very valuable remedy for chronic alcoholism and dipsomania, not merely 
curing the attacks, but abolishing the desire for drink, the patients abstaining 
from spirits of their own accord (Pombrak). Bromides, 3j every 4-6 hours 
in the " horrors " (B.). Phosphorus, in chronic alcoholism, recommended by 
Anstie (R.). Opium, cautiously, if at all (B.) ; — Morphine with tonics before 
meals for pain, nausea, and want of appetite (R.). Cocaine, has been pro- 
nounced of great benefit, restoring appetite, inducing sleep and promoting di- 
gestion, while it soothes the brain and induces a feeling of contentment and 
calm (R.). Cimicifuga, is said to be useful in the treatment of the drunkard's 
stomach (R.). Chloral, is very successful, gr. xv-xx, but must be cautiously 
used with old worn-out drunkards (B.). Picrotoxin, small doses for the tremor, 
gr. Y V repeated (B.). Lupulin, is the best substitute for alcoholic stimulants, 
and extremely serviceable in delirium tremens (B.). Zinc Oxide, is very useful 
in chronic alcoholism, to diminish the craving, to relieve the gastric catarrh 
and lessen the tremor (B.). The Keeley Injection contains Strychnine and 
Atropine, also Codeine and Cocaine for subjects of the opium-habit. {N. Y. Med. 
Record.) See under Patent Medicines. Acute Alcoholic Poisoning requires 
an emetic or the stomach-pump, cold douche to the head and breast, warmth 
to the feet and limbs. Artificial respiration may be required. Milk, mucilagin- 
ous drinks, and black coffee, are the principal remedies. A milk diet often 
creates a disgust for alcohol. [Compare Delirium Tremens and Vomiting.] 



R . Tinct. Capsici, 

Potass. Bromidi, .... 

Vel Liq. Potass. Arsenit., 

Vel Tinct. Nucis Vom., . 

Spt. Ammonise Aromat., . 

Syr. Tolutani . ... ad 
M. Fiat mistura. Sig. — A dessertspoon- 
ful in water four or five times daily. 



Prescriptions. 

R. 



Zinci Oxidi, gj. 

Piperinse, gr. xx 

M. Fiant pil. no. xx. Sig. — One pill 
thrice daily. 



R. Tinct. Gentiana; Co., . . :§ij. 

Tinct. Calumbse Co., . . Hpj. 

Tinct. Nucis Vom., . . . nllxxx. 
M. Sig. — A dessertsp. before each 
meal, for rum-stomachs. (Loomis.) 



494 



ALOPECIA AMAUROSIS. 



R. Tinct. Nucis Vom., . . . gj. 

Tinct. Gentianae Co., ... 3 iij. 

Spt. Limonis, ttLYJ. 

Spt. Chloroformi, .... gj. 

Aquae, q. s. ad ^vj. 

M. Sig. — One-sixth to be taken 3 or 4 
times daily, for insomnia. 



R. Ext. Lupulini Fl., . . . . gj. 

Ext. Aromatici Fl., ] 

Tinct. Capsici, . '. \ . . aa ^vj. 

Mucil. Acaciae, . J 

Aquae Menth. Viridis, . ad ^ iv. 
Fiat emulsio. Sig. — A teaspoonful 01 
two as required. 



Alopecia. 

Cantharides tincture, 1 part to 8 of castor oil, well rubbed into roots of hair, 
night and morning (Wa.). Arsenic, rr^v of liq. arsenic, ter die, exercises a more 
or less powerful influence (Wa.). Nitric Acid, with olive oil, makes a service- 
able liniment (Wa.). Pilocarpine, has a decided influence on the growth of the 
hair (B.). Glycerin in combination with the above remedies (Wa.). Sulphur 
Iodide, has been found very effectual, used internally and externally (Wa.). 
Frequent shaving may often save the hair in alopecia after illness. Use clean 
brushes with long bristles, and brush against the natural lay of the hair. [Com- 
pare Tinea.] 

Prescriptions. 



R 



01. Amygdalae Expres., 

Aq. Ammoniae, ... aa ^j. 

01. Rosmarini, gij. 

Alcoholis, ,-f ij. 

Aquae Destillat., . . . . ^ ij. 
Mellis Despumat., . . ad Jviij. 
M. Sig. — Lotion for the hair. 

( Wilson.) 



R. Tinct. Macis, gjss. 

OleiOlivae, ad ^ij. 

M. Sig. — Lotion for baldness. 

(Hebra.) 



R 



M. 



Tinct. Cantharidis, . . . gjss. 

Tinct. Capsici, rr^xx. 

Glycerini, 5ss. 

Spt. Odorat., .... ad 3 vj. 
Sig. — Hair tonic. (Gross.) 



R. Pilocarpin. Hydrochlorat., gr. j. 
Aquae Destillat., . . . . ^j. 
M. Sig. — Ten to thirty drops twice daily, 
according to age, to improve the growth of 
the hair. (Bartholow.) 



Amaurosis and Amblyopia. 

Arnica, has long been a popular remedy for amaurosis in Germany. Man- 
noir employed it with much success (P., Wa.). Rue, in minim doses night and 
morning, for dimness of vision from functional amaurotic condition. Elgajaki says 
it produces dimness of vision, and in smaller doses improves the eyesight (P.). 
Strychnine, may cure, in functional amaurosis from lead, tobacco and alcohol 
(B.). Gr. ¥ X q hypodermically (Nagel). Hypodermically in tobacco and trau- 
matic amaurosis, and in progressive nerve atrophy not dependent on inter-cra- 
nial disease (R.). Guaiac, is advised for cases of amaurosis occurring in persons 
of a rheumatic diathesis (Wa.). Santonin, has given very satisfactory results 
in amaurosis (Wa.). Veratrine, as lotion brushed over eyelids, brows and 
temples once a day, if often useful, but should not be permitted to touch the 
conjunctiva, or great pain will result. See formula below (Wa.). Potassium 
Iodide, in amblyopia from lead-poisoning (Wa.). Seton, a small seton in the 
temple kept open for a long period, has been found effectual when other reme- 
dies failed (Wa.). Amaurosis and Amblyopia are names formerly much used 
to denote the various conditions of blindness, before ocular diagnosis became 
as exact as it now is. Amblyopia is still used to designate certain impairments 
of vision not accounted for by any organic changes visible (Roosa). 



Prescriptions. 



R 



Veratrinae, gr. x. 

^Etheris, gij. 

Alcoholis, ....... ^j. 

M. Sig. — Use with a brush once a day 
over eyelids, eyebrows and temples. 



R. Strychninae Sulphatis, . . gr. j. 

Alcoholis, gj. 

Aquae Destillatae, . . ad %'w. 
M. Fiat solutio. Sig. — A teaspoonful 
thrice daily before meals, when not used 
hypodermically. 



AMENORRHEA. 



495 



Amenorrhcea. 

Aconite, sudden suppression from cold or wet feet (B., R-, P.). Pulsatilla, in 
sudden suppression, also aconite (B.) ; often of the greatest value in functional 
form (P.). Iron, when from anaemia, the most frequent cause. Small doses 
preferred. Solution of acetate, or ferri et ammonii citras (gr. ij), or ferri et 
strychnine citras (gr. j), also chalybeate waters. Caution. — Careful diagnosis 
before giving iron (B.). Aloes, when dependent on anaemia (B.) ; at the pe- 
riods, with hot pediluvia, friction, etc. (R., P.). Potassium Permanganate, gr. j 
thrice daily increased to gr. ij is the best of all remedies for bringing back the 
menses, having specific action on the uterine tissue (R.) ; — excellent in amen- 
orrhcea from cold feet, and is by far the best emmenagogue. In pill it may 
explode ; best in capsule with powdered elm or liquorice (Parvin). Manganese 
Binoxide, in pill, gr. ij thrice daily, is a very efficient emmenagogue. Mercury. 
The Biniodide is a certain and safe emmenagogue, gr. }4 in pill, four times 
daily. Oxalic Acid, is highly praised, gr. %-% in mixture, every hour 
(Poulet). Apiol, when from functional inactivity. First give iron for the blood; 
next aloetic purgatives, then apiol (gr. xv) just preceding the period ; or a daily 
dose for a week, or several days before (B.). The best emmenagogue next to 
Potass. Permang. (Parvin). Senega, a saturated decoction of the root, to extent 
of a pint in 24 hours, during preceding two weeks, advantageous (P.). Polygo- 
num, has given excellent results when used in £ss doses four times daily for a 
week (B.). Cimicifuga, has been recommended (R.) ; is of very great value 
(P.). Arsenic, combined with iron, when from functional inactivity of ovaries 
(B.). Aurum Salts, from torpor of ovaries (B.).- Ignatia, in suppression of hys- 
teria (P.). Cinnamon, causes a flow, of blood to the womb (Goodell). Indigo, 
is considered very efficient, in doses of from 3j to Jiv. Larger doses produce 
nausea and vomiting. Nux Vomica, small doses of the extract, of benefit in 
some obstinate cases (Wa.). Silver Nitrate, in substance lightly to the os uteri, 
at time of expected discharge (Wa.). Colocynth, in chlorotic amenorrhcea (P.). 
Ergot, has cured when due to plethora (B.) ; when anaemia after use of iron 
(R.) ; in chlorotic (P.) ; Try every ]/ z hour for 5 or 6 hours the day before and 
that of the expected flow, is very efficient when the cessation is not due to 
anaemia (A. A. Smith). Senecio Aureus, seems to have a well-founded reputa- 
tion. Rue, in functional inactivity. Ol. rutae, TT\j-v (B., P.). Sanguinaria, 
functional amenorrhcea, in absence of plethora (B., P.). Savine, general 
atony. Extractum sabinae, fl., tt^v-x (B., R., P.). Serpentaria, with anaemia 
or chlorosis (B.). Ammonium Chloride, for headache (R.). Sitz-baths, hot, 
for six days before period ; mustard may be added at period. Often effectual 
in sudden suppression (B.). Spinal-ice-bag, to lower dorsal and lumbar 
vertebrae ; or cold sponging usetul (R.). Electricity, in atony of uterus and 
ovaries (B.). [Compare Anaemia, Chlorosis.] 



R. Olei Sabinae, ^j. 

Olei Rutae, gj. 

Tinct. Polygon. Hydropip., . . 3J. 

01. Amygdalae Expres., 

Mucil. Acaciae, 

Aquae Menthae Pip., . . . aa gij. 

Fiat mistura. Sig. — A teaspoonful two 

or three times daily. (Bartholow.) 



Prescriptions. 



R, Extr. Aloes Aquosi, gj. 

Ferri Sulph. Exsic, ^ij. 

Asafcetidae, 3 iv. 

Fiant pilulae 100. Sig. — One pill after 
each meal, gradually increased to three. 

{Goodell.) 



R . Tinct. Ferri Chloridi, . . . giij. 
Tinct. Cantharidis, . . . . £j. 
Tinct. Guaiaci Ammon., . . ,^jss. 

Tinct. Aloes, J ss. 

Syrupi, q. s. ad ^§yj. 

Fiat mistura. Sig. — A tablespoonful 

thrice daily, in simple atonic amenorrhcea. 

(H. C. Wood. Dewees.) 



$ . Quininae Sulphat., .... gjss. 

Extr. Nucis Vom., . . . . gr. xij. 

Olei Sabinae, ^ss. 

Aloes Socotrin, gr. viij. 

Cantharidis, gr. xxiv. 

Fiant pilulae xlviij. Sig. — One pill thrice 
daily. 



49<5 



ANAEMIA. 



Anaemia. 

Nux Vomica, stimulates blood-making organs, and is used as an adjunct to 
restorative remedies (B.). Iron, its chief value is to improve digestion ; also 
furnishes haematin to the blood. The most astringent preparation is the best, 
and should be used after meals. Also chalybeate waters (B.). Some stomachs, 
with irritable mucous membrane, require bland preparations. A pale, flabby- 
tongue indicates large doses of the perchloride or sulphate (R.). Arsenic, as 
adjunct to iron, and where iron cannot be borne, or fails (B.). Quinine, for 
badly-fed town dwellers (R.). Hypophosphites, are useful, but should not be 
given with iron, cod-liver oil, or stimulants (R.). Phosphate of Calcium, in 
anaemia of growing persons, and of women weakened by rapid child-bearing 
or excessive menstruation (R.). Lacto-phosphate of Calcium, for nursing 
mothers, or in waste from suppuration (B.). Acids, added to purgative salts as 
tonics to the mucous membrane (R.). Pepsin, is recommended by Hollmann 
(B.). Manganese, alone not of much use; is best combined with iron (B.). Is 
not, like iron, found in the faeces, nor does it cause constipation (Wa.). Gal- 
vanization, as aid to remedies (B.). Cold Sponging, needs great caution, or 
may lower tone by minute degrees (R.). Diet and Hygiene, of prime import- 
ance. Nourishing, digestible food, in as large quantities as can be^assimilated 
— milk, eggs, animal broths ; afterwards, fish, poultry, game, mutton, etc. 
Moderate daily out-of-door exercise, in pure air, is indispensable. Bathing, 
especially sea-bathing, aids restoration. Wines, often useful. Red wines are 
the best. 



Tonic Prescriptions. 



R. Tinct. Ferri Chloridi, . . . . fiiv. 

Ac. Phosphorici Dil., . . . % vj. 

Spt. Limonis, gij. 

Syrupi, q. s. ad ^vj. 

Misce. Sig. — A dessertspoonful in water 
after meals. To the above may be added 
gij of the Liquor Strychninae Hydrochlo- 
ratis of the B. P. {GoodelL) 



R. Hydrarg. Chlor. Corr., . . . gr. j-ij. 

Liq. Acidi Arseniosi, . . . gj. 

Tinct. Ferri Chlor., . . . . 3 iv. 

Ac. Hydrochlor. Dil., . . . 3 iv. 

Syrupi, '^iij. 

Aquae, q. s. ad Jvj. 

Misce. Sig. — A dessertspoonful in a 
wineglassful of water after each meal, as 
an alterative tonic. (A. H. S??iith.) 



R. Tinct. Nucis Vom., .... gijss. 
Tinct. Cinchonse, ... ad 25 iv. 
M. Sig. — A teaspoonful after each 
meal. 



R. Tinct Ferri Chloridi, . . . . giij. 

Potassii Chloratis, ^j. 

Liq. Strychnine (B. P.), . . gj. 

Syr. Simplicis, g iv. 

Aquae Cinnamomi, . . . ad £iv. 
Misce. Sig. — One or two teaspoonfuls 
after each meal. 



R . Quininae Sulphatis, . . . . gr. xx. 

Ferri Sulph. Exsic, . . . . gr. xl. 

Strychninae Sulph., . . . . gr. ss. 
Fiant pilulae xx. Sig — One pill thrice 
daily. (Bartkolow.) 



R . Ferri Sulph. Exsiccat., 

Potass. Carbonatis, . . aa . . gij. 

Syrupi, q. s. 
Fiant pilulae no. xlviij. Sig. — One pill 
after each meal, gradually increased to 
three. {Bland.) 



R . Acidi Arseniosi, 




• gr-j- 


Quininae Sulphat. , 




• ZY 


Ferri et Potass. Tart., 




• 39- 


M. Ft. pil. no. xxx. 


Sig, 


—One pill 


after each meal. 







R . Pil. Ferri Comp. (U. S.), . 
Sig. — One to three after meals. 



R. Pil. Ferri Iodidi (U. S.), . 
Sig. — One to three after meals. 



xlviij. 



xlviij. 



R 



. Massae Ferri Carbonat., . . . 3J. 

Acidi Arseniosi, gr. j. 

Quininae Sulphatis, . . . . gr. xl. 
Fiat massa, et. div. in pilulas xl. 
Sig. — One or two thrice daily. 



ANAESTHESIA ANEURISM ANGINA PECTORIS. 497 

Anaesthesia. 

Morphine, subcutaneously before inhalation, diminishes the danger, and 
lessens the after-pain if an operation is to be performed (Nussbaum) ; Morphine 
gr. y 1 ^ and Atropine gr. T ^, hypodermically, after emergence from anaesthesia, 
will relieve the nausea and vomiting. A preliminary injection of Morphine 
lessens the stage of rigidity and spasm, enables a smaller quantity of the 
anaesthetic to be used with full effect, prolongs the stage of insensibility, 
prevents shock, and antagonizes the cardiac and respiratory depressions (B.). 
Atropine, is decidedly the best antagonist to the respiratory paralysis of Ether, 
and should be given hypodermically (gr. -£$) as soon as alarming symptoms 
manifest themselves (Amidon). The writer of this book has saved at least 
four subjects of chloroform-narcosis by the hypodermic use of Atropine after 
both heart and respiration had apparently failed. Alcohol, ^j-ij of whiskey 
or brandy, before inhalation, to sustain the heart and prolong narcosis (B.). 
[Compare pages 81 and 175, ante, for the general subject of Anesthesia, and 
page. 25 for a list of Local Anesthetics. See also the article Erythroxy- 
lon, ante, page 215, for the use of Cocaine as a local anaesthetic] 

Aneurism. 

Potassium Iodide, in large doses (gr. xv-3ss), 3 or 4 times a day, gives great 
relief and has cured (B.) ; combined with recumbent position and restricted 
diet (R.). Veratrum Viride, aids surgical expedients ; also in large internal 
aneurisms, with absolute recumbence and a little Opium to relieve pain, 
vomiting to be avoided (B.). Ergot, with recumbent position ; favors coagula- 
tion of the blood in sac (B.) ; Ergotin (P.). Gallic Acid and Iron, internally, 
have cured cases of aortic aneurism (Speer). Chloroform, inhalation, great 
dyspnoea (R.). Plumbic Acetate, a valuable auxiliary to the more important 
items of rest, diet and mechanical appliances, gr. iij-v ter die (Wa.) ; its use 
limited to the sacculated form (S.). Electrolysis, galvano-puncture in deep 
aneurisms; not very successful (B.). The object sought is the coagulation of 
blood within the aneurismal sac. Cures have not been attained by this treat- 
ment, but in many it has produced great amelioration of the most distressing 
symptoms (Petit). Aliment, milk regimen, for de nutrition (B.) ; a low diet, 
with absolute rest ; Ergotin and Iodide of Potass, for deep aneurisms beyond 
reach of surgical treatment (B.). Rest, in recumbent posture, and light, 
unstimulating diet, are primary and essential elements in treatment of aneu- 
risms. Surgical Treatment includes ligation of the vessels, also pressure by a 
tourniquet or bags of shot, the operator's fingers, etc., applied to the main 
artery above the tumor, and the introduction of fine wire into the sac to favor 
coagulation. 

Prescriptions. 



R. Potassii Iodidi, ^j. 

Tinct. Veratri Viridis, . . . zjss. 

Tr. Cinchonas Co., §j. 

Tr. Cardamomi Co., . . . . j^jss. 

Tr. Gentianae Co., ^ ss. 

Syrupi Simplicis, 

Alcoholis, aa ^iv. 

Aquae, q. s. ad ^ xvj. 

Misce. Sig. — ^ss thrice daily. Each 
dose has gr. xv of Pot. Iod. 



R. Acidi Gallici, 3J. 

Ext. Ergotae, gr. xx. 

Digitalis, gr. xx. 

Fiat massa, et div. in pil. xx. ' 
Sig. — One every two hours. 



R . Plumbi Acetatis, . . . . gr. xxxvj . 

Extracti Opii, gr. iv. 

Confectionis Rosae, q. s. 
Ft. pil. xij. One every four hours. 



Angina Pectoris. 

Aconite, believed by Gubler to be appropriate, and by Fleming to have been 

curative in many severe cases resisting other remedies (P.). In cardiac disease 

its action is uncertain (Br.). Arsenic, lessens or prevents paroxysms, if used in 

the intervals (B., R., Anstie). Amyl Nitrite, as inhalation, affords signal relief 

32 



498 



ANTRUM, DISEASE OF — ANUS, FISSURED APHONIA. 



(R., B.); unsafe in advanced degeneration of cerebral vessels and fatty de- 
generation of heart (B.) ; gives great relief during paroxysms (Br.). Nitrite 
of Sodium, is less rapid in action than Nitrite of Amyl, but is more efficient in 
preventing return of symptoms (Br.). Laurocerasus, as anodyne (P.). Strych- 
nine, in the milder forms ; very small doses, gr. T ^ to fa (P.). Glonoinum, 
doses of TT^yijj have been used with success f Pf., R.). Chamomile, in pseudo- 
spasms of hysterical persons (P.). Ether, aborts a mild attack (B.) ; Sulphuric 
Ether, in nervous form ; a spoonful immediately on commencement of attack 
will greatly mitigate it (Anstie). Phosphorus, often serviceable (R.). Morphine, 
hypodermically, especially in cardiac dyspnoea; strengthens the heart (R.). 
Turpentine, applications, hot, over chest, to mitigate severity of the paroxysms, 
especially in the aged (Wa.). Quinine, when intermittent (Wa.) or when any 
malarial taint (Br.). Brandy, in frequent small doses, with hot bran poultice 
over heart, and warmth to extremities. Cocaine, in doses of gr. l /$ to }i thrice 
daily for two days, proved curative in four very severe cases (Laskevitch). 

Antrum, Disease of. 

Hydrogen Peroxide, a solution, i to 12 of water, injected through the ostium 
for diagnosis of empyema of the antrum. If pus be present it is driven out, 
and fills the nose as a white foam (Brown). Chloroform, by inhalation, small 
quantities frequently, for treatment of acute catarrh extending to the antrum, 
extremely efficient, both as a remedy therefor and as a preventive of suppuration 
therein (Potter). Operative Measures. That in most favor is to enter the 
antrum through the alveolus of the second molar tooth (Garretson) ; to give 
free drainage and enable medication of the diseased mucous membrane, best 
to enter the antrum in its most dependent portion, through the upper part of 
the alveolus or immediately above it, between the roots of the 2d bicuspid 
and 1st molar. A gold tube then fitted to the opening, so as to project beyond 
the mucous membrane, will give free drainage, without sacrificing a sound or 
even diseased tooth (Brown). Boric Acid, in saturated solution, as wash to 
cavity twice a day, the after treatment ; and occasionally injecting Iodine, Zinc 
Sulphate, or Bismuth Subnitrate (Idem). 



Anus, Fissured. 

Hydrastis, locally, promotes healing (B.). Rhatany, as injection, night and 
morning, after enema in the morning to move the bowels (Pf., Tr.). Iodoform, 
improves and relieves pain (B.). Iodo-tannin, well applied effective (B.). 
Belladonna, locally of great service for painful spasms of sphincter (P.). 
Opium, with gall-ointment for fissures of anus ; mild purgatives should be 
simultaneously employed (R.). Sulphur, as a mild purgative, to cause soft 
motions (R.). Tannin, 3j-glycerin ^ij ; introduced on a tent, night and morn- 
ing, with great advantage (Wa.). Collodion, as protective covering (P.). Potassic 
Bromide, with 5 parts glycerin, as local application (R.). Castor Oil, as a mild 
purgative (R ) ; to keep motions soft (Br.). Surgical Means, the most efficient ; 
forcible dilatation of sphincter, or partial division in severe cases, through the 
mucous membrane, and a few fibres of sphincter. 



R. Tinct. Kramerise, . . . . zj. 



Ext. Kramerise, . . . . z, ij. 

Aquae, ad ^viij. 

M. Sig. — One-fourth as injection, night 
and morning, after using enema. 



Prescriptions. 

I R. Sulphuris, 25 j. 



Pulveris Aromat., . . . 31J. 

Confec. Rosae, 3 i j . 

Misce. Sig. — One-third to be taken at 
bedtime as a laxative. 



Aphonia. 

Ignatia, in hysterical women (P.). Atropine, in hysterical aphonia, and for 
fatigue of vocal cords, gr. T ^ to ¥ X q, morning and evening (B.). Nitric Acid, 
rr^v-x of the- dilute acid, for hoarseness of singers, in fatigue of vocal cords, 



APHTHA APOPLEXY. 499 

and when stomachal (B.). Benzoin, the tincture by inhalation in laryngeal 
catarrh (Br.). Oil of Rue, as inhalation in chronic catarrh (Br.). Nitrate of 
Uranium, as spray in very chronic catarrh (Br.). Alum, gr. x-^j aq., as spray, 
in chronic coughs and hoarseness (R.). Borax, a piece the size of a pea 
allowed to dissolve in the mouth (R.). Glycerin of Tannin, locally in chronic 
inflammation of the throat (R.). Sulphurous Acid, by inhalation, spray, or 
fumigation, in clergyman's aphonia (R.). Ipecacuanha, wine, as spray, when 
congestion of vocal cords (R.); in laryngeal catarrh (Br.). Ammonium 
Chloride, vapor inhaled, of great value in catarrhal aphonia (Wa.). Turkish 
Bath, at commencement of a feverish cold (R.) ; in acute laryngeal catarrh 
(Br.). Galvanism, localized, the best means for hysterical aphonia. 

Prescriptions. 



R. Liq. Ammonise, . . . . :§ j. 

Aquae, £J. 

M. Sig. — A teaspoonful in a pint of hot 
water for each inhalation. 



R-. Acidi Nitrici Dil., . . . . gij. 

Tinct. Calumbae, . . . . ^j. 

Aquae, ...... ad ^iv. 

M. Sig. — A dessertsp. in a winegl. of 
water thrice daily. 



Aphthae. 

Potassium Chlorate, the best remedy. Solution of gr. x to the 3, as wash, 
alone or with borax (Br.), and gr. x to xx by the stomach (B.) Borax, with 
honey, or as glycerin of borax, frequently used (R.) ; crystals allowed to dissolve 
in the mouth (W.). Sulphurous Acid, as solution, strong or diluted, locally (R.), 
dilute as spray (B.). Mineral Acids, formerly much used (B.). Mercury, Hydr. 
cum creta in small doses to remove the indigestion on which aphthae often 
depends (B.), borax being used locally, when aphthae exist in the mouth (Wa.). 
Copper Sulphate, a weak solution painted over mucous membrane (R.). Potas- 
sium Iodide, gr. j-v-gj aquae locally (B.). Salicylic Acid, one part (dissolved 
in alcohol) to 250 of water (R.). Quinine, gr. j every 2 or 3 hours, in infants 
(B.), especially when consequent on diarrhoea (Br.). Coptis, the infusion has 
repute in New England (B.). Bismuth, freely to parts (B.) ; as a local applica- 
tion (Br.). Glycerin, will sometimes cure (R.). Rhubarb, the compound 
powder of rhubarb, to remove indigestion (Br.) ; — is highly useful in small 
doses (Wa.). 

Prescriptions. 



R. Ac. Sulphurosi, 3 ij. 

Aquae ad ^ij. 

M. Sig. — Mouth-wash, or use as a spray. 



R. Pulv. Rhei Co., . . . . 3 ij. 
Sacch. Lactis, q. s. 

Triturat. et div. in pulv. xij. Sig. — One 
thrice daily. 



Apoplexy. 

Aconite, full strong pulse ; hot, dry skin, plethoric cases. The best remedy 
(P.) ; — to lower blood-pressure and prevent further hemorrhage, where the puhe 
is strong and the arterial tension high (Br.). Elaterium, as a purgative ; a 
large dose (gr. ij) in suppository with soap ; or as an injection into large bowel 
(P.). Croton Oil, as purgative, a drop may be put on the back of the tongue 
(Br.) ; — rr\,X or )/$ each hour (R.). Colocynth, as a derivative purgative (Br.) ; 
appears to act well (P.). Cold Water, often harmful, though frequently used. 
Injurious when face pale, surface cool, circulation depressed (B.). Electricity. 
Very mild galvanic currents to promote absorption. Caution necessary, espe- 
cially if much headache and vertigo (B.). Diet and Hygiene, of great import- 
ance in patients subject to apoplexy. Avoid stimulating food and drink 
(especially beer), over-eating, excitement, haste, exposure to hot sun, heated 
rooms, etc. At no subsequent period should a full animal diet or the use of 
undiluted wines be indulged in (A.). Diagnosis. Should be carefully differ- 
entiated from drunkenness, with which it is often confounded. [Compare 
Cerebral Congestion.] 



500 APPETITE ASCITES ASTHENOPIA ASTHMA. 



Prescriptions. 



R . Tinct. Aconiti, n\x. 

Aquae Cinnamomi, . . ad 5ij. 
M. 
hours, then every half-hour. 



R. Ext. Colocynthidis Co., . . gr. xx. 
Olei Tiglii, n\,ij. 

Fiat massa, et div. in pil. iv. 
Sig. — One pill as required, until free 
purgation ensues. 



Appetite. 

Ignatia, will correct diseased appetite (P.) ; especially in hysterical subjects 
(Br.). Anthemi^, will stimulate the appetite. Bitters, to stimulate the appe- 
tite (R ). Food should be savory and well cooked. Habits require examining 
into, when lost appetite complained of. Fluorides of Sodium or Potassium will 
produce almost total anorexia, and may be employed with advantage in bulimia 
(Da Costa). [Compare Dyspepsia.] 

Prescriptions. 



R . Gentianae, Quassiae, 

Cinnamomi, aa gij. 

Sig. — Put into a pint of boiling water, 
and when cold, strain; take a winegl. 
thrice daily as an appetizer. 



R . Anthemidis, 

Quassiae, aa 5>j. 

Sig. — -Put in a pint of boiling water, and 
when cold, strain; take a winegl. thrice 
daily before meals as an appetizer. 



Ascites. 

Diuretir*, employed with marked benefit (see under Dropsy). Digitalis of 
the greatest service, except where aortic regurgitation and cardiac hypertrophy 
(P.) ; fresh infusion best (R.) ; — its action increased by combination with squill 
and pil. hydrargyri (Br.). Arsenic, when from feeble heart, and in old age (B.). 
Apocynum Can., an active diuretic (P.). Copaiba, excellent in hepatic dropsy 
(Br.). Jaborandi, has given good results (B.). Stillingia, in ascites due to 
hepatic changes (B.). Jalap, the compound powder, with podophyllum, the 
most generally approved hydragogue purgative (B.). Elaterium, to produce 
free watery evacuations. Cautiously in debilitated subjects. Contraindicated 
when gastro-intestinal irritation or inflammation. Is depressant (B.). Milk- 
diet, successful ; an ancient practice ; causes profuse alvine and urinary dis- 
charges (B.) ; — sometimes very useful when the kidney action is inadequate (Br.). 
[Compare Dropsy.] 

Prescriptions. 



R. Resinae Copaibae, .... pjiij. 

Alcoholis, 3 v. 

Spt. Chloroformi, . . . . ^j. 

Mucil. Acaciae, ^ij. 

Aquae, q. s. ad J> xij. 

M. Sig. — A tablesp. thrice daily. 



R . Hydrarg. Chlor. Mitis, 
Pulv. Digitalis, 

Pulv. Scillae, aa gr. vj. 

Fiat massa, et div. in pil. vj. 
Sig. — One pill thrice daily, in ascites 
from hepatic changes. 



Asthenopia. 

The proper glasses ; cold douche ; rest of eyes. Atropine, systematically 
instilled, to prevent strain, and control spasm of the accommodation (C). 
[Compare Myopia.] 

Asthma. 

Antipyrine, is successfully employed in bronchial asthma. Aconite, in spas- 
modic (P.) ; often averts the attack, if given at commencement ; useful also in 
the asthma following coryza and sneezing in children (R..). Ipecacuanha, the 
wine as spray to the fauces, sometimes useful in severe bronchial asthma, but 



ASTHMA. 50I 

not of much service in genuine asthma (R.) ; nauseating and emetic doses in 
spasmodic form (B.). Lobelia, gtt. x of the tincture every % hour during parox- 
ysm ; tt^x ter die, with additional doses at night, in bronchitic asthma when 
worse at night. Cautiously if heart disease (R.). Often gives permanent relief 
(B.). Arsenic, as cigarettes as well as by internal administration (B.). One 
drop of liquor arsenicalis ter die, in attacks from bronchitis, local irritation, 
etc., allied to hay fever (R.). Belladonna, relieves paroxysm when expectora- 
tion abundant, skin cool and moist (B.). Internally in large doses, also in 
cigarettes (Br.). Atropine hypodermically is more efficient, gr. ^ at bedtime 
to abort morning paroxysm (B.). Large doses required, but very satisfactory 
(R.). Was much valued by Dr. Salter and M. See (P.). Potassium Iodide, 
when from acute bronchial catarrh, gr. xv-xx each 2, 3, or 4 hours (B., R.). 
The best medicament to suppress the asthmatic attack, in bronchial asthma, is 
iodide of potassium and chloral (Lazarus). Is the specific in asthma, if any 
drug can be so called ; should be given with Lactucarium (See). Cocaine, 
hypodermically, is used with the best results, even where other remedies failed 
to relieve (Mosler). The leaves of the coca-plant make the best cigarettes for 
asthma (Nachtigal). Pilocarpine Hydrochlorate, gr. ye in water, at bedtime, 
promptly and effectively relieves, in c'ases of bronchitic asthma with hyper- 
trophic rhinitis. In some of nine years' standing it gave permanent relief 
apparently (Wyss). Nux Vomica, in nervous subjects (B.) ; in spasmodic 
asthma, often of great benefit (P.). Chloral, may arrest paroxysm (B., R.). 
Chloroform, inhaled from warm water. Anaesthetics relieve, but increasing 
doses required, leading to habit (B., R.). Ether, full dose, may avert a mild 
attack (B.). Amyl Nitrite, inhaled, quickly checks spasmodic asthma (B., R.). 
Antimony, in an affection of children like asthma. Dissolve a grain of tartar 
emetic in half a pint of water, and give a teaspoonful of this every % hour for 
the first hour, then hourly. If vomiting induced, lessen the dose (R.). Coffee, 
a small cup of very strong coffee often useful in a paroxysm (R.). Asthmatics 
should not use it as a beverage (P.). Stramonium, twenty grains of the dried 
leaves or ten of the powdered root may be smoked. Datura tatula sometimes 
better. Stramonium preparations often bad. Asthmatics advised to grow the 
drug themselves (R). Grindelia, gives relief in spasmodic form (B.) ; three 
grains of extract thrice daily, to prevent attacks, or rr\,xx-xxx of liquid extract 
every half-hour or hourly from onset of paroxysm (R.). Ethyl Iodide, very 
valuable in spasmodic form, and lessens liability to subsequent attacks, tr^v-xx 
thrice daily by inhalation (B.). Cannabis Indica, has been useful (R.) Sulphu- 
rous Acid, by inhalation, spray, or fumigation (R.). Morphine, hypodermically, 
quickly cuts short a paroxysm (B.) ; in some cases morphine will induce a 
paroxysm (R.). Apomorphine, gr. -^ hypodermically, has been found effective ; 
or gr. -^2 every 3 or 4 hours in camphor water, with or without morphine or 
ipecacuanha. Tobacco, smoking sometimes relieves (R., P.). Asafcetida, has 
been recommended (R.) ; palliative only (P.). Colchicum, in gouty subjects 
(R.). Bromides, relieve but soon lose effect (B., R.). Eucalyptus, smoked 
with stramonium, belladonna, tobacco (B.). Quinine, after acute symptoms 
subside, as antipyretic to succeeding fever and restorative tonic (B,). Potassium 
Nitrate, the inhalation of fumes of burnt nitre paper will sometimes avert a 
paroxysm. Different methods of preparation useful for different cases (R.). 
Oxygen, when no heart disease (R.). Silver Nitrate, sometimes injected into 
trachea (R.). Chamomile Oil, has been found very serviceable (P.). San- 
guinaria, is very useful in humid asthma, and occasionally so in the spasmodic 
form (R.). Galvanism, of pneumogastric often relieves ; '-j- pole beneath mas- 
toid process ; — pole to epigastrium. Faradism of no use (B.), Prophylaxis, 
avoidance of exciting causes, especially indigestible food, wet, damp, and sud- 
den changes of temperature. Attention to the stomach will do most for many 
asthmatic patients. An important point is to take the heaviest meal early in 
the day, and very solid food after 2 p.m. Shower-bath and out-of-door exer- 
cise, not, however, to a fatiguing extent (R.). In special cases operative treat- 
ment of the nose and naso-pharynx is required (Lazarus). 



5o: 



ASTIGMATISM ATHEROMA ATROPHY. 



Prescriptions. 



Arsenical Cigarettes. 



R • Sodii Arseniatis, 3 ss-j. 

Aquae Destillatae, . . . . ^j. 

Moisten unsized white paper, and roll 

into cigarettes, each containing gr. ^ to 

gr. j of the salt. Two or three of these 

to be inhaled daily. (Bartholow.) 



R. 



M 



Ext. Grindeliae Fluidi, . . ^ss. 
Ext. Lobeliae Fl., . . . . 3 ij. 
Ext. Belladonnae Fl., . . . s;j. 

Potassii Iodidi, giij. 

Glycerini ^iij. 

Sig. — A dessertspoonful as required. 



R. Chart. Potass. Nitratis, . . . j. 

Burn in a close room and inhale the 
fumes. 



R. Ammonii Bromidi, . . . . gr. clx. 
Ammonii Chloridi, ... gr. xc. 

Tinct. Lobeliae, 3"j- 

Spt. Etheris Comp., . . . *%]■ 
Syrupi Acaciae, . . . ad % iv. 
M. Sig. — A dessertspoonful in water, 
every hour or two, for the paroxysm. 

(Pepper.} 

R. Spt. Etheris Comp., . . . 25 j. 
Tinct. Belladonnas, . . . ^j. 
M. Sig. — A teaspoonful ter in\iie. 



R. Belladonnae Fol., .... ^j. 

Stramonii Fol., 

Hyoscyami, aa ^ss. 

Extracti Opii, gr. iij. 

Aquae Laurocerasi, q. s. 

Dissolve the opium in the water, and 

moisten the leaves therewith. When dry, 

roll into twelve cigarettes. Smoke two 

to four daily. (Trousseau.) 

R. Tinct. Sanguinariae, 

Tinct. Lobeliae, 

Ammonii Iodidi, . . . aa £j. 

Syr. Tolutani, £vj. 

M. Sig. — A teaspoonful every 2, 3 or 4 
hours, in humid asthma. (B.) 



R 



M 
or 4 

R. 



Tinct. Lobeliae, .'..... %'}. 
Ammonii Iodidi, . . . . .' jjjij. 
Ammonii Bromidi, .... giij. 

Syrupi Tolutani, 5 ij. 

Sig. — A teaspoonful every 1, 2, 



hours. 



(B.) 



Spt. Etheris. Compos., 
Liq. Morph. Sulph. 

(g r - j ad IJ), . . . . aa %). 
M. Sig. — A teaspoonful every half-hour 
or hour in the paroxysm. 



R . Potassii Bromidi, . . . . 3 j. 

Potassii Iodidi, . . . . . t ^ss. 

Aquae Cinnamomi, . . . . ^ iv. 
M. Sig. — A teaspoonful in water every 
half-hour or hour. (B.) 



Astigmatism. 

Atropine, a weak solution to aid examination of eye by dilating pupil, and 
paralyzing accommodation (B.). Duboisine, as substitute for atropine, has more 
rapid action, with shorter duration of effects, and less conjunctival irritation. 
Glasses, of suitable form, cylindrical in simple astigmatism, bi-cylindrical in 
mixed astigmatism. Pray's Test Letters, to determine degree and direction of 
the defect (C). 

Atheroma. 

Phosphorus, in minute doses, for atheroma, with cod-liver oil (B.). Arsenic 
often of great value in atheroma, especially where imperfect action of kidneys 
(Br.) ; indicated when there are puffy eyes, drowsiness, intellectual torpor (B.). 
Quinine, gr. iij-x daily, in atheroma, with advantage (B.). Ammonium Bro- 
mide, in atheroma, to promote absorption of deposit (Wa.). Digitalis, maybe 
useful in general capillary atheroma ; cautiously ! (W.). Cod-liver Oil, with 
phosphates, hypophosphites, or the lactophosphate of lime, in combination 
(B.). [Compare Aneurism.] 

Atrophy. 

Cod-liver Oil, has proved beneficial (Wa.). Olive Oil, by inunction, every 
12, 6, or 4 hours, successfully employed (Wa.). Arsenic, has had remarkable 
success in muscular atrophy (Tr.). Electricity, in progressive muscular atrophy, 



BALANTIS BED-SORES BILOUSNESS. 503 

the induced current very strong at first, then weaker as improvement ; inter- 
rupted currents from vertebral column and plexuses to nerves of affected mus- 
cles ; in more extended forms, the constant current to the nerves, the induced 
to the muscles (Ros.). Massage, removes the waste products and restores the 
muscular power (Br.). [Compare Emaciation, Locomotor Ataxia.] 



Balanitis. 

Mercury, Hydr. Chlor. Corr. gr. j to ^jss aquas calcis, as lotion, if not much 
inflammation (Br.). Oil, on linen, to inflamed part, beneath foreskin, which 
must be again drawn forward ; strict cleanliness. Astringent Lotions, Alum, 
Sulphate of Zinc, with warm water injections (Br.). Lime-water, the best lotion 
if much inflammation (D.). Tannin, in alcohol, equal parts, as dressing after 
washing with a weak solution of common salt. Carbolic Acid, a 5 per cent, 
solution, on cotton rag after washing, thrice daily, is generally sufficient. [Com- 
pare Phimosis, Gonorrhoea.] 



Bed-sores. 

Alcohol, Brandy, or eau-de-cologne, to harden skin of parts exposed to 
pressure (R.) ; as wash to parts threatened (B.). Glycerin, or glycerin cream, 
rubbed over the parts exposed to pressure, after washing, morning and evening, 
is one of the best preventives (R.). Alum, jfss, whites of four eggs, Tinct. 
Camphoras, ifij, an excellent application (B.). Charcoal, sprinkled over the 
black slough, which is then covered with poultice (R.). Galvanic Couplet, of 
zinc and silver, connected by a copper wire; one element on sore, the other on 
adjacent part (B.). Silver Nitrate, a solution (gr. xx-^j) to be painted on the 
threatened but unbroken skin, as soon as it becomes red, will prevent sores; if 
Nitrous Ether solution be used, 5 grs. to the oz. is enough (R.)- Iodoform, dusted 
over sores (R.). Linen, air-dried better than that which is ironed or mangled, 
by reason of its greater softness. 



Biliousness. 

Podophyllum, acts as a cathartic (B.) ; corrects deficient secretion of bile, espe- 
cially in children and infants ; gr. -^ to t X q, every six hours, to correct white or 
clayey stools ; also in general hepatic derangement (P.). Aconite, in occa- 
sional doses, improves the effect of Podophyllum (R.). Mercurial Cathartics, 
act only as purgatives, Calomel gr. j-x, or Pil. Hydrarg. gr. v-x ; Mercury 
as purgative restricted to cases where there is excess or deficiency of bile (B.). 
Frequent small doses of gray powder for deficiency (R.) ; Calomel, gr. iij, fol- 
lowed by 3ij each of Rochelle and Epsom Salts, when the tongue is heavily 
coated and furred (Gross). Yellow Oxide of Mercury, in doses of gr. ^ to ^, 
in trituration with sugar of milk, exceedingly efficient in many disordered con- 
ditions of the alimentary canal and its appendages (Schaffer). Bryonia, is 
worthy of commendation in the ordinary bilious headache with vomiting, and 
in general hepatic derangement known as sluggish liver (P.). Hydrastis, gtt. 
v-xv fl. ext. daily before meals, when with chronic gastric catarrh and dys- 
pepsia (B.). Mineral Acids, before meals, Hydrochloric Acid and Pepsin after 
meals, in atonic dyspepsia (B.). Stillingia, when deficient biliary secretion (B.) ; 
may be used in place of Mercury (Br.). Ammonium Iodide, gr. j-iij in water 
each 2, 3, or 4 hours, when catarrh of duodenum and biliary ducts (B.). 
Ammonium Chloride, is much employed in Germany for hepatic derangements, 
and with good success. Euonymus, is considered very efficient by many prac- 
titioners in cases of hepatic dyspepsia, or " bilious attacks," so-called. Man- 
ganese, gouty subjects. Rhubarb, as a cholagogue. Aloes, with constipation. 
Angostura, is suitable to worst forms of bilious fevers (P.). Calumba, is of 
benefit in many forms (P.). Alkalies, and their laxative salts, when bilious 



104 



BLADDER BLEPHARITIS. 



state, with uric acid diathesis (B.). Milk-cure, in obstinate cases ; buttermilk 
or skimmed milk often agrees best (B.). [Compare Dyspepsia, Hepatic 
Congestion, Duodenal Catarrh.] 

Prescriptions. 



Be. Ext. Stillingise Fl., 3 v. 

Tinct. Aloes, ^ij. 

Tinct. Nucis Vom., gj. 

M. Sig. — Twenty drops in water thrice 
daily. (B.) 



R 



. Ext. Euonymi, 3 ss. 

Ext. Hyoscyami, gr. xv. 

Ext. Gentianae, g r « v j- 

Fiat massa, et div. in pil. xij. 
Sig. — One pill every other day. 



&. Hydrarg. OxidiFlavi., . . . . gr. j. 
Sacch. Lactis, q. s. 

Triturat. et div. in chart, xlviij. 

Sig. — One powder dry on the tongue 
twice daily. 



R . Massae Hydrargyri, 

Ext. Colocynthidis Co., aa gr. iij. 

M. et div. in pil. ij. 

Sig. — Take at once, and follow in a few 
hours with a saline cathartic. 



Bladder, Irritable. 

Belladonna, in nocturnal incontinence, due to relaxation of sphincter, or irri- 
table mucous membrane (B.) ; gtt. v-xx of tinct. every 3 or 4 hours give gradual 
but sure relief (P.). Cantharis, in women, without acute inflammation (B.) ; 
on coughing (R.). Benzoic Acid, when from enlarged prostate, removes fetor 
of urine ; also renders phosphaticor alkaline urine acid (P.). Ammonium Ben- 
zoate, may be used instead of Benzoic Acid (Br.). Gelsemium, the best remedy 
for irritable bladder of women of hysterical type, with constant desire to urinate 
(B.). Cubebs, is often successful in women, but Cantharides generally better 
(B.) ; is of especial value when vesical catarrh present (P.). Aqua-puncture, 
strange to say, has been used with considerable success (B.). Cannabis Indica, 
in spasm of the bladder, and in irritable conditions of that organ is generally 
useful. Eucalyptol, is often very efficient, but frequently fails, rr\,ij on sugar 
two or three times a day. [Compare Cystitis, Dysuria, Enuresis, Lithiasis, 
Calculi, Urinary Disorders.] 



Prescription. 



R. Tinct. Gelsemii, gss. 

Sodii Bromidi, 3 iij. 

Ext. Tritici Fluidi, ....:§ iss. 



Sig. — A teaspoonful in water every four 
hours, for irritable bladder. 



Bladder, Paralysis of. 

Cannabis Indica, in retention from spinal disease (R.). Ergot, in paralytic 
dysuria, especially when sensation of bladder being only partially emptied 
(P.) ; when incontinence from paralytic sphincter, and in paralysis from over 
distention (B., Wa.). Arnica, has proved curative (P.). Strychnine, gr. ^ to ^ 
useful (B.). Cantharides, often given with excellent effect, when bladder atonic 
(Wa.). Galvanism, may greatly benefit (B.) ; electro-magnetic current from 
the bladder to the spine, of great use (Wa.). 



Blepharitis. 

Pulsatilla, internally and externally (P., B.). Mercury, after detaching crusts, 
rub in brown citrine ointment (B.) ; should be diluted with vaseline or simple 
ointment (Br.). Tannin, powdered, or tannic acid solution, gr. j-x to the J 
(B.). Alum, after acute symptoms subside (B.) ; a solution, gr. viij-^j aquae, 
every % or Yz hour, an excellent application (R.). Hydrastis, as lotion, very 
serviceable (P.). Bismuth, equal parts of the subnitrate and glycerin to the 
inflamed surface, in ciliary and glandular blepharitis (Wa.). Ergot, the fluid 
extract locally, gives excellent results (B.). 



BOILS BONE BREATH. , 505 

Prescriptions. 

R . Aluminis, gr. x. j R . Unguent. Hydrarg. Nitrat., ^j. 

Aquae Rosa?, ^ij. Vaselinae Albae, 3 iij. 

M. Sig. — Lotion for the eyelids. (B.). \ M. Sig. — Ointment for the margins of 

I the eyelids. 

Boils. 

Belladonna, as plaster, to subdue inflammation, or use lint wetted with Atro- 
pine, gr. iv, Aquae Rosas, 3J (B.) ; with Glycerin locally, to allay pain ; inter- 
nally often successful (R., Wa.). Sulphides, in small doses (gr. T L to y z of Calx 
Sulphurata) every hour or two, or Sulphurous Mineral Waters will abort or 
mature, and aid to expel pus (B., R.) ; of no use in the boils of diabetes (R.). 
Aromatic Sulphuric Acid, for the tendency, gtt. x-xv, in plenty of water thrice 
daily. Silver Nitrate, gr. v-xx-^j of nitrous ether, painted over adjacent part, 
to abort ; specific if used early (B., R.). Boric Acid, gr. xij daily, in 2 wafers; 
also a 4 per cent, aqueous solution, warm, externally by gentle friction, 4 or 5 
times a day, and on compresses to the parts — will abort furuncles yet in the 
commencement of development, rapidly cure those matured, and prevent new 
ones (Alison). Arsenic, long-continued for succession of boils (B.) ; to lessen 
tendency to recurrence (Br.). Opium, a thick extract locally (R.). Camphor- 
ated Alcohol, smeared over boils in the earliest stage, then, when skin dry, 
smear with camphorated oil, to abort (R.). Sodium Phosphate, the best remedy 
for the systemic condition which produces boils (R.). Carbolic Acid, undiluted, 
on a thread passe.d through centre of boil while recent, will abort it. A carbol- 
ized solution on dressings after opening a boil, of 5 per cent, strength, will pre- 
vent a second crop, due, as is often the case, to the migration of cocci by the 
skin from the original boil. Counter-irritation, by blisters or iodine around 
the boil (R.). Collodion, at papular or pustular stage (R.). Salicylic Acid, 
locally to destroy the parasitic organism (staphylococcus pyogenes), on which 
boils depend. See formula below. (Heitzmann.) Hydrarg. Biniodide, the 
oint. locally, with Calcium Sulphide, gr. j daily in divided doses internally, 
leaves little to be desired so far as treatment is concerned. Corrosive Subli- 
mate, the B. P. solution, dropped into the ear twice daily, in furunculosis of 
the ear, also on cotton wool in the canal, gives satisfactory results and prevents 
return. Aluminium Acetate, a solution in water, 1 to 4, causes the speedy abor- 
tion of boils in the external auditory canal (Grosch). Poultices to assist matu- 
ration and allay pain, may be smeared over with Belladonna or Opium (R.). 
[Compare Acne, Carbuncle.] 

Prescriptions. 

R- . Acidi Salicylici, ^ij. 

Emplast. Saponat., t ^ij. 

Emplast. Diachyl., .... ^j. 
Sig. — Ointment. {Heitzmann.} 



R . Calcis Sulphurat., . . . . gr. iij 
Sacch. Lactis, q. s. 
Triturat. et. div. in chartas xxx. 
Sig. — One powder every 2 hours 



Bone, Diseases of. 

Iodine, in scrofulous affections of bones, should be used locally, with the 
iodide of iron or cod-liver oil internally, nutritious diet, wine, out door exercise 
(Wa.). Cod-liver Oil, in scrofulous affections, may be relied on if perseveringly 
used, and accompanied by good hygienic conditions (Wa.). [Compare Caries, 
Exostosis, Nodes, Periostitis, Rachitis, Spina Bifida, etc.] 

Breath, Fetid. 

Potass. Permang., gr. j-^j aquae rosae, as a wash for the mouth (B.). Chlo- 
rine, as solution of chlorinated lime, to remove fetor (B.). Carbolic Acid, a 
dilute solution, as wash for mouth (W.). Camphor, is used as a corrective (R.). 



5°6 



BRIGHT S DISEASE. 



Look for bad teeth, disordered digestion ; in very offensive cases, gangrenous 
lungs, cleanliness of 1 teeth and mouth are essential. Thymol, in solution, as a 
mouth-wash is very efficient in removing the odor of tobacco from the breath. 

Prescriptions. 

& . Calcis Chlorat., giij. j R. Acidi Salicylici, gj. 

AquDe Destillate, Liq. Ammonii Acet., . . . . %\\y 

Alcoholis, aa ^ij. Glycerini, 3j. 

Olei Rosas, ^iv. Aquse, q. s ad Jjvj. 

M. Sig. — A teaspoonful in a glassful of M. Sig. — A tablespoonful every six 

water as a lotion for the mouth. (B.) j hours. [Robinson.) 



Bright's Disease, Acute. 

Aonite, should be given immediately on the appearance of the nephritis in 
scarlatina (R.) ; as a diuretic, advocated (P.). Cantharis, after subsidence of 
the acute stage, one-minim dose every 3 hours will stop the hematuria (R., 
B.). Digitalis, (infusion ^ss) the best remedy in renal dropsy from acute 
desquamative *nephritis (B.) ; only diuretic as long as dropsy lasts (R.). Can- 
nabis Indica, as diuretic ; is especially useful when bloody urine (R.). Eu- 
calyptus, sometimes effective; cautiously, or it will aggravate symptoms (B.). 
Hyoscyamus, in irritable kidneys (P.) ; may be substituted for Belladonna 
(Wa.). Jaborandi, is much used (Da Costa); large doses very depressant to 
the heart, but ni.v-x of the fluid extract every half-hour or liour will produce 
sweating. It may be combined with tinct. of Digitalis (A. A. Smith) ; or the 
Nitrate of Pilocarpine, to excite skin when symptoms urgent, gr. ^ to ]/% for 
adult (B.). Turpentine, in drop or half-drop doses every 2 to 4 hours, controls 
the dropsy in a remarkable manner (P.) ; hot turpentine epithems are service- 
able, but may increase the action of the kidneys (Wa.). Belladonna, has 
often proved useful (P.) ; may be used with benefit (Wa.). Jalap, the com- 
pound powder is the most generally useful purgative, used in the early morn- 
ing, to produce free watery evacuations, when ursemic symptoms supervene 
(B.). Gallic Acid, checks albuminuria (B.). [See Albuminuria, for formula.] 
Juniper, as diuretic ; often aggravates (P.). Poultices, large, of linseed meal, 
made light and soft as possible, beneficial (Wa.). Cupping, in lumbar region, 
ameliorates acute desq. nephritis, and congestion of the kidney (B.) ; cupping 
or leeches over the loins, with opiates freely, diluents, and demulcents, with 
rest and antiphlogistic regimen, often suffice (Wa.). Vapor-bath or Warm 
Pack, to increase the action of the skin (B.). Diluents, as milk, and cream-of- 
tartar in solution, should be used freely to relieve the congestion and remove 
obstructions from the tubules (B.). Iron, after the acute symptoms have sub- 
sided, as a tonic, the most suitable preparation being Basham's mixture, the 
now official Mist. Ferri et Ammonii Acetatis, in ,^ss doses thrice daily. (Da 
Costa). [Compare Albuminuria, Hematuria, Uraemia.] 



Prescriptions. 



R. Potassii Acetatis, .... gijss. 

Infusi Digitalis, . . . . %\\). 

Infusi Juniperi Jiij. 

M. Sig. — A tablesp. every 2 to 4 hours 
as a diuretic. 



rje. Pulv. Jalapse Comp., . . . ^iv. 
Div. in chartulas no. iv. 
Sig. — One in water before breakfast. 



R . Mist. Ferri et Ammonii Ace- 
tatis, ^ v "j- 

Sig. — A tablesp. thrice daily, as soon as 
hematuria disappears. 



R- . Ext. Pilocarpi FL, . . . | ss. 

Vini Ipecac, 3J SS - 

Mucil. Acaciae, . . . . !$j. 
Aq. Cinnamomi, . . ad ^ij. 
M. Sig. — A teasp. every four hours 

until free diaphoresis. 



BRIGHT'S DISEASE, CHRONIC BRONCHIECTASIS. 507 

Bright's Disease, Chronic. 

Milk-cure, has been very successful ; skim-milk alone for some time, then 
gradual addition of other diet (B.). Water, in large draughts, as diuretic, 
when excretion of solids is deficient (Br.); hot fomentations to lumbar region 
(B.). Lead, diminishes the albumen (R.). Gallic Acid, to lessen the albu- 
minuria. See under Albuminuria for formula (A.). Hydrastis, lessens excre- 
tion of albumen (B.). Potassium Bitartrate, to prevent dangerous accumula- 
tions in cellular tissue or important cavities, also to draw off effete matters ; 
care must be used as it is a brisk purgative, and is weakening (R.) ; in form of 
" cream-of-tartar lemonade," an agreeable diuretic (B.). Jalap, the compound 
powder occasionally, as derivative cathartic, to relieve the kidneys (Da Costa). 
Nitro-glycerin, ttl -ji^ to dilate peripheral vessels, relieves the heart and the 
renal congestion, and diminishes albumen (B.). Fuchsin, in doses of gr. vij-xv 
daily, used with considerable success in different stages of the disorder, and was 
well borne (Riess). Oleum Erigerontis, lessens albumen, lowers vascular ten- 
sion, improves general condition, and favorably influences the headache, nausea, 
and other uraemic symptoms (B.). Tartrates, excellent diuretics (R.). Cod- 
liver Oil, is very useful (R.). Baths, warm and Turkish, when uraemic symp- 
toms and dropsy ; discretion needful, as baths may weaken (R.). Cannabis 
Indica, as diuretic when bloody urine (R.). Turpentine, sometimes given in 
very small doses as a diuretic, and to check hematuria (R.) ; half-drop or drop 
doses every 2 to 4 hours very successful in dropsy with albuminous urine de- 
pending on non-desquamative disease of the kidneys. Jaborandi, in uraemia 
is very satisfactory (B.) ; large doses very depressant to the heart (A. A. Smith) ; 
rti, xx of the fluid extract ter in die if the urine decreases much (Da Costa). 
Iron, to improve digestion and correct anaemia ; the tinct. of the chloride or 
tinct. ferri acetatis preferred (B.) ; in chronic tubular -nephritis with cardiac 
hypertrophy the mist, ferri et ammonii acetatis, £ss ter in die, with an occa- 
sional vapor-bath (Da Costa). Chimaphila, has power over various forms of 
nephritic disease, especially when albuminuria present (P.). Eucalyptus, in 
chronic desquamative nephritis, cautiously used, will cause improvement (B.). 
Elaterium, for the dropsy, as a derivative cathartic ; must be cautiously used 
(R.). Bromides, are useful in the convulsions (R.). See Uraemia. Potassium 
Iodide, has improved some cases, which were possibly due to syphilis (R.). 
Aurum, the chloride in pill gr. -^ to -^ ter in die, persistently, in the chronic 
interstitial nephritis, to arrest hyperplasia of the connective tissue ; may be 
combined with Arsenic, which has a similar influence (B.). Mercuric Chloride, 
acts in the same manner, gr.-^- bis die (Da Costa). Food, should be nourish- 
ing, particularly suitable are milk, eggs and rare beef (Da Costa). Buffalo 
Lithia Water, of Virginia, has many advocates. [Compare Dropsy, Uraemia.] 

Prescriptions. 
(Compare those under Bright's Disease, Acute.) 
R. Strychninae Sulphatis, . . . gr %. I R. Tinct. Nitro-glycerini, . . . gj. 

Tinct. Ferri Chloridi, . . . ^ss. Sig. — One drop, gradually increased to 

Acidi Acetici, 3J SS - I fi ye > f° ur times daily, on sugar. (B.) 



Curacoae 



Liq. Ammonii Acetat., . ad 5vi. 1 „ . . . „ ,.. ^,, 

J R . Aun et Sodn Chlor., . . . . gr. jss. 

M. Sig. — A tablesp. every 6 hours, fol- ! Aquae Destillatce, ^iv. 

lowed by a glass of water. For the anaemia. | Solve. Sig. — A teasp. ter in die. 



Bronchiectasis. 

Quinine, the most useful remedy as a tonic (B.). Phosphates, are undoubt- 
edly useful, so also are the Hypophosphites (B.). Chlorine, in solution as a 
stimulant and deodorizer, or as inhalation to lessen fetor (Br.). Palliation of 
the cough and expectoration, with care of the general health of the patient, is 
all that can be accomplished. [Compare Emphysema.] 



5o8 



BRONCHITIS. ACUTE. 



Bronchitis, Acute. 

Acetanilide, in dose of gr. iv every two hours, has often arrested the attack 
within 24 hours. Aconite, gtt. ss-j every hour (B.) ; in catarrh and bronchitis 
of measles (R.)- Tartar Emetic, first stage, gr. 2V t0 tz> especially if cough 
is violent (B.) ; — gr. j to a quart of water, a teasp. of this every hour for the 
wheezing and cough of slight bronchitis in children (A. A. Smith) ; — gr. % 
to yi every 2 or 3 hours (R.). Ipecacuanha, as wine, when expectoration 
profuse and difficult to expel (R.) ; dry stage (P.) ; Ipecac, when secretion 
is scanty and dry ; Squill, when the secretion, though copious, is difficult 
to expel (Brunton). Lobelia, as expectorant (B.) ; for paroxysmal dyspnoea 
(R.). Sanguinaria, after subsidence of acute symptoms, as expectorant (B.) ; 
very successful (P.). Quinine, to reduce temperature (R.). Colchicum, useful 
when gouty diathesis (P.). Opium. Morphine and quinine combined, or 
Dover's powder, to abort an attack ; also with expectorants to allay cough 
(B.). Frequent and violent coughs, without obstructed oxidation ; also to 
check excessive secretion (R.). As sudorific very useful, grs. x of Dover's 
powder (P.). Carbolic Acid, as spray, a 5 per cent, solution with steam 
atomizer, prompt and efficient. Apomorphine, the hydrochlorate in doses 
of gr. -^ every 3 hours, the best of all expectorants. Cimicifuga, an 
excellent expectorant, and useful when acute symptoms have subsided 
(B.) Nitric Acid, n^x of dilute acid relieve (B.). Asafcetida or Ammo- 
niacum, the last best, in bronchitis with wheezing of old people (R.). 
Asafcetida, is an excellent stimulant of respiration, especially when the 
capillaries have become clogged with the products of inflammation, and 
suffocation seems imminent. Here also the Cold Bath is a means of enabling 
the patient to expel the mucus, the equal of which has not been yet 
advanced. The cold bath may be used for even very young infants, and 
should be but momentary (W.). Ammonium Carbonate, when the expectora- 
tion is profuse, and the condition low (R.). Ammonium Acetate, from its sudor- 
ific action is always indicated, especially in children (Dessau). See formula 
below. Cubebs, very useful, especially when secretion copious and system 
relaxed (P.). Copaiba, after subsidence of the fever, the most serviceable ex- 
pectorant, but nauseous (B.). Counter-irritants, mustard as poultice (large), 
with linseed or oatmeal, or both, very useful (R.). Iron, Lead, Zinc Oxide, 
to check profuse secretion (R.). Heat to chest by linseed poultices, of great 
service. Diet, should be light and in liquid form. Temperature of atmosphere 
in room about 8o° F., and the air moistened by steam. [Compare Cough.] 



Prescriptions. 



R . Antim. et Pot. Tart, . . 

Liq. Ammonii Acet., 

Spt. Etheris Nitrosi, . . 

Tinct. Aconiti, . . . . 

Syr. Simplicis, . . . q. 
M. Sig. — A teaspoonful 
hours. In first stage. 



. • gr. ij. 

• • n 

. . .^ss. 
s. ad ^ vj. 
every 2 or 



R. Liq. Ammon. Acetat., . . . ^iv. 

Spt. Etheris Nitrosi, 

Syr. Ipecac, aa ^iss. 

Syr. Senegoe, %]. 

Syr. Limonis, %]. 

M. Sig. — A teaspoonful every 3 hours 
for children. (Dessazt.) 

R. Tinct. Aconiti, . . . • . . TT\viij. 
Aquae Cinnamomi, . . . . ^j. 
M. Sig. — A teaspoonful every J4 hour 
for 2 hours, then every hour. In acute in- 
flammatory form. 



R • Ext. Cimicifugae Fl., . . . | ss. 
Tinct. Opii Deodorat., . . . £j. 
Syr. Tolutani, .... ad ^ij. 
M. Sig. — A teaspoonful every 4 hours. 

(B.) 



R 



. Tinct. Sanguinariae, 

Tinct. Lobeliae, ... aa cjj. 

Vini Ipecac, 51J. 

Syrupi Tolutani, . . q. s. ad giv. 
M. Sig. — A teasp. every 3 hours. 



(B.) 



R 



Apomorph. Hydrochlor, . . gr. % , 

Ac. Hydrochlor. Dil., . . . mjij. 

Syrupi Senega?, . . . . . 2 v. 

Aquae Destillat., }fj. 

M. Sig. — A teaspoonful every 2 hours. 
For a child of 3 years as expectorant. 
Should be put up in a blue bottle. 



BRONCHITIS, CAPILLARY- 



R • Vini Ipecac, 

Liq. Potassii Citratis, . 
Tinct. Opii Camphorat., 

Syr. Acacias, 

M. Sig. — Tablesp. ter die. 

of ordinary acute bronchitis. 



=PJ- 



aa 5j. 

In first stage 
[Da Costa.) 



-BRONCHITIS, CHRONIC. 509 

R. Ext. Eriodyctii Fl., . . . . gvj. 

.Ext. Senegse Fl., ^iv. 

Syr. Pruni Virginian., . . . ^ij. 

Aquas, q. s. ad % iv. 

M. Sig. — Teaspoonful every 3 hours. 



Bronchitis, Capillary. 

Ipecacuanha, as emetic, preferred to tartar emetic in capillary bronchitis of 
very young or very old (B.) ; as wine, when expectoration profuse and difficult 
to expel (R.). In very young infants should be used in place of antimony 
(M. & P.). Squill, as expectorant, may be used with benefit (Wa.). Antimony, 
sulphurated, gr. T V in combination with Dover's powder, every 2 or 3 hours, 
when the temperature very high, and pulse full and strong. Must be stopped as 
soon as nausea and vomiting begin (M. & P.). Lobelia, for paroxysmal dysp- 
noea (R.). Ammonium Carbonate, when expectoration profuse and strength 
diminishing ; in severe bronchitis or broncho-pneumonia of children, especially 
when prostrate and livid (R.) ; has probably a specific action on the diseased 
tissue and its products (Clymer). Ammonium Iodide, in small, rapid doses, 
often gives great relief to the catarrhal process (Da Costa) ; often gives the 
most astonishing relief (B.). Ammonium Muriate, gr. ij every 2 hours, either 
alone or with potassic chlorate (Clymer). Serpentaria, in capillary bronchitis 
of children gives excellent results (B.). Turpentine, one of the best stimulants 
when vital powers are depressed and peripheral circulation feeble (B.). Cam- 
phor, to allay cough and promote expectoration (B.). Hydrocyanic Acid, for 
cough and tendency to spasm. Hydrarg. Subsulph. effective as emetic (B.). 
Mustard, as poultice or bath, useful (R.) ; — the most important part of the treat- 
ment (M. & P.). Poultices, to encircle the whole chest in children (R.). A 
jacket of cotton-wool around the chest. Steam, by inhalation, may be impreg- 
nated with sedatives, or with carbolic acid; — is of great importance (M. & P.). 
Quinine, in that form of capillary bronchitis occurring in tropical climates, and 
where marked debility (M. & P.). Stimulants, are often necessary, especially 
in the suffocative form, and where marked prostration (M. & P.). Emetics are 
necessary when suffocative symptoms become prominent. [Compare Cough.] 



R. Ext. Serpentaria FL, . . . J ss. 
Ammonii Carb., gij. 



Prescriptions. 

R. 



M. 



Syr. Tolutani, 3J SS - 

Sig. — A teasp. every 2, 3 or 4 hours. 



R. Quininas Sulph., gr. vj 

Ac. Sulph. Dil., rt^xij 

Syr. Simplicis, ^ss. 

Aquas, J ijss. 

M. Sig. — A teasp. every 2 hours 



child of 2 or 3 years; 
quire more quinine. 



to 

older children re- 
(M. & P.) 



Liq. Ammonii Acet., . . . ^ss. 

Syr. Ipecac, 3J. 

Liq. Morph. Sulph. 

(gr. j ad D), ..... TTlxI. 

Syr. Acacise, I|j. 

Aquas ,^j ss - 

M. Sig. — A teasp every 2 hours for a 
child 2 years old When surface pale and 
expression languid, skin cool. (M. & P.) 



R 



M. 



Ammonii Iodidi, ..... ^j-ij. 

Ammonii Carb., gvj-iij. 

Syr. Glycyrrhizse, . . . ^ij. 

Syr. Tolutani, ^ ij. 

Sig. — A teasp. every 2 or 3 hours. 



Bronchitis, Chronic. 

Antimony, when expectoration copious and difficult to expel (R.). Arsenic, 
where emphysema, in cigarettes (B.). [See ante, Asthma, for formula.] Sul- 
phur, gr. v-x, in severe cases, with abundant discharge, especially where con- 
stitutional debility (R.). Sulphurous Acid Gas, inhalations, or the acid in form 



5IO BRONCHITIS, CHRONIC. 

of spray, sometimes beneficial (B., R.). Lobelia, for paroxysmal dyspnoea (R.). 
Ammonium Chloride, combined with stimulating expectorants, such as Serpen- 
taria, Sanguinaria, or Eucalyptus (B.) ; — when secretion is thick and abundant, 
may be applied by an atomizer (R.). Carbolic Acid as inhalation of spray, i 
part to ioo of water ; may be combined with tincture iodine (B. R.). A 5 per 
cent, solution in steam atomizer as inhalation. Hydrastis, fluid extract, locally 
and internally (B.) ; of great value internally and externally in chronic coryza 
(P.). Senega, especially in the aged (R.). Iodine, by inhalation, sometimes 
used (R.) ; — the Iodides, especially the iodide of ammonium, are very service- 
able in combination with expectorants (B.). Colchicum, in gouty subjects (R.). 
Balsams of Peru, and Tolu, when copious secretion of pus (R.). Ammonia, 
inhalation, to lessen expectoration (R.). Oleum Anthemidis, in pulmonary 
catarrh with excessive secretion and difficult expectoration, a very useful 
remedy, nyj-iv (P.). Ammoniacum, the mistura, with chloride or carbonate of 
ammonium, efficient in the bronchitis of old people, with wheezing and abund- 
ant secretion (R.). [See Bronchorrhcea, for formula.] Benzoin, 3J of the 
compound tincture to boiling water, as inhalation ; eases cough and lessens 
expectoration (R.). Sometimes used by atomization (B.). Phosphates, for the 
resulting cachexia (B.). Phosphate of lime (R.). Serpentaria, as stimulant. 
Alum, powdered, dusted over surface (B.). Silver Nitrate, locally (gr. v-^j- 
^ j) on sponge probang (B.). Camphor, to allay cough and promote expectora- 
tion (B.). Sumbul, has decided efficacy (P.). Opium, with expectorants, to 
allay cough (B.). When frequent and violent cough, without any signs of ob- 
structed oxidation ; also to check excessive secretion (R.). Codeine, gr. ]/e 
every 3 to 6 hours, when other opiates are not well borne (P.). Ethyl Iodide, 
by inhalation, is very valuable by reason of its local influence, rri^v-xx thrice 
daily (B.). Grindelia, an excellent expectorant, and especially when cough is 
troublesome (B.). Strychnine, as a respiratory stimulant and to check the re- 
flex vomiting (B.) The syrup of the phosphates of iron, quinine and strych- 
nine. Squill, in chronic forms with tenacious sputa, but not when fever or 
acute inflammation (R.). The Pil. Ipecac, cum Scilla, of the Br. Ph. in 10- 
grain doses night and morning, is a most useful remedy (Br.). Tar, diminishes 
the secretion and allays the cough (P.) ; gr. ij in pill every 3 or 4 hours in 
chronic paroxysmal winter cough (R.). Digitalis, when interstitial pneumonia 
and general anasarca (B.). Eucalyptus, valuable in chronic cases of broncho- 
pulmonary catarrh (B.). Gallic Acid, useful in some forms of chronic broncho- 
pulmonary catarrh (B.). Iron, with free expectoration, mistura ferri composita ; 
or better, the phosphate of iron, quinine, and strychnine (B.). To check pro- 
fuse bronchial secretion (R.). Myrtol, in fetid bronchitis, of great value 
(Gubler). Copaiba, when purulent secretion (R.) ; — for profuse secretion, the 
best of all expectorants, but nauseous (B.). Cubebs, when profuse expectora- 
tion, has similar remedial influence (B.). [See Bronchorrhcea, for formula.] 
Terpine Hydrate, gave immediate and curative results in cases of long-stand- 
ing and obstinate bronchitis, which had resisted all other treatment; gr. xlviij, 
in Glycerin, q. s. ut. ft. soiutio, Syr. Lactucarii, q. s. ad ^\), of which a teasp. 
every three hours (Boyland). Terebene, is proving very valuable ; requires an 
equal weight of light carbonate of magnesium to suspend it. Koomiss-cure, 
possesses great value (B.). Cod-liver Oil, a teaspoonful ter die after meals, of 
great service, if continued (B.) ; to control expectoration (R.). Poultices, made 
large, of hot linseed meal to cover the chest, when congestion of lungs. Olive 
Oil, inunctions to chest, has soothing and strengthening effects. Diet, nutri- 
tious, and stimulants necessary when great prostration. Koomiss is an excel- 
lent article of diet. [Compare Cough, Emphysema.] 






Prescriptions. 



R. Ext. Eucalypti Fl., . . . . ^j. 

Amtnonii Chloridi, . . . . 3 ij. 

Ext. Glycyrrhizaj, , . . . . ,^ij. 

Syrupi Tolutani, . . . . . ^iij. 

M. Sig. — A teasp. 4 to 6 times daily. 



R . Syrupi Scillae, 3 ss. 

Tinct. Opii Camph., . . . . 3 ij- 

Ammoniaci, ,^ss. 

Syrupi Tolutani, 3 x. 

M. Sig. — A teasp. p. r. n. 



BRONCHORRHCEA BRUISES BUBO. 



511 



R 



M. 



Tinct. Sanguinariae, 
Ammonii Chloridi, 
Syrupi Tolutani, . . 
Spt. Etheris Nitrosi, 

Aquae, 

Sig. — Tablesp. p. 



R. 



M 



Ammonii Carbon at., . . . . gr. xl. 

Infusi Serpentariae, ^iv. 

Sig. — A tablesp. every 3 hours. 



R 



M 



Ammonii Chloridi, 3"j- 

Syrupi Picis Liquidae, .... £v). 
Sig. — Tablesp. 4 times daily. 



Bronchorrhcea. 

Ammonium Iodide, often improves the condition, especially if used with 
arsenic (B.). Oil of Eucalyptus, of great utility (B.) ; rr\jj ter die on sugar, or 
see formula -above. Sulphurous Acid Gas, as inhalations, or the sulphurous 
acid as spray, sometimes improve (B.). Lead Acetate, as astringent to restrain 
secretion (B.) ; gr. j-ij every 2 hours. Petroleum, crude, in capsules, has been 
administered with rapid amelioration as the result (Blache). Grindelia, an 
efficient remedy (B.). Iodine, as liniment, over front and. back of chest (R.). 
Spinal Ice-bag, to restrain excessive secretion (R.). Quinine, and the Phos- 
phates, also Cod-liver Oil, as restoratives (Wa.). Copaiba, the most serviceable 
expectorant, but nauseous (B.) ; when copious secretion of pus (R.). Cubebs, 
has remedial effect in chronic bronchial affections with profuse expectoration 
(B.). Asafetiua, is of great benefit (B.). Turpentine, an excellent remedy 
when fetid expectoration ; may be used internally (n\ v ) or by inhalation from 
atomizer. Terpine Hydrate, seems to be even more efficient than turpentine, 
in doses of gr. x-xx daily. Carbolic Acid, internally (™J), an d by spray (gr. v 
ad 3J aquae), often of great utility (Da Costa). Benzoin, by inhalation, for its 
local influence. Myrtol, is largely eliminated by the lungs, and is a most valu- 
able agent in bronchorrhcea and fetid bronchitis, acting as a stimulant and 
antiseptic (Gubler) ; dose rr\jj in capsules (Br.). [Compare Cough.] 



R. 



M 



Copaibse, 

Syrupi Tolutani, . . 
Spt. Etheris Nitrosi, . 
Aquae Menth. Pip., . 
Sig. — A teasp. every 



Prescriptiotis. 



aa ^ss. 

• si- 

hours. 



R. Copaibae Bals. Tolutan., 

Pulv. Acaciae, . . . . aa ^ ss. 
Ac. Sulph. Aromat., . . ^ss. 

Aquae Destill at., ^ yj. 

M. Sig. — Tablesp. bis vel ter in die. 



R 



. Ammonii Chloridi, . . . ^j. 

Mist. Asafcetidae, . . . . Bj iv. 
Misce. Sig. — Tablesp. as required. 



R. Potassii Iodidi, ^j. 

Ac. Nitrici Dil., giij. 

Tinct. Belladonnas, . . . ^j. 

Ac. Salicylici, pjj. 

Aquae Camphorae, . . ad "^ iv. 
M. Sig. — Dessertsp. in water 3 or 4 
times daily, for fetid bronchitis. 



Bruises. 

Arnica, the infusion very useful as an external application for bruises and 
cuts ; also an excellent internal remedy for internal bruises, shake, falls, blows, 
or shock ; n\,v-x every 2 or 3 hours (P.) ; in bruises, sprains, etc. (Wa.). Aconite, 
the liniment locally to painful sprains and bruises (Wa.). Capsicum, a strong 
tinct. applied with gum, said to act like a charm on discolored bruises (R.). 
Sulphurous Acid, a solution constantly applied (R.). Oil of Bay, as stimu- 
lating liniment (P.). Opium, the tincture with lmimentum saponis (£j to £j) 
diligently rubbed in two or three times a day, affords great relief (Wa.). 



Bubo. 

Mercury, necessary in the indurated buboes diagnostic of syphilis (Ricord); 
the powder of calomel locally applied for indolent buboes refusing to heal after 
opening (H.). Nitric Acid, indolent and broken bubo (R.). Sulphides, are 



512 



BUNION BURNS AND SCALDS. 



less useful in maturating than in the case of ordinary boils or abscesses (R.) ; to 
check suppuration (St.). Iodoform, locally, has proved useful (Wa.). Iodine, 
applied to produce vesication around a bubo, relieves inflammation (R.) ; freely 
every day, with rest and compression, to cause absorption (St.). Silver Nitrate, 
lightly to surface, to stimulate indolent buboes (Wa.). Potassio-tartrate of Iron, 
30 parts to 250 aquas destil., three tablesp. daily ; also as lotion to sore (Ricord) ; 
phagedena (St.). Tartar Emetic, gr. j every two hours reduces inflammation 
in many cases (Wa.). Ice, greatly relieves (B.). Surgical. — Open freely with 
a bistoury when suppurating; if pus is virulent, the open bubo is a chancroid, 
and must be treated as such (Keyes). Pressure, by compressed sponge under 
a spica bandage, or a shot bag, the best local treatment for indolent bubo 
(Keyes) ; in all cases cleanliness, rest in recumbent posture, emollient poul- 
tices. Diet, should be generous, with cod-liver oil, in phagedenic bubo. The 
treatment of Syphilitic Bubo is that of general syphilis, local measures are use- 
less, and no treatment called for until a general eruption appears (Keyes). 
[Compare Chancroid, Syphilis.] 



Bunion. 

Iodine paint, or Emplastrum Hydrargyri, for indolent form, thick but not 
tender (D.). Rest, fomentations, and anti-arthritic remedies for thickened 
bunion ; burst it by pressure if recent and sac thin (D.). [Compare Bursitis.] 



Burns and Scalds. 

Carbolic Acid, 1 part to 30 of lin. calcis, or 1 part to 6 of olive oil; the latter 
speedily relieves pain, and promotes healing without suppuration (Wa.) ; 1 part 
to 10 of olive oil, applied on layers of cotton, batting, the best application for 
burns of all degrees. Boracic Acid, a saturated watery solution, used with 
great success by Lister (B.). Lead Carbonate, white lead paint, an excellent 
application to burns of small extent (B.). Salicylic Acid, Sj-^viij ol. olivae is 
an efficient local application (B.). Collodion, flexible, to burns of first degree 
(B., R., P.). Phytolacca, relieves pain (B.). Lime, as lime-water and oil, equal 
parts (R.) ; or lime-water with linseed oil, a favorite application (P.). Rhus 
Toxicoden., externally Z to the pint, in superficial but extensive burns (P.). 
Cantharis, the tincture diluted with 40 parts of water and applied on rags, is a 
most excellent application. Sodium Carbonate, in solution as lotion, immedi- 
ately relieves pain and promotes rapid healing. Turpentine, in dangerous 
cases, where great constitutional depression (P.) ; as wash to severe burns, then 
locally basilicon ointment mixed with turpentine (B.). Cotton-wool, to allay 
pain and exclude air (P.). "Warm Bath, immerse for some days (R.) ; exclu- 
sion of air the main indication (H.). Pinus Canadensis, the concentrated 
extract, painted on freely, relieves the pain effectually. 



Prescriptions. 



Lime and Linseed. 



R. Olei Lini, ,l v ij- 

Aquas Calcis, Jviij. 

M. Sig. — Apply on sheet lint, and 
cover with oiled silk. 



R. Sodii Carbonatis, . . . . ^vj. 

Aquae, Oiij. 

M. Sig. — Apply freely for 3 days on 
old cloths or lint. 



R. Iodoformi, gj. 

Cetacei, ^j. 

Ext. Conii Alcohol., . . . gr. xl. 

Acidi Carbolici, gtt. x. 

M. Sig. — Spread on lint and cover the 
parts therewith. 



R. Pulv. Carbonis Ligni, . . ^viij. 

Sig. — To be dusted thickly over the 
burned parts. 



BURSITIS— CACHEXIA CALCULI. 513 

Bursitis. 

Iodine, painted on outside, after removal of fluid with aspirator (D.) ; after 
blistering (Wa.). Blisters, in rheumatic enlargement of bursae, are almost 
indispensable for a rapid cure (Wa.). Fomentations, with rest, to relieve pain 
and swelling. If unavailing, a crucial incision into the bursa, care being taken 
not to open the capsule of the knee (D.). Excision, when chronic, tumor hard, 
resisting other measures (C). 

Cachexise. 

Lime, the phosphate, in scrofulous affections and anaemia (Wa.) ; in phthisis, 
and affections marked by mal-nutrition (B.). Iron, in splenic, syphilitic, and 
strumous, and especially in all anaemic states ; also in the malarial and phthis- 
ical ; chalybeate waters (B.). The ammonio-citrate the best tonic in the 
cachexia of gastric ulcers, especially in chlorotic females (Wa.). Arsenic, a 
prompt remedy in the malarial cachexia ; also in cancerous of real value 
( Wa.). Hydrastine, in paludal and splenic cachexise, stands in high esteem 
(B.). Nitric Acid, is adapted to the cachexia following acute diseases or intem- 
perance ; also as alterative after long course of mercury (Wa.). Potassium 
Iodide, in constitutional syphilis, and resulting affections of bones and skin 
(Wa.). Mercury, in the syphilitic; but its utility much questioned (Wa.). 
Aurum, in cancerous, mercurial, and syphilitic cachexiae, especially when 
bones, glands, and oculo-nasal mucous membrane affected. Phosphates, in 
bone diseases, wasting, bronchitic, leucorrhceic, etc. (B.). Arnica, in very 
developed cachexiae, has excitant action on the nervous system (Wa.). Euca- 
lyptus, a serviceable tonic and stimulant in cachectic states generally (B.). 
Manganese, the syrup of the iodine of iron and manganese in anaemic, syphi- 
litic, strumous, malarial, cancerous, etc. (B.). Grape-cure, often modifies most 
happily many conditions (P.). Air, in good condition, an important element 
(B.). Water, the Turkish bath and wet pack as aids to remedial action, in 
plumbic, mercurial and paludal (B.). Oils and Fats, to promote constructive 
metamorphosis in many cachexiae, especially cod-liver oil (B.) ; the latter a 
most valuable remedy in scrofula, phthisis, atrophy, tubercular and jail ca- 
chexias, anaemia, etc. (Wa.). Massage, has been productive of remarkable 
results in many forms of cachexiae (B.). Aliment, of prime importance (B.). 
[Compare the various titles Anemia, Scrofula, Syphilis, etc., and the 
formulae for tonics, on pages 492 and 496, ajite.~\ 

Calculi, Biliary. 

Chloroform, is supposed by some to act as a solvent in 20 to 60- drop doses 
every 3 or 4 hours ; it cannot act as a solvent, but undoubtedly affords some 
relief (B.); as an inhalation it may be used to relieve the pain of the paroxysm 
(Br.). Ether and Turpentine, equal parts of each, 3j once daily for a year, is 
Durande's solvent remedy ; is not solvent, and as an anodyne inferior to mor- 
phine or chloral (B.). Morphine, gr. % with Atropine gr. -^q, hypodermically, 
the best anodyne for the pain and vomiting during the paroxysm (Br.). Chloral, 
sometimes relieves the pain (R.). Counter-irritants, as mustard poultices to 
relieve the pain during tne paroxysm (Br.). Olive Oil, ^ij at night, followed 
next morning by 3 or 4 seidlitz powders an hour apart, efficient in facilitating 
the expulsion of accumulated gall-stones. Nitro-muriatic Acid, as bath, found 
useful in India to relieve the pain and promote expulsion of the calculus, ^iij 
of the acid to a gallon of water (Scott). Sodium Phosphate, in 3 doses before 
each meal for several months, to prevent recurrence (B.) ; should be given in 
plenty of water (Br.). Sodium Salicylate, increases the secretion of bile and 
renders it more watery. It is therefore indicated in cases where there is a 
tendency to the formation of gall-stones (Br.). Succinate of the Peroxide of 
Iron, hydrated, contains a large proportion of nascent oxygen, and is given in 
teaspoonful doses after meals for several months, and resumed at intervals 

33 



5H 



CALCULI. 



afterwards to prevent reformation of the calculi (Buckler). Diet, is import- 
ant ; withhold all starches, sugars and fats, also malt liquors and spirits ; mod- 
erate exercise out of doors, lean meats, eggs, fish, fruits, and succulent vegetables 
to be used freely. Mineral Waters, the alkaline are useful, especially Vichy, 
which is deemed of great benefit. [Compare Colic, Jaundice.] 



R . Succinat. Hydrat. Ferri Per- 

oxidi, ,lj ss - 

Aquae, ^ v j ss - 

M. Sig. — Teasp. after each meal for 
several months. 



Prescriptions. 

R. Spt. Etheris Comp., . . . £ij. 
Liquor. Magendie, .... n^xxx. 
Syr. Zingiberis, . . . . ad ^j. 
M. Sig. — Teasp. doses, an hour apart, 
until pain is relieved. 



Calculi, Renal and Vesical. 

Alkalies, especially potassium salts, if long continued will effect solution of 
uric acid calculi (R.) ; sodium salts should not be used (B.). Potassium Citrate, 
in large doses for bloody urine containing uric acid crystals (R.) ; the citrate 
and carbonate of potassium are the most desirable solvents for uric acid 
gravel (Sir H. Thompson). Potassium Tartra-borate, if long used, is very 
efficient as a solvent for uric acid calculi (B.). Potassium salts are much more 
efficient than those of Lithium as solvents for uric acid (Prof. Rogers). Alka- 
line Mineral Waters, those rich in potassium preferred, especially Vichy (B.). 
Ammonium Benzoate, long-continued, will dissolve phosphatic calculi (B.). 
Ammonium Biborate, will prevent attacks of colic where uric-acid calculi, in 
20-grain doses every two hours until free urination, then gr. 15 thrice daily in a 
glass of flaxseed tea. Magnesium Boro-citrate, is a good solvent of uric acid 
calculi (Madsen). Lithium Citrate, to promote oxidation (Da Costa). Hy- 
drangea, in decoction, used by the Cherokees in all calculous affections with 
uniform success (Butler). Lead Acetate, gr. x / 2 to the § of distilled water, in- 
jected into the bladder to prevent formation of phosphatic calculi, or a solu- 
tion of Dilute HC1 Acid, n\, ij-iij to the 3 (Sir H. Thompson). Nitric Acid, 
very dilute, as injection for phosphatic calculi (R.) ; gtt. j to the ^, as injection 
into the bladder in chronic cystitis and phosphatic deposits (B.). Cotton-root, in 
decoction, as a demulcent for strangury and gravel (P.). Castor Oil, of value as 
a purgative (P.). Calumba, to relieve the vomiting (P.). Counter-irritants, as 
mustard-poultices, or turpentine stupes, to relieve pain of the paroxysm (R.). 
Anaesthetics, for the same purpose (B.). Morphine, hypodermically, as an ano- 
dyne and to relieve the vomiting (B.). Hot Fomentations, to alleviate spasm 
and pain while calculus is passing. Diet. Restrict the use of sugar in any 
form or combination, also fats and alcoholic beverages. Fresh, green vege- 
tables may be used freely, also skimmed milk or buttermilk. Mineral waters, 
preferably Vichy, Friedrichshall and Carlsbad. Frequent abstinence from 
animal food. Lemon-juice and soft water in large draughts, are useful. Sur- 
gical Measures. — Lithotomy or Lithotrity for removal of stone from bladder. 
Solvents are of no use except for a very small calculus, and even then a con- 
siderable time must be occupied in the process. No operation in surgery more 
certainly safe, rapid and successful than lithotrity (Sir H. Thompson). [Com- 
pare Colic, Lithiasis, Oxaluria, etc.] 



Magnesium Boro-citrate. 



Prescriptions. 



ft. Magnesii Carbonat., . . . gj. 

Sodii Biborat., 

Acidi Citrici, aa sjij. 

Aquae Bullientis, .... Jviij. 
M. Sig. — Tablespoonful 3 or 4 times 
daily. (B.) 



Potassium Tartra-borate. 



R. 



Potassii Bitartratis, .... partes iv. 

Ac. Borici, partem j. 

Aquse, partes x. 

By heating the above together, the salt 
is obtained as a white powder, of which 
gr. xx in a large draught of water 3 or 4 
times daily. 



CANCER CANXRUM ORIS. 



515 



Cancer. 

Arsenic, in cancer of the stomach, diminishes pain and checks vomiting ; also 
in scirrhus of stomach and epithelioma ; is believed to retard the growth of 
uterine cancer (Br.). Arsenious acid, pure or with starch, as a caustic ; enough 
should be used to set up active inflammation (R.). Belladonna, locally and 
internally (rrLv-x), of great benefit as palliative in severe pains of cancer (P.). 
Conium, as poultice, and internally to relieve pain (R.). Is particularly 
applicable to pain of cancer (P.). As palliative (Wa.). Hydrastis, has a 
renewed interest (Pf.). Carbolic Acid, undiluted, to sore, and injected beneath 
it, limits and retards (B.) ; pure, as anaesthetic, before applying caustics ; with 
glycerin, as application to fetid cancers (R.). Mercuric Chloride, in small 
closes, long-continued, will retard the growth of gastric cancer (Da Costa). 
Citric Acid, Sj-^viij aquae, useful in allaying pain of cancerous ulcerations 
(Wa.). Acetic Acid, 1 to 3 aquae ; n\xxx injected into the tumors, has been 
used with varying success (Wa.). Chloral, in gr. x doses, 3 times a day, has 
relieved most severe pain of cancer (R.). Chloroform, as vapor to raw surface 
(R.). Pyoctanine, or Methyl Violet, in solution, by injection into the neoplasm, 
to bring about the shrivelling up and final disappearance of carcinoma (von 
Mosetig). Hyoscyamus, bruised leaves, locally (P.). Bismuth, relieves pain 
and vomiting of gastric cancer (B.). Glycerin of Tannin, with glycerin of car- 
bolic acid, checks discharge and stench of uterine cancer (R.). Carbonic 
Acid, injected up vagina in cancer of uterus, to relieve pain (R.). Iodoform, 
applied to diseased surface, relieves pain and removes fetid odor (B., P.). 
Resorcin, 15 parts to 20 of Vaseline as an ointment twice daily after washing 
with a solution of pot. permanganate has successfully stopped epithelioma 
(Antonio). Potassium Chlorate, in impalpable powder, dusted on epithelioma, 
said to be curative (B.). Pepsin, injections into tumor (B.). Salicylic Acid, 
pure, applied in powder (B.). Zinc Chloride, the most efficient and safe 
escharotic. Parts j-ij-v flour, or " caustic arrows " inserted at base of tumor 
(B.). Potassa Fusa, as escharotic (B.). Opium, to cancerous sores. Mor- 
phine, dissolved in glycerin, and spread on lint, very useful where there is 
much pain. Opium is also used in cancer of the stomach (R.). Codeine 
(& r - To t0 t\j)- a good hypnotic (P.). Zinc Sulphate, dusted over, dry. An 
excellent caustic. Remove the eschar by poultice (B.). Bromine, for destruc- 
tion of uterine cancer, is preferred by some (B.). Chromic Acid, a power- 
ful escharotic (B.). Carbonate of Lime, as calcined oyster-shell, very efficient 
in arresting growth of cancerous tumors, and in alleviating the pain thereof 
(Hood). Rumex Acetosa, an excellent local application ; has a popular 
reputation. Iron and Manganese, the syrup of the iodide, for resulting cachectic 
state (B.). Poultices, of starch, applied cold (R.); or poultices of bread, 
sprinkled with charcoal or freshly ground coffee, as deodorizers to open cancers. 
"Water Enemata, to relieve pain and straining in intestinal cancer (R.). 



Prescriptions. 



R. Bismuthi Submit., . . . . gij. 
Morphinse Sulph., . . . . gr. j. 
Fiant pulv. vj. Sig —One thrice daily 
in milk, when gastric pain and vomiting. 

(B) 



R. Acidi Arseniosi, gij. 

Mucil. Acacise, ^j. 

As paste on cancerous sore, followed after 
2 or 3 days by bread poultices until slough 
separates. 



Cancrum Oris. 

Arsenic, in medicinal doses (R.). Nitric Acid, to surface (R.) ; strong nitric 
acid the best caustic for worse forms of the disease (Wa.). Potassic Chlorate, 
gr. xx-xl in 24 hours, has been strongly recommended (D.). Quinine, made 
into a syrup, or as enema, to support the strength (Wa.). [Compare Aphthae, 
Stomatitis.] 



5 i6 



CARBUNCLE — CARIES. 



Carbuncle. 

Boric Acid, administered internally and externally as for Boils (which see) ; 
equally efficacious in anthrax, diminishing pain, redness and hardness ; numer- 
ous apertures rapidly form for the elimination of the core ; the fever falls, 
excitation and insomnia abate ; and the anthrax heals, in the majority of 
cases, without surgical interference (Alison). Mercury, Corrosive Sublimate, 
injected into an anthrax tumor at several points, in doses of 2 drachms 
of a -^y per cent, solution dividedly, has produced good results. The injections 
were often repeated, in broken doses likewise, on the following days (Casson). 
Belladonna, with glycerin, as local application to relieve pain (R., P., Wa.). 
Ammonium Acetate, to support the system (Cezard). Carbolic Acid, on lint, 
with glycerin or oil, into discharging sinuses (R.) ; or hypodermically into the 
sloughing tissues. Iodine, to produce vesication around carbuncle ; reduces 
inflammation (R.) ; part j of the tincture to iij aquse, locally, has most striking 
effect (Wa.) ; may be used with benefit internally or hypodermically (Cezard). 
Calcium Sulphide, gr. -^ hourly, or every two hours, of great service (R.). 
Opium, a thick extract, locally (R.). Potassium Chlorate, highly recommended, 
also Quinine and Iron, freely to support the system and counteract the carbun- 
cular poison. Poultices, the inflamed surface having been previously smeared 
with belladonna and glycerin (R.). Long-continued poulticing thought to 
create tendency to a fresh crop. Strapping, with plaster, concentrically from 
border inwards, leaving the centre free, will sometimes arrest extension (R.). 
Collodion, as protective covering (P.) ; as zone around base, leaving the centre 
exposed (Wa.). Collodium cum cantharide in a broad zone painted around the 
carbuncle, to relieve the tension (Ag.). Ice, or Ice-bags or iced water on cloths 
in early stage, changing to warm fomentations as soon as suppuration has 
begun (Hebra). Galbanum and Opium as plaster to relieve pain, the separa- 
tion of the core then proceeding painlessly (Hill). Crucial Incisions are not 
so frequently made now as formerly ; they relieve tension but often give rise 
to severe hemorrhage. Diet should be very supporting, and stimulants may 
be used freely when the. patient is debilitated. Saline purges occasionally 
(Hill). Cauterization, with fuming nitric or carbolic acid, on top of a free 
crucial incision, followed by dressing with carbolized oil, is the course to pursue 
in malignant pustule. Caustic Potash, applied before an opening occurs, or 
small pieces inserted into openings made by scalpel, to cause the rapid separa- 
tion of the slough. The resulting ulcer should be treated on general principles. 
[Compare Boils, Pustule, Malignant.] 



Prescriptions . 



R- . Calcis Sulphurat., . . . . gr. iij. 

Sacchari Lactis, q. s. 

Triturat. et div. in chart, xxx. 
Sig. — One powder every 2 hours, to be 
taken dry on the tongue. 



& . Tinct. Ferri Chloridi, . . ^j. 

Potass. Chlorat., 3"j- 

Liq. Ammonii Acetat., . . 5 iij. 
Syrupi et Aquae, . q. s. ad J viij. 
M. Sig. — Dessertsp. every 2 hours. 



Caries. 

Aurum, in syphiloma of bones (B.). Calcium Chloride, where strumous 
cachexia (B.). Phosphoric Acid, with 8 parts water, locally applied, has been 
of benefit (Wa.). Phosphates, best is syrup of lacto phosphate of lime, or 
Parrish's phos. (B., R.). Villate's Solution, to dissolve the carious bone, has 
cured many cases (B.) ; see formula below. Sarsaparilla, a very useful medi- 
cine (P.). Iodine, locally, with iron or cod-liver oil internally (Wa.) ; see 
Bone. Potassic Iodide, in syphilitic caries, holds the first place (Wa.). Cod- 
liver Oil, to promote constructive metamorphosis (B., R.). Mechanical Contri- 
vances, necessary in most cases ; Sayre's plaster jacket, Agnew's jacket of 
leather and steel, Taylor's apparatus, etc., are used in spinal caries to separate 
the diseased bones, and extend the spinal column. [Compare Necrosis.] 



CATALEPSY CATARACT CATARRH, ACUTE NASAL. 517 

Prescriptions. 



Vitiate 1 s Solution. 
R • Cupri Sulphat., 

Zinci Sulphat., aa partes xv. 

Liq. Plumbi Subacetat., p. xxx. 

Aceti, p. cc. 

To be injected through the sinuses. 



R . Syrupi Calcii Lacto-phos- 

phatis (U. S. P.), . . . ^viij. 
Sig. — A dessertsp. to a tablesp. 3 or 4 
times daily. 



Catalepsy. 

Turpentine, in enemas, and embrocations along the spine, affords the best 
chance of stopping the paroxysms (Wa.). Treatment must be essentially tonic 
and restorative (H.). No constant line can be stated (A.) ; external stimulation 
to arouse consciousness, by Ammonia, cold douches, Faradism, etc. Apomor- 
phine, gr. ^ to ^, in the paroxysm ; with the onset of nausea, consciousness 
returns and spasm ceases; in the intervals between the attacks the treatment 
should be that of hysteria (Gowers). 

Cataract. 

Phosphorus, with oil, by frictions to the forehead, and instillation of the same 
into the eye, may cause absorption of the lens or capsule (Wa.). Codeine, in 
diabetic cases (Br.). Sodium Sulphate, a solution suggested as injection into 
anterior chamber, in hope to dissolve the nebula (Wa.). Galvanism, has been 
successfully employed in incipient stage (Wa.). Mydriatics, Atropine, Duboi- 
sine, etc., to secure full dilatation of pupil, as a means of ascertaining when 
the operation should be made, which is when the cataract is mature, there being 
no vision even with dilated pupil (Wa.). Diet and Regimen, may do much 
to retard degeneration of the lens, in cases due to diabetes, or malassimilation 
in gouty or rheumatic persons (C). Iridectomy, made early and effectually 
may postpone the progress of lenticular opacity, if due to increased intraocular 
tension (C.). In partial cataracts, which have become stationary, iridectomy 
for artificial pupil may be done to expose clear portion of lens (Roosa). Medi- 
cine accomplishes nothing except to improve general health and so delay the 
progress of the opacity. Removal may be performed by one of several opera- 
tions (Roosa). 

Catarrh, Acute Nasal. 

Sodium Salicylate, to abort a cold (see ante, page 359). Aconite, in severe 
coryza with much chilliness, aching limbs, hot and dry skin, and quick pulse ; 
also in catarrhs of children and that accompanying measles (R.) ; in acute 
coryza (P.) ; with Belladonna in ordinary colds with sore throat and high fever 
(B.) ; in doses of rr\^ every % hour, very useful for a commencing cold in 
the head (A. A. Smith). Belladonna, in acute nasal catarrh with profuse watery 
secretion, \\ y of tincture, then tt\J each hour (B ). Nux Vomica, has great 
effect upon a dry cold in the head (P.). Euphrasia, is of decided utility in 
coryza (P.). Pulsatilla, a warm lotion, 3j-ij in ^iv aquae, syringed into the 
nasal passages in subacute coryza with muco-purulent secretion (P.) ; acts simi- 
larly to Aconite, but is contraindicated if much gastric or intestinal irritation 
exists (B.). Iodine, by inhalation in daily attacks with itching nose (R.) ; gij 
of the tincture with 3\j of carbolic acid inhaled from a sponge in the bottom of a 
wide-mouthed bottle placed in hot water (B.). Iodides, are unquestionably 
serviceable, their action being local and substitutive ; Ammonium Iodide, gr. j 
every two hours, the best mode of using them (B.). Sodium Iodide, gr. x ter 
die, with Pii. Ferri Iodidi, in catarrhs of specific origin (B.). Potassium Iodide, 
gr. x at bedtime at the onset, to cut short an acute cold in the head ; also useful 
in chronic colds (R.). Quinine and Morphine, gr. x with gr. ye, at incipiency, 
will often abort (B.). Opium, at night, if taken earlv, will often abort an 
attack of coryza; a glass of hot grog assists its action (R.) ; Dover's powder, 



5i8 



CATARRH, CHRONIC NASAL. 



in a full dose at the onset may abort (B.). Codeine, is useful in common colds, 
as a palliative (B.). Ammonia, may be inhaled in the early stage (R.). Potas- 
sium Chlorate, 8 or 10 lozenges a day will abort many a cold (R.). Cam- 
phor, as inhalation, the spirit in form of vapor (R.) ; with Opium and ammonium 
carbonate as powder (see formula below), to break up or modify a cold (Beard). 
Tartar Emetic, gr. ^ to ^ in the first stage (B.) ; in acute catarrh of children 
often accompanied by vomiting and diarrhoea (R.). Arsenic, when sneezing, 
itching of nostrils, frontal headache (R.) ; as cigarettes (B.) ; see under Asthma, 
for formula. Veratrum Viride, if arsenic fails (R.). Ipecacuanha, for acute 
nasal and bronchial catarrh, and ordinary colds in children (B.). Cimicifuga, 
when headache, stiff muscles, dull aches, bone-pains, etc. (R.) ; an excellent 
expectorant (B.) ; rheumatic colds, neuralgic pains in jaw (P.). Jaborandi, 
the fluid extract in doses of rr\,x to xxx, every half hour until profuse diaphoresis 
sets in, is one of the best modes of aborting a cold ; or Pilocarpine Hydro- 
chlorate, gr. ]/$ in water at bed-time, will give prompt relief, and cure in a 
few days (Wyss). Cocaine, a 4 or 5 per cent, solution locally as spray, to 
empty the engorged venous sinuses of the nasal mucous membrane, by their 
contraction, which it induces.* The fluid extract of Erythroxylon diluted with 
water is equally efficient if enough be used (Cohen). Resorcin, the best of 
all applications (see Catarrh, Chronic). Cubeb, or Ammonium Chloride, 
in the dry, congestive stage of a cold in the head ; Cubeb cigarettes may be 
smoked as a temporary palliative with great relief. Sulphurous Acid, in coryza, 
by inhalation, spray or fumigation, is very efficient (R.). Oil Inunctions, daily 
to the whole body, in cases of undue susceptibility to taking cold, will prevent 
the frequency of the attack (B.). Baths, a warm foot bath before going to 
bed; Turkish bath, at onset in coryza, may prove abortive ; also useful later on. 
Cold sponge bath, in cases of extreme susceptibility, supplemented by occa- 
sional Turkish baths (R.). [Compare Cough, Hay-Fever, Influenza.] 



Prescriptions. 



R. 



Quininae Sulph., . . . 
Liq. Arsenicalis (B. P.), 
Liq. Atropine (B. P.), 
Ext. Gentianae, . . . 
Pulv. Acaciae, .... 
Ft. pil. no. xij. Sig. — One every 3, 4 or 
six hours, for acute colds. (Whalen.) 



. gr. xvnj. 
. TT\, xij. 

. gr. xx. 

• q- 



R. Camphorae, gr. 1. 

yEtheris, q. s. 

Dissolve to creamy consistence, 
then add — 

Ammonii Carbonat., . . . gr. xl. 

Pulv. Opii, g»". x. 

Divide into thirty papers. 
One or two powders, according to age, 
twice or thrice daily. {Beard.\ 



R . Acidi Carbolici, gr. lxxx. 

Alcoholis, E ss - 

Aq. Ammoniae, TT\Jxxx. 

Aquae, 3 ijss. 

M. Sig. — A few drops as an inhalation 

from a cone of blotting paper. {Brand.) 



R. Morph. Acetat, gr. iv. 

Bism. Subnitrat., 

Pulv. Talc, aa 3j. 

Ft. Chartulas, No. xxx. 
Sig. — Use as snuff in acute rhinitis. 

(Sajous.) 



£ r - 'J- 



R . Codeinae, 

Syrupi Tolutani, 

Syr. Scillae Comp., ... aa 3 j. 
M. Sig. — Teaspoonful occasionally for 
a common cold. (B.) 



R . Tinct. Aconiti, Tl^ x. 

Tinct. Belladonnae, . . . ■ sjss. 

Syrupi Zingiberis, ... ad t Bjij. 
M. Sig. — Half to one teasp. according 
to age, every hour. 



R 



Ferrier^s Snuff. 
Morph. Hydrochlor., . . . gr. ij. 

Bismuthi Subnit., ^vj. 

Pulv. Acaciae, . . . . gij. 

M. Sig. — Use as snuff, % to l / z the 
above in 24 hours. 



Catarrh, Chronic, Nasal. 

Sanguinaria, the tincture in 10-drop doses thrice daily, or gr. T X F of the alka- 
loid, internally, and the powder in small quantity locally to the mucous mem- 
brane, is successful treatment for chronic nasal catarrh (B.). Hydrastis, is of 



CATARRH, CHRONIC NASAL. 



519 



value in chronic coryza, also in ulceration of the septum or any other part of 
the nasal fossae, gtt. v of the tincture thrice daily internally, and Z) to ^viij of 
water locally with syringe (P.). Pulsatilla, is excellent in subacute inflamma- 
tion of nasal passages, with offensive muco-purulent discharge, 3j-ij ad ^iv 
of water, as wash (P.)- Potassium Bichromate, is an excellent local application 
in a solution of gr. j-x to ^iv water (B.). Iodoform and Tannin, 1 of the former 
to 2 or 3 of the latter, carefully triturated, and applied by an insufflator every 
other day only, is the very best of all applications (B.). Sodium Chloride or 
Phosphate, a teasp. to the pint of warm water as cleansing solution, or the 
Bicarbonate in the same proportion. A sea-water gargle in the nasopharyn- 
geal space, has been used with success (Mosler). Wei de Meyer's Catarrh 
Cure is simply bicarbonate of sodium and a little pink coloring matter (Robin- 
son). Potassium Permanganate, gr. j-x to the pint of warm water, as a deodo- 
rant solution when necessary. Ammonia, by inhalation, when painful inflam- 
mation of nasal mucous membrane and frontal bones (R.). Carbolic Acid, a 
1 per cent, solution as spray, or inhalations of the vapor with that of iodine 
from a bottle in hot water, or vaporized by the warmth of the hand (B.). Sali- 
cylic Acid, in weak solution, 1 to 500 of water, as a disinfectant and astringent 
injection, used with a retro-pharyngeal syringe, and followed by applications 
of powdered Calomel, through a speculum, upon the ulcerated parts of the 
mucous membrane (Massei). Cubebs, finely powdered and blown into the 
nares by an insufflator (B.), have proven very useful (P.); may be smoked, 
and administered internally in teasp. doses (Wa.) ; in freshly ground powder, 
as a confection (see below for formula), very efficient in follicular disease of the 
naso-pharyngeal space (Robinson). Ammoniacum, in the same condition, very 
small doses, gr. j-iij, with ipecac, or carbonate of ammonium, will greatly lessen 
the amount of secretion (Robinson). Bismuth, in powder, with gum acacias, as 
in Ferrier's snuff (see above for formula), or with tannin, calomel, iodoform, 
etc., used by insufflation, daily (Robinson). Aurum Chloride, in mercurialized 
and syphilitic subjects, with offensive discharge, depressed spirits, and soreness 
of the nasal bones. Iodides, of iron and sodium, in catarrh of specific origin 
(B.). Silver Nitrate, in powder, as alterative application, gr. x-xv to the ^ of 
menstruum, is oftt-n a useful adjunct to treatment, used once every 4 or $ days 
(Robinson). Cod-liver Oil, should be used in strumous subjects (R.). Alum, 
in powder, dusted over the affected surface, is a useful application (B.). Resor- 
cin, the best of all applications, in acute and chronic catarrh. After cleansing 
the nose with a Boracic Acid solution, or Dobell's, use a 2 to 10 per cent, oint- 
ment (vaseline), also a spray every other day, of 2 to 4 per cent, solution. It 
gives the same results as Cocaine, but is slower in action and more lasting, and 
does not suppress the normal function of the mucous membrane, as Cocaine 
does. Eucalyptus, has been employed with benefit (Wa.). Bromine, the 
vapor may greatly benefit, but must be used with caution (B.). Senega has 
been found serviceable (Wa.). Douche is dangerous, being likely to cause 
extension of the catarrh to the Eustachian tube and the middle ear. It has 
been very generally abandoned. Sprays by hand-ball atomizers, or com- 
pressed air apparatus, of warm watery solutions, vaseline, etc., are used with 
considerable success (Cohen). The Hank's atomizing tubes, with a 2-ball 
rubber syringe, are very serviceable for office use, and for the application of 
Rumbold's hot vaseline spray. (See formula below.) Sulphur Waters, inter- 
nally, of great benefit in follicular disease (Robinson). [Compare Oz^ena.] 



Prescriptions. 



R . Acidi Carbolici, TT^x. 

Glycerini, gij. 

Vaselini, ^ ij. 

M. Sig. — Warm and use as a spray 
every 4 hours. [Rumbola.) 



R . Acidi Carbolici, ..... Tt\xl. 
Sodii Boratis, 
Sodii Bicarbonat., . . . aagij. 

Glycerini, Z v 'j- 

Aquae, q. s.ad £ viij. 

M. Sig. — Use daily as spray. 

{Dobell. 



20 



CEREBRAL ANAEMIA — CEREBRAL CONCUSSION. 



R. 



Pulv. Argenti Nitrat., . . . gr. vij. 

Pulv. Acaciae, £j 

Bismuthi Subnitrat, . . . 3 iij. 
Triturat. Sig. — Apply with insufflator 
once in 4 or 5 days. {Robinson.) 



R. Bismuthi Subcarb., . . . . ^vj. 

Morph. Muriatis, . . . . gr. ij. 

Pulv. Amyli, gvj. 

Triturat. Sig. — Burners' molirication of 
Ferrier's snuff. 



R. Bismuthi Subcarb., 

Pulv. Acaciae, . . . . aa ^ss. 

Zinci Sulphat., gr. x. 

Morph. Sulphat., . . . . gr. ij. 
M. Sig. — Snuff, to be used thrice daily. 
(Sajous.) 

R. Pulv. Cubebse, ^ij. 

Syr. Aurantii, jjpij. 

Aq. Menth. Pp., .... £ij. 

Aquae, q. s. ad % viij. 

Ft. mistura. Sig. — A teaspoontul every 
3 or 4 hours. [Robinson.) 



R. Acidi Carbol gtt. xv. 

Extr. Hydrastis Fl , . . .. 3J. 

Sodii Bicarb., 

Sodii Biborat., . . . . aa ^j. 

Glycerini, t ^j. 

Aquae Camp* orae, . . .ad ^ viij. 
M. Sig. — Use w nh posterior nasal 
sprayer. 



R. Sodii Boro-benzoatis, . . . %j. 

Ext. Hydrastis FK, . . . \). 

Glycerini, ^j. 

Ac. Carbolici, rr^xx. 

Aquae Camphorae, . . . . 5vj. 

Aquae, q. s. ad J xij. 

M. Sig. — Use with syringe or atomizer 
thrice daily. {Chamberlain.) 






R . Sodii Iodidi, % ss. 

Syrupi Picis Liq., . . . . gvj. 
M. Sig. — Des c ertsp. thrice daily with 
Pil. Ferri Iodidi (U. S.) one thrice daily, in 
chronic nasal catarrh of specific origin. 

(B.) 



. Ext. Pini Canad., .... TT\xx. 

Glycerini, rr^xxx. 

Aquae, Oj. 

M. Sig. — Use with post-nasal syringe. 



R. Sodii Salicylatis, . . . . 5pj. 

Sodii Boratis, ^iij. 

Glycerini, t ^ss. 

Aquae, q. s. ad % vj. 

M. Sig. — Of this put a dessert-poonful 
into a pint of warm water, and snuff it from 
the hollow of the hand thrice daily. 

\Sajous.) 



Cerebral Anaemia. 

Iron, the tincture of the chloride, or mild chalybeate waters, in chronic 
cases from general anaemia (B.). Amyl Nitrite, in vaso-motor spasm; affords 
relief in sudden attack (B.). Chloral, in small doses with stimulants, warm 
baths (Ros.). Camphor, or other cerebral exctfants, as asafcetida, valerian, 
serpentaria (B.). The mono-bromide of camphor in one to five-grain doses 
(Hammond). Glonoinum, rr\j of I per cent, solution (P.). Phosphorus, sup- 
plies the needed material for healthy brain-action (B.). Strychnine, stimu- 
lates the circulation generally ; as a tonic with iron preparations. Galvanism, 
a mild current transversely through the head, gives excellent results in the 
confusion of mind, vertigo, etc., due to imperfect nutrition of the brain from 
atheroma of the cerebral vessels (B.). Arsenic, is highly efficient in some 
hypochondriacal cases (B.). Aurum, is of great utility in vertigo, melan- 
cholia, etc., when due to or accompanied by cerebral ansemia (B.). [Compare 
Insomnia.] 

Cerebral Concussion. 

Arnica, when from a fall, cannot be too highly spoken of (P.). Warmth, to 
extremities, rest, expectant treatment, will suffice in mild cases (Ag.). The 
indications are : (i) to recover from insensibility and collapse; (2) to prevent 
inflammation ; (3) to restore impaired faculties (D ). Stimulants or Venesec- 
tion, cannot be too strongly reprobated (Ag.). 



CEREBRAL CONGESTION CHANCRE CHANCROID. 521 

Cerebral Congestion. 

Aconite, in active form, renders important service (B.). Is much the best 
remedy in this condition (P.) Belladonna, one of the best remedies in all 
hyperaemic conditions of the brain or spinal cord (P.). Gelsemium, vn^v of the 
fluid extract every 2 hours, very useful (B.). Bromides, are very useful (B.) ; 
must be used in full doses. Colocynth, as counter-irritant, appears to act well 
(P.). Cathartics, lessen blood-pressure (B.). Colchicum, in plethoric subjects 
(B.). Galvanism, of brain and cervical sympathetics (B.). Chloral, when tem- 
perature high (B.). Arsenic, sluggish venous circulation, torpor (B.). Hydro- 
cyanic Acid, tT> L ij-v of Scheele's dilute acid (B.). Venesection, will prevent 
injury to brain. Not to be adopted as a matter of course. It is contraindicated 
when anaemia, aortic valvular disease, or in cases commencing with syncope 
(A.). Water, cold douche to head, feet in warm water; ice and hot water 
alternately to head and nape of neck, often more effective than ice alone (B.). 
Hot water to head on flannels ; mustard and hot-water packing for 20 to 30 
minutes, around legs, when active congestion. Protect bowels well (R.). Diet, 
should be low, but not too low, until all fear of relapse past. Full animal 
diet should be avoided, also undiluted wines (A.). [Compare Apoplexy, 
Coma.] 

Cerebral Softening. 

Venesection, and antiphlogistic treatment generally, most beneficial in red 
softening, result of inflammation. Require wise discretion, and should be used 
early. Not to be thought of in the yellow form, from want of nutrition ; where 
restoratives and food, perhaps wine (A.). Phosphorus, in threatened softening 
of the brain ; is the only drug which affects the nerve-centers (W.). 

Chancre. 

Mercury, small doses steadily, ptyalism must not be induced. Black-wash 
(calomel gr. viij, aq. calcis ^j), or yellow-wash (hydr. chlor. corr. gr. j, aq. 
calcis ^j) on lint, to erosions and ulcerated indurations (B.). Calomel alone 
as dry dressing. Internal use of mercury best postponed until secondary 
symptoms appear (St.). Carbolic Acid, as wet dressing, gr. ij of crystals to 
jfiv aquae ter die (St.). Iodoform, heads the list of dry dressings ; with lyco- 
podium, equal parts, or 1 to 2 zinci oxidi ; 2 to 1 hydr. chlor. mite (St.). Hy- 
drogen Peroxide, said to destroy the specific character. Wash lesions ter die, 
and apply lint soaked in it (R.). Caustics, should never be used unless chan- 
cre attacked by phagedena (St.). Caustic Alkalies, to hard edges (R.). Bro- 
mine, Chromic Acid, best escharotics (B.). Dressings, are effective as far as 
the local trouble is concerned in the majority of cases ; sometimes a piece of 
lint on the erosion will suffice. Never cauterize an initial lesion unless it is 
attacked by phagedena (St.). Cleanliness, of great importance; tepid water 
locally frequently suffices for the outward treatment of infecting chancre. 
[Compare Syphilis.] 

Chancroid. 

Mercury, the acid nitrate one of the best caustics; apply with a glass rod 
(B.). Nitric Acid, fuming, as caustic (B., R.) ; Jj to ^ viij aquae is an excel- 
lent dressing (St.). Carbolic Acid, injected into sore (B.) ; 3ij-v to Oj aquae 
locally in phagedena (St.). Ferri et Potas. Tartras, the " born enemy of 
phagedena" (Ricord) ; |jj to ^vj aquae, internally, teasp. doses thrice daily; 
also locally (St.). Ferric Iodide, in sloughing phagedena, or simple c. in de- 
bilitated constitutions (B.). Iodoform, powdered and dusted over the sore, 
allays pain, changes morbid action, and is antiseptic (B., R.) ; 1 part to 2 of 
lycopodium, or one of tannic acid ; as stimulant and alterative (St.). Does 
no good except to relieve pain (Gross). Potassium Chlorate, in impalpable 
powder, is better than iodoform (B.). Chloral, gr. iij ad ^j aquae, the best 



522 CHAPPED HANDS CHICKEN-POX CHILBLAINS. 

local application to relieve pain (Gross). Caustics, in severe cases, the white 
iron strong sulphuric acid, pure nitric acid, pure carbolic acid, are effective in 
the order named (St.). [Compare Bubo.] 



Chapped Hands and Lips. 

Sulphurous Acid, as solution, or by fumigation, will speedily cure (R.)- 
Glycerin, diluted, or better still, glycerin of starch, or with y z the quantity of eau 
de cologne (R.). Benzoin, the comp. tinct., I part to 4 of glycerin ; an admira- 
ble application (P.). Hydrastis, on compress as lotion (P.). Collodion, is 
usefully employed (P.). Carbolic Acid, 1 to 2 of glycerin, locally ; one applica- 
tion is generally sufficient. Unguentum Aquae Rosea alone, is often efficient; 
may be combined with oxide of zinc. 

Prescriptions. 

R. Resinse, gj. R. Cetacei, ^j. 

Cerse Albse, ^ij. Glycerini, . . . . . . . spj. 

Adipis, ^ij. Cerae Albse, gr. xv. 

Zinci Oxidi, 3 v 'j- 01. Amygd. Amarse, . . . TT^iij. 



Chest-pains. 

Belladonna, as ointment, when tenderness is in skin (pleurodynia) (R.). 
Iodine, oint. ; pain in muscles (myalgia) of chest, they being tender on pressure, 
while the skin may be pinched without pain (R.). Strychnine, affords relief in 
functional irritability of the nervous system, manifested by wandering neural- 
gic pains (B.). Arnica, for a "stitch" in the side. Bryonia, when painful 
catching of breath. Cimicifuga, for intercostal rheumatism and pains under 
the breasts in women. 

Chicken-pox. 

Aconite, is of great value (B.). Water, hot and cold baths and packs are of 
great utility ; cold, if hyperpyrexia ; cold compress if sore-throat ; hot or warm 
pack when free diaphoresis required (B.). Treatment, precautionary only 
required. Avoid exposure to cold and wet ; maintain the action of skin and 
bowels (H.). Acetate of Ammonium, in diaphoretic and antifebrile mixture. 
See Fever, Simple, for formula. Inunction, with camphorated oil, or thin 
starch, to relieve itching and allay inflammation (P.). 



Chilblains. 

Arnica, a useful application (Wa.). Iodine, ointment, the best application 
(R.). Carbolic Acid, an efficient application is an ointment of carbolic acid and 
iodine (B.). Benzoin, the tincture in glycerin, applied after thorough washing 
in soap and water and drying, the best application. Sulphurous Acid, an effi- 
cient application ; 3j-3nj each of water and glycerin (B.) ; as solution or fumi- 
gation (D.). Balsam of Peru, in ointment for broken chilblains (R.) Capsi- 
cum, tinct. painted over unbroken chilblains (R.). Cajuput Oil, applied 
locally (R.). Turpentine, as wash, then apply basilicon ointment mixed with 
turpentine (B.). 

Prescriptions. 



]$. Acidi Carbolici, gj. 

Tinct. Iodi, gij. 

Ac. Tannici, £ij. 

Cerati Simplicis, ^ iv. 

M. Sig —Ointment. (B.) 



R. Tinct. Benzoini, ^ij. 

Olei Lini, ^iv. 

Cerae Flavse, 55 Ij 

Glycerini, q.s. 

M. Sig. -Ointment. [Reveil.) 



CHLOROSIS CHOKING — CHOLERA ASIATICA. 



523 



Chlorosis. 

Iron, combined with arsenic or strychnine. Occasional purgation and active 
exercise. Also chalybeate waters for blood deficiencies (B., R.) ; is not a specific 
in chlorosis, and acts best in the purest types (Tr.); the iodide, when much 
torpor of the system, is often speedily efficacious (Wa.). Arsenic, if iron fails, 
or disagrees (B.). Ergot, in chlorotic amenorrhcea (P.). Manganese, the sac- 
charated carbonate of manganese and iron (B.). Nux Vomica, stimulates the 
blood-making organs, and may be combined with iron. Avery generally useful 
preparation is the syrup or elixir of iron, quinine and strychnine (B.). Cocculus 
Indicus, with amenorrhcea and exhausting leucorrhcea (P.). Hypophosphites, 
of lime or sodium (R.). Benzoin, has been used with advantage (P.). Pepsin, 
benefits, especially where digestive derangement (B.). Sulphur, of great benefit 
in cases where iron is of no effect ; also to prepare the system for benefit from 
iron (Schulz). Purgation, is very important, to prevent auto-infection from 
putrid intestinal decomposition, which is the true cause of this disease (Duclos) ; 
absorption of such products tending to impoverish the blood, and produce a 
" faecal anaemia " (Sir A. Clark). Oils and Fats, as inunctions after baths, of 
great benefit (B.). Galvanization, central : will aid the action of the remedies 
(B.). [Compare Anaemia, Amenorrhcea.] 



Prescriptions. 



R. Ferri Arseniatis, . . . gr. ij. 
Extracti Cinchonas, . . gr. xij. 
Fiant pil.xij. Sig. — Oneafter each meal. 
(B.) 

R. Ferri Sulph. Exsiccat., . gr. xl. 
Quininae Sulphatis, . . gr. xx. 
Strychnine Sulphat., . . gr. ss. 
Ft. pil. xx. Sig. — One thrice daily. 



R . Pulv. Aloes Socot., 


gr. v. 


Ferri Sulph. Exsiccat., 


gr. xv. 


01. Tanaceti vel 




01. Sabinse, .... 


gtt. XXX. 


Myrrhae, Croci, 




Cantharidis, . . . . aa 


gr. xxx. 


Ft. pil. lx. Sig. — Two 


thrice daily 


gradually increased to four. 






{Wallace.) 



Choking. 

Potassic Bromide, benefits a curious affection, sometimes found in children 
who from their birth can swallow solids with ease but choke at drinks (B.). Oil 
of Cajuput, in one case of persistent " choking" sensation in the throat, a few 
doses removed the symptoms which had lasted several weeks (Hale). 



Cholera Asiatica. 

Camphor, a drop or two of the saturated tincture, or v-x drops of the spirits 
with a little opium every half-hour (B.) ; gtt. iv-vj of strong spirits every ten 
minutes until symptoms abate, then hourly (R.). Arsenic, in epidemic cholera ; 
some cases of arsenic poisoning not distinguishable from cholera (B.) ; for the 
vomiting and in collapse (R.). Copper salts have been given (R.). Turpen- 
tine, rr^x-xx every two hours promises to be a remedy of value ( Wa.). Chloral, 
as injection, the most efficient treatment, especially when morphine and atropine 
are given coincidently (B.). Chloroform, a few drops frequently repeated, or 
x-xxx drops of chlorodyne, of great value (B.). Opium, -^ to }i gr. morph. 
hypodermically in preliminary diarrhoea (B., P.); yi to X g r - °f the greatest value 
even in collapse (R.) ; dangerous if kidney complications exist (P.). Lead, the 
acetate in early stages (R.). Carbolic Acid, with iodine, has given good results 
(B.). Sulphuric Acid, the aromatic, with opium, is very effective (B.); two parts of 
the former with one of laudanum, of this 5 to 30 drops as per age, is one of the 
best prophylactics (McClellan). Strychnine, as prophylactic during the pre- 
liminary diarrhoea, and in epidemic when nearing collapse (B.). Alcohol, small 
doses of iced brandy for vomiting (B.). Spinal Ice-bag, for cramps (R.). 
Saline Injections, into the veins, have been successful in the collapse (B.). 



524 



CHOLERA INFANTUM. 



Transfusion, of milk, in collapse (B.). Absolute Rest, recumbent posture, no 
food, ice ad libitum ; enemata of warm milk ; fresh air, friction, and heat to 
abdomen, legs and feet ; stimulants worse than useless. 



Prescriptions. 



R. Chloralis Hydrat., .... giij. 

Morphinse Sulph., . . . . gr. iv. 

Aquae Laurocerasi, . . . . ^j. 
M. Sig. — Fifteen to twenty drops as 
injection hypodermically. (B.) 



R. Chloroformi, 5jj. 

Tinct. Opii, 

Spt. Camphorae, 

Tinct. Capsici, . . . . aa % iij. 

Alcoholis, . . . . q. s. ad % ij. 

M. Sig. — 30 to 60 drops in water. 

(Squibtf 's Cholera Mixture?) 



R. Acidi Carbolici, gr. iv. 

Tinct. lodi, gtt. xvj. 

Aq. Menth. Pip., . . . . f iv. 
M. Sig. — A tablesp. every hour or oft- 
ener. (B.) 



R . Acidi Carbolici, gr. viij . 

Bismuthi Subnit., . . . . 2fij. 

Mucil. Acaciae, 

Aquae Laurocerasi, . . aa !|j. 
M. Sig. — Teasp. every hour or two, for 
vomiting and diarrhoea. 



Cholera Infantum. 

Ipecacuanha, greenish stools with mucus and often blood (B.). Arsenic, for 
vomiting and collapse (R.). Mercury, gr. l /e of gray powder hourly of great 
service in infantile cholera with incessant sickness, profuse almost continuous 
diarrhoea, offensive and nearly colorless stools. A starch injection, with a 
minute quantity of laudanum, assists the gray powder, and should be given in 
urgent cases (R.). Zinc Oxide, with bismuth and pepsin, is very useful (B.). 
Camphor, 3}-%iv of milk, very serviceable (B.) ; an admirable remedy for 
summer and choleraic diarrhoea (R.). Opium, generally necessary. Enemata 
of starch and laudanum (see above under Mercury). Morphine, hypoder- 
mically, in doses of gr. -^tre to -£$ according to age, the latter dose for a child of 
one year, with 5 or 6 drops of ether, to be repeated in an hour, the most effi- 
cient treatment (E. Smith). Copper Sulphate, often very successful (B.). Car- 
bolic Acid, with Bismuth, may arrest the disorder promptly (Br.). Lead Ace- 
tate, is one of the most useful astringents in this complaint (Br.). Potassium 
Bromide, when due to nervous irritation or cerebral congestion (B.). Silver 
Nitrate, is beneficial after the acute symptoms have passed (B.). Caffeine, 
when due to nervous irritation (R.). Coto Bark, the tinct. gtt. j-iij is highly 
recommended by Rohrer for choleraic diarrhoea in children. Alcohol, in grave 
cases, with tendency to collapse, gtt. x-xx of brandy with milk every 30 to 60 
minutes. Diet. Farinaceous food a common cause. Cow's milk 0}4 with 
sacch. lactis %] to Oj( aquae -bul., or cold milk with lime-water (R.) ; milk, ani- 
mal broths; no starches or fats (B.). Drinks, as water, weak tea, etc., freely, 
to keep vessels filled and prevent paralysis of the heart (Meinert). Spice Poul- 
tice, to abdomen, composed of cloves, ginger and cinnamon, mixed with brandy 
or whiskey. Mustard Bath, in stage of collapse, with mustard over the heart, 
and ether hypodermically (Smith). Lactic Acid, a 2 per cent, solution in 
drachrn doses, 5 to 8 times in 24 hours, in epidemic diarrhoea of infants with 
green discharges, with local antisepsis as to linen and diapers, on the theory of 
a bacillary origin for the disease (Hayem). 



Prescriptions. 



R . Acidi Carbolici, . . . . gr. iv. 
Bismuthi Subnit., . . . . JTij. 
Mucil. Acaciae, .... 5 j. 
Aquae Menth. Pip., . , . 5 iij. 
M. Sig. Teasp every 2, 3, or 4 hours. 

(B.) 



R . Cupri Sulphat., . . . . gr. j. 

Tinct. Opii Deod., . . . gtt. viij. 

Aquae Destil., ^iv. 

M. Sig. — Teasp. every 2, 3, or 4 hours 
for a child of one to two years old. (B.) 



CHOLERA SIMPLEX CHORDEE CHOREA. 



525 



Acidi Carbolici, . . 


. gr. xxiv. 


Spt.-Vini Gallici, . 


. gtt. xxiv. 


Aquae Menth. Pip., . 


. gjss. 


Mucil. Acacise, . . 


• 3 V J- 


Syr. Papaveris, . , 


■ • 3 V J- 


Tinct. Opii Deod., . 


. . gtt. X. 


Sig. — A teasp. every 


2 hours. 



M. 



R . Hydrarg. Chlor. Mitis, . . gr. ^L 
Bismuthi Subnitrat., . . gr. ij-v. 
In powder every half-hour for the vomit- 
ing and purging. 



B 



. Plumbi Acetat., . . . . gr. xxiv. 

Pulv. Opii, gr. xij. 

Pulv. Camphorse, . . . gss. 

Sacch. Lactis., q. s. 

Triturat. et div. in chart, xij. 
Sig. — One every hour. (B.) 



R . Hydrarg. Chlor. Mitis, . gr. A. 

Plumbi Acetatis, . . . . gr. |-. 

Opii, gr. i to Jjy. 

Ft. pulv. no. j. Repeat every half-hour 
or hour for the acute gastric symptoms. 



Cholera Simplex. 

Camphor, an admirable remedy (R., B.). Veratrum Album, for the vomiting 
(R.). Copper Salts, have been given (R.). Arsenic, for vomiting ; also for col- 
lapse in latter stages (R.). Chloral, by injection, the most efficient treatment 
(B.). [See C Asiatica for formula.] For the cramps, Chloral ^j, in Lin. 
Saponis ^iv-vj, applied with friction to the abdomen (Da Costa). Carbolic 
Acid, with bismuth, very effective (B.). [See above, C. Infantum.] Lead, 
the acetate, in early stages (R.). Opium, gr. X~/^ morphine, hypodermically ; 
very useful (B.). Gr. l /e, %, or y z opii, every 2, 4, or 6 hours in early stage (P.). 
Calumba, as anti-emetic, of great value (P.). Ipecacuanha, has been used 
with much advantage (Wa.). Sumbul, said to have proved successful (P.). 
Mustard, as an emetic in collapse, to stimulate a failing heart (P.). Cajuput 
Oil, much used in India for choleraic affections (P.). Alcohol. Iced brandy 
in small doses for vomiting (B.). The value of stimulants justly doubted; if 
given, should be largely diluted (Wa.). [Compare Cholera Asiatica and 
Infantum, above.] 

Chordee. 

Aconite, gtt. j hourly, will relieve (R., P.). Belladonna, combined with cam- 
phor or opium, gives the best results of remedies administered internally (St.). 
Camphor, o\j doses of the spirits will relieve (R.). Cantharis, gtt. j ter die, will 
prevent (B., R.). Cannabis Indica or Cannabis Sativa (P.). Lupulin, valu- 
able (P.); said to prevent (B.). Morphine, hypodermically, the one sure 
remedy; should be injected into the perineum at bedtime (St.). Cocaine, a few 
drops of a 4 per cent, solution, locally to the glans ; or injected into urethra, 
promptly relieves chordee. Diet should be plain, even low, no stimulants ; 
copious draughts of barley-water, or linseed tea. 



R. Liq. Morph. Magendie, . ^iv. 
Atropinae Sulphat., . . . gr. j. 

Acidi Acetici, q s. 

Aquse Destillat., . . . ad %). 
M. Sig. — TTLv-viij hypodermically 



Prescriptions. 



bedtime. 



(St. 



R . Pulv. Opii, gr. xij. 

Pul. Camphorae, . , . . gr. xxiv. 

Sacch. Alb., q. s. 

Fiant capsulae xij. 
Sig.— One at bedtime, to be repeated in 
2 hours if required. (St.) 



Chorea. 

Antipyrine, is successfully employed. Cimicifuga, in cases due to menstrual 
derangement, is very useful (P.) ; when rheumatic history (R.) ; a very valu- 
able remedy (P.). Strychnine, in doses gradually increasing to toxic (Tr.) ; 
minute doses (gr. -^ to ^q) have been of much use when from fright or com- 
mencing puberty (B.) ; Arsenic, large doses required HL v ter die, when non- 
ansemic (B.) ; very successful in uncomplicated cases (R.). Zinc, the Sulphate, 



26 



CHOROIDITIS — CLIMACTERIC DISORDERS. 



has similar action to Arsenic, but is inferior (B.). In large and increasing 
doses it is very useful (R.). Iron, large doses of the Subcarbonate in anaemic 
cases, about the time of puberty (B.). Chalybeate waters often relieve or 
cure. Arsenic generally better, unless anaemia coexists (R.). Hyoscyamine, 
gr. yoo ter die, gradually increased, has cured cases which resisted all other, 
remedies (Da Costa). The mydriatics are very suitable in nervous, delicate 
children. Copper. Cupr. Ammoniatum has been used successfully (B.). 
Veratrum Viride, has been employed (R.). Cocculus, picrotoxine, large doses 
(B., P.). Conium, in large doses, to quiet muscular agitation (B.) ; is only pal- 
liative (R.) ; evidence contradictory as to its value (P.). Valerian, said to 
restrain the movements (R.). Useful when from worms (P.). Chloral, con- 
tributes to a cure by inducing quiet sleep (B., R.). Chloroform, inhalations, 
often of great service in severe cases (R.). Morphine, with Chloral, hypo- 
dermically in large doses for severe cases (Tr.) ; when the movements prevent 
sleep (R.). Physostigma, is recommended (R.) ; — of doubtful benefit (B.). 
Musk, has been given (R.). Cod-liver Oil, in low nutrition (B., R.). Water. 
Cold affusion to head and spine, and cold baths, important (B.) ; not to be 
used if rheumatism, fever, or pain in joints. Tepid water first (R.). Galvanism, 
the constant current, used by Benedict in twenty cases, all recovering. Gal- 
vanic chain around neck and down the back. 



Prescriptions. 



ft. Tinct. Ferri Chloridi, . . . gj. 

Liq. Acidi Arseniosi, . . . gij. 

Syr. Limonis, o Si> * 

Syr. Simplicis, 

Aquae, . . . . aa q. s. «</ ^iv. 
M. Sig. — Half a teaspoonful thrice 
daily, after meals, gradually increased, and 
effects carefully watched. 



R- . Chloralis Hydrat., . . . . ^iv. 

Tinct. Hyoscyami, .... Sj. 

Syr. Limonis, 3J. 

Aquae Cinnamomi, . . . . ,§iv. 
M. Sig. — A teasp. 3 or 4 times daily, 
according to age. 



Choroiditis. 

Mercury, as in iritis ; cannot be borne to the same extent as in latter dis- 
ease (A.). Opiates, necessary externally and internally to overcome pain (A.). 
Treatment, is generally the same as in corresponding forms of iritis, but when 
atrophic spots appear on the choroid, no treatment can repair the damage 
(A.). Rest of eyes and protection from light by blue glasses. In suppurative 
form (panophthalmitis) use Atropine in strong solution, with ice compresses 
and leeches in early stage. Paracentesis repeatedly to relieve tension and 
give exit to pus. Canthoplasty of outer canthus to relieve the pressure of the 
lids (Roosa). 



Climacteric Disorders. 

Aconite, for nervous palpitations, and restlessness or " fidgets ; " gtt. j hourly 
(R.). Cimicifuga, for distressing headache (R.). Nitrite of Amyl, in small 
doses when the "heats" predominate, followed by cold, clammy, pale skin 
(R.). Ergot, for the flooding, gr. ij of Squibb's extract, in fresh pill every hour 
until relieved. Cannabis lndica may be well combined with it. Cannabis 
Indica, is used in the headaches of the menopause with uniformly good results. 
[See Headache, for formula.] Nux Vomica, Opium, and Belladonna, when 
symptoms described under Iron are limited to head and face (R.)- Iron, for 
flutterings of the heart, with fullness of head, heat and weight on the vertex, 
frequent flushings, and hot and cold perspirations. Large doses of Sesqui- 
chloride ter die (R.). Ammonia, Raspail's sedative lotion to painful part of 
head, in headaches (R.). Potassium Bromide, for despondency, with sleep- 
lessness and irritability, often also with heats, flushings, perspirations (R.)- 
Physostigma, the extract, gr. ^ every y z hour for 7 or 8 doses for flatulence 
and a sensation of fluttering at the pit of the stomach (A. A. Smith). Cam- 



COCCYODYNIA COLDNESS COLIC, INTESTINAL. 



527 



phor, for drowsiness and headache. Eau-de-cologne saturated with camphor 
rubbed to head (R.). Zinc Valerianate, hysterical symptoms (R.). Change of 
air and scene, where other treatment only partially successful (R.). Warm 
Bath, to promote free perspiration. 90 to 95 Fah. for an hour once a week, 
will obviate many of the symptoms (R.). [Compare Metrorrhagia.] 



Coccyodynia. 

Chloroform, injected as deeply as possible about seat of greatest pain (B.). 
Electricity, has cured one severe case of 12 years' standing, and helped others. 
Surgical treatment the only resource in rebellious and painful cases (Ros.). 
Nott extirpated the coccyx ; Simpson performed subcutaneous section of mus- 
cles and ligaments. Goodell removes the bone, after first treating the case as 
a local expression of a general neurosis. 



Coldness. 

Strychnine, for cold hands and feet (R.). Cold Baths, with friction to the 
skin, nightly for cold feet (R.). Spinal Ice-bag, is often efficiently employed 
in general coldness of the surface, and persistent coldness of the hands and 
feet (R.). 

Colic, Intestinal. 

Nux Vomica, quickly subdues abdominal cramps and spasms (P.). Bella- 
donna, especially in children (R.). Chamomile Oil, rr\, iv-vj, in colicky 
attacks of hysterical women (P.). Cocculus, of great value, especially during 
pregnancy (P.). Chloral, sometimes relieves (R.). Chloroform, effective in 
flatulent colic; also useful in hepatic and saturnine (B.). Often used combined 
with Opium (D.). Potassium Bromide, in a peculiar form in young children 
(R.). Given in anise or peppermint water is of greater efficacy for the colic of 
infants than the opium preparations in general use, and perfectly safe (B.). 
Asafoetida, no better remedy in flatulent colic of infants. Teasp. doses of the 
mistura asafcetidas (B.). Morphine, gr. yi-% hypodermically, repeated in 15 
minutes, gives more relief than any other remedy, in all forms of colic (B.). 
Frequent small doses (R., P.). Arsenic, will cure in a surprising manner when 
enteralgia is idiopathic (B.). Essential Oils, especially those of Cloves and 
Cinnamon (R.)., Anise, Cardamom, etc. Oil of Rue in flatulent colic of 
children (P.). Magnesia, the carbonate with Opium and Asafetida, as in 
Dewees's Carminative, now official as Mistura Magnesias et Asafcetidse, the dose 
being ttlxx for an infant of 2 to 4 weeks old. Tobacco, as enema ; dangerous ! 
(B.) ; as clyster, or by stomach (R.). Ammonia, in spasm of intestinal canal 
and in colic of children or infants from bad feeding (R.). Lime Water, for 
young children who eject milk in lumpy masses, with colic and flatulence 
(R.). Water, Hot fomentations to ease pain (R.). A copious enema of warm 
water often gives immediate relief. 

Prescriptions. 

R- . Ext, Gentianse, 



R. Spiritus Chloroformi, 

Tinct. Cardamomi Co., . aa ^ij. 

M. Sig. — Teasp. in water every ^ 

hour. (B.) 

R. Atropinae Sulph., . . . . gr. j. 

Zinci Sulphatis, gr. xxx. 

Aquae Deslil., ^j. 

M. Sig. — 3 to 5 drops 2 or 3 times 
daily. (B.) 



Pulv. Rhei, aa gj. 

Ft. pil. xx. Sig. — One or two thrice 
daily for tendency to colic. 



B 



. Pulv. Camphorae, 

Pulv. Capsici, 

Pulv. Zingiberis, . . . aa gr. ij. 
Ft. pil. ij. Sig. — One as required. 



28 



COLIC — COMA. 



•Colic, Lead. 

Alum, singularly, is the best remedy (B.) ; gr. x hourly (R.) ; converts the 
poisonous salt of lead in the system into a comparatively innocuous sulphate ; 
3jss-ij daily with nvxl-l Tinct. Opii, and an occasional dose of castor or croton 
oil to procure one or two motions daily (Wa.). Opium, gives more relief than 
any other remedy, gr. yi to % °f morphine hypodermically (B.) ; gr. ij-iv of 
opium, with a moderate dose of castor oil (P.). Sulphuric Acid, diluted 
well, as a prophylactic, and is useful in the treatment of the disease (B.); con- 
sidered remarkably efficient when used in association with repeated sulphur 
baths (Wa.). Calomel, a full dose, with or without opium, followed in a few 
hours by castor oil and a turpentine enema, often affords speedy and marked 
relief (Wa.). Tobacco, may control, but is dangerous (B.). Croton Oil, in 
half-drop doses, with sufficient opium to relieve the pain, repeated every 3 
or 4 hours until free evacuations are produced ; proves effectual when other 
remedies fail (Wa.). Magnesium Sulphate, for the constipation, and to remove 
the poison from the system ; should be combined with Iodide of Potassium, 
3j of the former given ter in die and about two hours after gr. v-x of the 
iodide. This treatment dissolves the lead in the tissues, causes its elimination 
by the intestinal mucus, renders it insoluble after it has entered the intestinal 
canal, and quickly removes it from the body (Br.). [Compare the treatment of 
Lead-poisoning, ante, page 327.] 



Prescriptions. 



R . Aluminis, ^ij. 

Ac. Sulph. Dil., 3j. 

Syr. Limonis, if j. 

Aquae, g iij. 

M. Sig. — Tablesp. every hour or two 
for colic. (B.) 



Eh 

§3- 



R. Magnesii Sulphatis, . 

Ac. Sulph. Dil., . . . 

Aquae, 3 iv. 

M. Sig. — Tablesp. every 3 hours (B.) ; 
or thrice daily, each time preceded by a 5 to 
io-grain dose of Potassium Iodide. (Br.) 



Colic, Renal and Hepatic. 

Ether, inhaled in paroxysms of hepatic colic (R.). Chloroform, inhalation 
in renal and biliary colic, inferior only to morphia injection, superior to opium, 
warm baths, etc.; two or three administrations may be required (R.). [See also 
Colic, Intestinal.] Counter-irritation, flying blisters for renal colic (R.). 
Opium, small doses with spt. chloroform, every five or ten minutes until the 
pain gives way, or morphia hypoderm. (R.). Turpentine, has been given with 
benefit in biliary colic (R.). Dioscorea, is used successfully in so-called bilious 
colic, rr\xv-xxx of the fluid extract. Water, warm baths to ease the pain (R.). 
Aliment. Withhold all starches and fats. Alkaline mineral waters are useful 
(B.). [Compare Calculi.] 

Coma. 

Blisters, in a comatose condition, large blisters or mustard poultices should 
be applied in quick succession to different parts of the body — chest, abdomen, 
thighs and calves ; often very valuable in the critical condition near the end of 
an acute illness (R.). Cold Douche, for stupor of drunkenness or of opium 
poisoning. May have to be repeated if relapses occur. It should be kept up 
for a long time if pulse and breathing improve, or no worse (R.). Croton Oil, 
as purgative, tr^X or }{ every hour (R.). Potassium Bitartrate, as purgative 
when blood is^poisoned (R.). Mustard, as poultice to the feet and ankles in 
the coma of narcotic poisoning (P.). Exercise. In coma from poisoning the 
patient should be persistently walked about. [Compare Cerebral Conges- 
tion, Uraemia, and the treatment of Narcotic Poisoning, ante, page 303.] 



CONDYLOMATA CONJUNCTIVITIS. 529 

Condylomata. 

Nitric Acid, ^j to Oj aquae, as wash, frequently used (B., R.). Thuja, 
locally a strong tinct. with gtt. v in water, night and morning, internally, for 
warts with narrow base and pendulous body. Warts about anus or pudenda of 
either sex, whether syphilitic or not, often rapidly cured by Thuja (P.). In non- 
syphilitic warts of penis or vulva, I have employed it with satisfaction (Pf.). 
Mercury, Calomel dusted over, after washing with a solution of chlorinated 
soda (Ricord, R., B.) ; the nitrate locally or a 20 per cent, oleate (R.). Zinc, 
the chloride, iodide or nitrate as local applications (R.). Arsenic, arsenious 
acid as a caustic (R.). Carbolic Acid, as a mild escharotic (B.). Chromic 
Acid, gr. c-^fj aquae dest.; a good local application (B.). [Compare Syphilis, 
Warts.] 

Conjunctivitis, Catarrhal. 

Zinc, a weak solution of the sulphate or acetate as astringent collyrium (B.) ; 
gr. ij ad Jj aquae destil. as mild astringent lotion every few hours, with ice locally 
in the earlier stage (Roosa). Borate of Sodium, gr. v ad ^j aquae dest. a good 
and mild astringent for ordinary cases. Boric Acid, gr. vj ad ^j each of aq. 
camph. and aq. destil., as collyrium (Fox). Boro-glyceride, £ss a d gj f a q ^ 
camph. and aq. dest. a very efficient application. See ante, page 60. Carbolic 
Acid, a 5 per cent, solution applied every two hours by spray of steam atomizer, 
which dilutes it one-half, an extremely efficient application, relieving the pain 
and contracting the vessels. Cocaine, the hydrochlorate in 3 to 5 per cent, solu- 
tion or oleate, applied to the palpebral conjunctiva, is a very efficient palliative, 
especially where much pain and photophobia (Koller). Alum, potassa alum 
after acute symptoms subside (Br.) ; gr. iij-v ad 3ij aq. destil. brushed over the 
conjunctiva twice daily. Pulsatilla, 3j-ij of tincture to ^iv aquae as wash sev- 
eral times daily, also n\j-x internally every 3 or 4 hours (P.). Opium, the wine 
dropped into the eye relieves pain and improves the condition of the conjunc- 
tiva (R.) ; Morphine, gr. j-ij ad £j, is often used in collyria with zinc salts 
or alum. Mercury, Calomel dusted over the palpebral conjunctiva, in severe 
cases ; should be finely levigated and dusted from a camel's-hair brush (B.) ; the 
oleate of mercury and morphine to the outside of the lids in palpebral conjunc- 
tivitis (R.) ; the red oxide as ointment, gr. x ad gj vaseline (Bader) ; the yellow 
oxide, gr. viij-x ad ^j vaseline (Seely). Cadmium, as collyrium gr. ij of the 
sulphate to 3J aquae rosae (B.). Tannin, in glycerin, £j ad ^j, every second day 
in chronic catarrhal conjunctivitis, presenting diffused injection of vessels with 
oedema (Hansell). Silver Nitrate, solutions of strength gr. j-iv ad Jj applied by 
physician to conjunctiva (R.) ; should not be given to patient. Zinc and copper 
salts are preferred (B.). Copper, the sulphate crystal in chronic cases where 
great swelling or hypertrophy of the papillary layer. Is too irritating to be 
entrusted to the patient. Lead salts should never be used lest deposits occur 
in slight abrasions or ulcerations of the cornea. Sulphates, of zinc, copper, 
and iron with alum, aa gr. j to ^j of aq. destil. as collyrium, extremely effi- 
cient ; in severe cases may be used in saturated solution by the physician 
(Holmes). Castor Oil, a drop placed in the eye often allays the pain and pho- 
tophobia caused by an irritant (R.). Belladonna, locally and internally (B.). 
Atropine in strong solution, gr. iv to ^j, is one of the best local applications 
where mydriasis is not objectionable. Euphrasia, as a mild astringent (P.). 
Blisters, behind the ears in bad cases (R.). Ergot, the fluid extract locally 
gives excellent results in acute conjunctivitis (B.). Staphisagria, especially in 
tarsal ophthalmia (P.). Colchicum, when gouty diathesis (A.). Spigelia, in 
rheumatic form (P.). 

Prescriptions. 



R . Zinci Sulphatis, gr. ij . 

Morphinse Sulph., gr. ij. 

Atropinae Sulph., gr. ss. 

Aquae Rosse, l|j. 

M. Sig.— Eye-water. (B.) 

34 



R. Hydrarg. Oxidi Rub., . . . gr. x. 

Atrophias Sulph., gr. j. 

Vaselini, £). 

M. Sig. — A minute portion as an oint- 
ment for the eye. {Bader.) 



530 CONJUNXTIVITIS. 



R. Liq. Plumbi Subacetat., , . gj. 

Aqure Destillatse, ^iij. 

M. Sig. — For local use. To be brushed 
over coi junciiva of everted lids by the sur- 
geon and washed off with water. {Buller). 



H . Ung. Hydrarg. Nitrat., . . gr. xx. 
Cocainse Hydrochlorat., . . gr. v. 

'Vaselini Albi, 3 ij. 

Use a fresh ointment, triturate thor- 
oughly, and label " Ointment for the eye." 



Conjunctivitis, Diphtheritic. 

Zinc Chloride, gr. ij-iv ad ^j, as collyrium, has succeeded admirably 
(Wa.). Atropine, locally throughout the disease. Treatment not very effectual 
(Roosa) ; is, tor severe cases, powerless ; cornea sure to be attacked and liable 
to slough (Noyes). Boric Acid, 4 per cent, solution, as antiseptic, the best 
application, with Quinine, internally in full doses (Noyes). Iron, the pyro- 
phosphate for children, 3j in ^iij of simple syrup, of which a teasp. thrice daily 
after meals, with quinine in 1 to 3-grain doses thrice daily, and good food 
(Derby). Cold by compresses, as in purulent ophthalmia, in early stages. 
Silver Nitrate in solution locally, a 10-grain solution or the mitigated stick in 
the second stage. Tannin, gr. xx to the 3 of glycerin, later on, applied every 
day, with hot water lotions if corneal complications. 



Conjunctivitis, Gonorrhceal. 

Zinc Chloride, gr. j-ij ad £j aquas, as collyrium, with marked benefit (Wa.). 
Silver Nitrate, a 2-gr. to the Jj solution, after syringing out the eye with warm 
water, followed by ice compresses, in hope to abort the attack, if seen early 
(Roosa). Cold, by ice or wet compresses, essential in the early stages (C). 
Atropine, may be used from the beginning, as corneal complications begin 
very early. Treatment, generally the same as for Purulent Conjunctivitis. 
Isolation and cleanliness are of prime importance. 

Conjunctivitis, Granular. 

Silver Nitrate, the diluted stick (seepage 115) applied lightly and quickly 
(C.) ; strong solutions to granular lids, gr. xx ad ^j cautiously when corneal 
ulcers exist (B.) ; mild solutions better, gr. v ad gj, daily in the papillary 
form ; in miliary trachoma it should not be stronger than gr. ij ad ^j (Noyes). 
Applications lose their effect after a time, and should be changed (Roosa). 
Copper Sulphate, the solid crystal lightly touched to the membrane once a day, 
the favorite astringent and caustic in all forms of trachoma (Roosa) ; when 
membrane torpid to other stimulation and when lymphoid substance is pre- 
dominant. As ointment gr. v-x ad %] vaseline, when for use by patient 
(Noyes). Alum, a smooth crystal is a useful daily application (Noyes). 
Tannin, gr. x-xxx ad glycerini %}, an application to change to from others 
(Roosa). Bismuth is one of the numerous applications in chronic conjuncti- 
vitis and granular lids (B.). Phytolacca internally, is undoubtedly efficient in 
granular conjunctivitis (W.). Jequirity, to excite substitutive inflammation. 
See ante, page 55. Atropine, gr. ij ad %] aquae, thrice daily, is often advisable, 
where moderate irritation and haziness of the cornea (Noyes). Hygienic Meas- 
ures, of great value. Protection by blue or smoked glasses. Rest of eyes, best 
secured by using atropine collyria. Hot or cold water as local bath frequently. 
Tobacco must be avoided, also all locations contaminated by impure air. 
Canthoplasty of outer commissure when lids press on globe. 

Conjunctivitis, Phlyctenular. 

Mercury. Calomel finely levigated and dusted from a camel's-hair pencil 
over the membrane in phlyctenular ophthalmia, an excellent local applica- 
tion ; which should never be used when iodine is being taken. In more obsti- 



CONSTIPATION. 



531 



nate cases a small bit of Pagenstecker's ointment, the size of a pin-head (Hy- 
drarg. Ox. Flav. gr. j-iij, Vaselini 3j), placed between the lids (Noyes). Ergot, 
the fluid extract, applied undiluted, gives excellent results in the phlyctenular 
ophthalmia of children (B.). Antimony. Tartar emetic gr. fa to fa 3 or 4 
times daily in strumous ophthalmia, with sharp purgation at the outset (R.). 
Belladonna, or Atropine, locally in strumous ophthalmia, of great service in 
relieving pain ; constitutional treatment also required (Wa.). Arsenic, invalu- 
able in inveterate cases of strumous ophthalmia, especially when complicated 
with cutaneous eruptions (Wa.). Tannin, finely powdered and dusted over the 
everted lid, gives remarkably good results in this and other forms of conjunc- 
tivitis, causing very little pain and no inflammatory reaction (B.). Carbonic 
Acid Gas, applied to the eye is said to relieve the pain and photophobia of 
strumous ophthalmia (R.). Hydrastis, as lotion, is serviceable when Meibo- 
main follicles are implicated, causing adhesion of lids in the morning (P.). 
Eserine, locally, to reduce the pupil and shut out the light (P.). Iodine, is em- 
ployed locally in strumous ophthalmia, for its alterative stimulation (W.). Zinc 
Chloride, gr. ij-iv ad ^j, as collyrium, has succeeded admirably in pustular 
ophthalmia (Wa.). Zinc Sulphate, gr. j-iv ad ^j, is very serviceable ; the addi- 
tion of liquor plumbi improves its efficacy. (Wa.). Rhubarb, the mistura rhei et 
sodas where much disturbance of digestion present. Tonics, may be given 
later, preparations of Cinchona and Iron. Cod-liver Oil, in strumous subjects, 
tends to remove the manifestations of the disease (R.). 

Conjunctivitis, Purulent. 

Alum, gr. ij ad Jj aquae, a sufficient astringent application in ophthalmia 
neonatorum (Roosa) ; gr. viij ad Jj aquae, applied every % or ^ hour in the 
purulent ophthalmia of children, its success depending on the frequency of the 
application (R.). Copper Sulphate, gr. j ad ^j aquae camph. as collyrium in 
purulent ophthalmia of infants (Wa.). Silver Nitrate, gr. iij-x ad ^j aquae destil., 
rarely so strong as gr. x, once daily applied by brush to everted lids in purulent 
ophthalmia of infants (Noyes) ; solution gr. }( ad ^j twice daily under lids 
(Meigs) — by many it is considered needless and injurious (Roosa). Boric Acid, 
a 4 per cent, solution, as antiseptic, is all that is necessary in mild cases ; in 
others it is the proper fluid for cleansing the eye (Noyes). Atropine, when the 
cornea becomes invaded, and shows haziness, a solution gr. ij ad 5jj, must be 
instilled every 3 hours (R.). Cold, by ice or wet compresses, essential in the 
early stages of acute purulent ophthalmia (C). Cleanliness, a matter of great 
importance. As the discharge is infectious the patient should be isolated and 
care taken to prevent inoculation of the other eye therewith. 



R . Sodii Boratis, gr. xij. 

Zinci Sulphatis, gr. j. 

Aquas Camph., ^j. 

Aquas Destillat., ..... '^j. 

M. Sig. — Apply to lids 2 or 3 times daily 

in oph. neonatorum, with solution of Silver 

Nitrate, gr. ^ ad £j injected under lids 

twice daily. (Meigs.) 



Prescriptions. 



R. Sodii Boratis, gr. iij. 

Aquas Rosas, 

Aquas, aa^j. 

M. Sig. — Apply beneath lids three or 
four times daily after cleansing. 



$ . Atropinas Sulph., gr. j. 

Glycerini, 3 ss. Aquas, . . 3 ij. 
M. Sig. — Two drops into the eye. 



Constipation. 

Nux Vomica, gtt. j-ij of tincture bis vel ter in die (R.) ; gtt. v-x in a glass of 
cold water before breakfast and dinner, often overcomes the most obstinate 
constipation (P.) ; especially useful when great fecal accumulations from torpor 
of bowel (B.). Sulphur, gr. x with confectio sennae, often succeeds after other 
remedies fail (R.). Sulphurous mineral waters (B.) ; or sulphates in purgative 



532 CONSTIPATION. 

waters; frequent small doses (R.). Podophyllum, the most generally used 
cathartic when deficient secretion (B.). Gr. T ^ to y& night and morning when 
constipation with nervous and bilious headaches (P.). Senna, as in the pulvis 
glycyrrhizae compos. U. S., which may be taken in doses of a teasp. to a tablesp. 
as required, and kept up for months (Goodell). Mercury, Calomel or gray 
powder as cathartic (R.). Hydrastis, very valuable, when constipation refer- 
able to a sluggish liver (P.). Magnesium, the bi-carbonate, a useful and mild 
aperient (R.). Alum, cheap and serviceable laxative (B.). Aloes, in minute 
doses, in pill with Sulphate of Iron, as the official Pil. Aloes et Ferri, is one of 
the best agents in the management of chronic cases : — purgation should not 
be aimed at. Ipecacuanha, gr. j every morning, fasting, when great torpor of 
bowel (R.)- Cocculus, flatus, hard lumpy motions (P.). , Turpentine, in purely 
atonic constipation, with gaseous distention of colon, has triumphed when all 
other remedies failed (P.). Physostigma, very effective in intestinal torpor (B). 
Stillingia, n\,x of fluid extract in habitual constipation (B.). Castor Oil, a mild, 
efficient cathartic (B.). Ammonium Chloride, in the so-called bilious state, with 
constipation (B.). Arsenic, small doses (ffUj) of Fowler's solution often over- 
come constipation (R.). Belladonna, gr. }4 of the extract at night, in habitual 
constipation (B.) ; gr. )/(>-%. once a day, especially when dyspepsia (R.). Acts 
directly on the bowel as a stimulant (P.). Croton Oil, the most efficient ca- 
thartic, when simple impaction without inflammation. Gtt. j-ij (B.) ; when 
evacuation of blackened feces (R.). Cascara Sagrada, the fluid extract in 
doses of 3j, produces large, soft evacuations without griping, and leaves behind 
it a laxative influence. Frangula, in similar doses, is equally efficient, but if 
from a fresh bark may produce griping. Cathartics, especially confectio sennas, 
pil. rhei compos., pil. aloes, the comp. cathartic pill, as well as those above 
(B.). Purgation as usually practiced denounced by editor of the Lancet, Octo- 
ber I, 1870. Saline Waters, are useful (B.). Pullna, Friedrichshall, or Hun- 
yadi ; the first two with milk, are good for children (R.). Enemata, of soap- 
suds and salt, or a pint of cold water (B.); or turpentine, castor oil, aa gss, to 
Oss-j of gruel (P.). The habitual use of warm enemata increases torpor of the 
bowels (R.)« Tamar-Indien, a favorite mild aperient, is proprietary, and sup- 
posed to contain cocculus, Glauber's salts, etc. Aliment, important in habitual 
constipation ; corn bread, cracked wheat, oatmeal, bread of unbolted flour, 
fruits, green corn, tomatoes, and celery, yi dozen each of almonds and rai- 
sins daily. A glass of cold water before breakfast may overcome habitual 
constipation (B.). An orange or a smoke after breakfast (R.). Tobacco 
habitues rarely suffer from constipation. [Compare Intestinal Obstruc- 
tion.] 

Prescriptions. 



R . Ext. Colocynth. Co., . . , gr. xij. 
Ext. Belladonnae, . . . . gr. ij. 

Ext. Gentianse, gr. vj. 

Olei Cari, gtt. iij. 

Ft. pil. vj. Sig. — One pill at bedtime. 
(Goodell.) 

R. Podophylli Resinse, . . , gr. ij. 

Quininae Sulphatis, 

Ext. Aloes Aquosi, . . aa gr. viij. 

Fellis Bovini, gr. xvj. 

Ft. pil. no. xvj. Sig. — One or two at 
bedtime. (Goodell.) 



R. Ext. Cascarae Sag. Fl., . . |j. 

Ext. Belladonnse Fl., . . 3]. 

Tinct. Nucis Vom., . . . 55 ij. 

Syrupi et Aquae, . aa ad %iv. 
M. Sig. — Teasp. thrice daily in obsti- 
nate constipation. (Clarke.) 



Castor Oil Emulsion. 

R . 01. Ricini, 

Glycerini, aa gj. 

Tinct. Aurantii, TT^xx. 

Tinct. Senega?, X(\v. 

Aq. Cinnamomi, . . ad %ss. 
M. ft. emulsio. Sig. — One dose. 



Artificial Hunyadi Water. 

R . Magnesii Sulph., 

Sodii Sulph., aa ^ss. 

Potas. Sulph., • . gr. ij. 

Sodii Bicarb., gr- viij. 

Sodii Chloridi, gr. xx. 

Aquae, q. s. ad % viij. 

M. Sig. — A winegl. before breakfast. 



CONVALESCENCE CONVULSIONS. 533 

Convalescence. 

Lime, as lime-water, or the carbonate, in convalescence from serious dis- 
ease (R.). Quinine or Hydrastine, to promote digestion and appetite (BX 
Fats, especially cod-liver oil (R.)- Alcohol, before or during meals (R.). 
Koumiss, possesses great value (B.). Bitters, especially gentian and calumba 
(B.) ; the latter especially when stomach weak (R.). Eucalyptus, a serviceable 
tonic (B.). Coca, ^ss-ij of the fluid extract as a dose (B.). Guarana, gr. xv- 
3] may be given (B.). Opium, as laudanum, injected per rectum, for insomnia 
of convalescents (R.). Sea-Baths, valuable in many cases (R.). Diet, requires 
the most careful attention ; the prevalent error of giving food of difficult diges- 
tion too early must be guarded against, especially in intestinal and gastric dis- 
orders. The strictest moderation should be enjoined. The symptoms must 
be watched closely, and combated by appropriate medication. [Compare 
Adynamia for Tonic Prescriptions.] 



Convulsions. 

General Directions. — In all cases, horizontal posture, fresh air, loosen the 
clothing; insert a plug of soft wood, or a cork, between the teeth, to prevent 
biting the tongue ; sprinkle the face and chest with cold water. Epileptic. — 
The general directions above will usually suffice. [See also Epilepsy.] Hys- 
terical. — The diagnostic peculiarities are: pupils not dilated, but are sensitive 
to light; no wounding of tongue; face not livid; pulse usually normal. [See 
also Hysteria.] Infantile. — Administer some anti-spasmodic, as Ether, alone 
or combined with Musk or Belladonna ; then search for any mechanical cause, 
as a pin in the dress, etc. Lance gums if dentition the cause (A.). [See Con- 
vulsions, Infantile.] Uraemic. — [See Uraemia ; Puerperal Convulsions.] 



Convulsions, Infantile. 

Belladonna is of the highest value in certain congestive forms, as in fits due 
to the irritation of teething, or those referable to whooping cough (P.). Ignatia, 
is efficient in convulsions of children from intestinal irritation, no cerebral con- 
gestion being present (P.). Valerian, has been successfully used when from 
worms, to which parasites it is fatal (P.). Potassium Bromide in all forms of 
convulsions in children (R.) ; children bear it in large doses, gr. v thrice daily 
or oftener for a child a year old in convulsions from teething (Br.). Chloral, 
in large doses, gr. v, by mouth or rectum (Br.) ; best used as a suppository 
rather than by liquid injection, and often very useful (R.). It gives better results 
than any other agent. Chloroform, inhalations of great service (R.) ; useful in 
all forms (B.); should be used to arrest the convulsion and prevent recurrence 
(A. A. Smith). Alcohol, has remarkable power in arresting convulsions of den- 
tition ; small doses of wine or brandy (Wa.). Asafetida, in the convulsions of 
teething, a small portion in enema, appears to mitigate them (Wa.). Opium, 
efficient, but dangerous in young children. Veratrum Viride, has been em- 
ployed successfully (R.). Amyl Nitrite, gtt. v with gr. % of morphine used in 
one case as a last resort, after five hours' convulsions in a child of 18 months, 
which resulted in producing quiet sleep (Engel). Hot Baths, are important, 
with cold affusions or ice to the head (B.). Spinal Ice-bag, may be very 
efficient (R.). 

Prescriptions. 



R . Chloralis Hydratis, gr. v. 

Lactis, 3jj. 

M. Sig. — As rectal injection. Or the 
dose may be made into a suppository with 
cacao-butter and inserted well up into the 
rectum. 



U. Sodii Bromidi, 

Chloralis Hydratis, 

Sodii Bicarb., . . . . aa gr. viij. 

Aquae, |j. 

M. Sig. — A teaspoonful every hour to 
a child under four months old. 



534 



CORNEAL OPACITIES CORNS — COUGH. 



Corneal Opacities. 

Cadmium, is said to promote their absorption ; gr. ij of the sulphate to 3J of 
rose-water as collyrium (R., Wa.). Mercury, Calomel by insufflation, or the 
red iodide gr. ij, cerate gr. xl, oil gtt. xx, as ointment, successfully used (Wa.) ; 
weak solutions of the bichloride, or ointments of the oxides, gr. }( ad £j, as 
remedies, among many others, to hasten their absorption in recent cases (Arlt). 
Oils, eel-liver and cod-liver oils, ox-gall, juniper oil, oil of turpentine combined 
with olive oil, and others, dropped into the eye once or twice daily for the same 
purpose (Arlt). Opium, the wine at first, then insufflations of calomel and red 
precipitate or yellow oxide of mercury ointment, most frequently used by me in 
recent cases (Arlt). Potassium Iodide, as ointment with carbonate of potassium 
after cod-liver oil or oil of turpentine with olive oil, in cases of longer standing 
(Arlt). Silver Nitrate, gr. v-x ad ^j aquae, as lotion (C). Iodine, internally 
and as collyria, has been efficacious, especially in strumous cases (Wa.). 
Sodium Chloride, gr. x ad ^j aquae destil., of which tr^ v-x injected subcon- 
junctival^, to hasten disappearance of turbidity (C). Operative Measures, 
only in case of incrustations, as of lead and lime, situated superficially by 
removal of epithelium and anterior elastic layer. Deeper interference may lead 
to suppurative keratitis. Excision of opaque cornea and transplanting of one 
from an animal's or a recently enucleated human eye (keratoplasty), has always 
failed. Artificial pupil by iridectomy, for central opacities which are unre- 
movable. Tattooing to relieve deformity of disfiguring leucomata (Arlt). Pannus 
and leucoma are best let alone (D.). Stenopaic Spectacles, for semi-transparent 
opacities in pupillary region (Donders). [Compare Keratitis.] 






Corns. 

Silver Nitrate, solid, after soaking and paring (Wa.) ; the best application 
for soft corns, and very irritable ones (D.). Acetic Acid, strong, to remove 
corns (Wa.). Mercury, corrosive sublimate in alcoholic solution locally to 
remove corns (Wa.). Iodine, gr. xl ad ^j alcoholis, locally (Wa.). Poultices 
are useful ; or a plaster of soft material with hole in centre (D.). Water, hot 
and cold, alternately applied to inflamed corns. Keep a corn thin by fre- 
quent washing and paring. In performing the latter operation, the knife should 
work downward to the apex of the corn, so as to remove pressure from its centre. 



Prescription. 



& . Acidi Salicylici, . . . . gr. xv. 
Extract. Cannabis Ind., . gr. vijss. 

Alcoholis, 90 , rr^ xv. 

yEtheris, 62 , TT^ xxxvij. 

Collodii Flexilis, .... TT^lxxv. 



Mix, and keep in closely-corked vial. 
Paint the corn every other day for .a week, 
and it can be easily squeezed out. 

( Vigier.) 



Cough. 

Opium, in some form, is much used in cough-mixtures; morphine and gly- 
cerin to fauces (B.) ; moderate doses only are useful in irritative affections ot 
the air-passages, to allay irritation and hypersecretion, but it may do even fatal 
mischief in cases where secretion is copious and expulsory power feeble (P.) ; 
opiates inadmissible when with copious expectoration there is any indication 
of bronchial congestion (Wa.) ; very useful in violent and frequent cough with 
little rhonchus and no signs of obstructed oxidation ; also, when cough is due 
to red, inflamed and ulcerated throat ; opium or morphine given so as to 
cling for some time in contact with the pharyngeal structures (R.). Codeine 
is often efficient in cough (Br.) ; of particular value in ^ gr. doses ; is slightly 
expectorant, also laxative, does not nauseate nor cause vomiting, nor affect the 
appetite ; is far the best agent for the cough of phthisis, when morphine is not 
well borne (Kobler). Nux Vomica, has specific action on the pneumogastric, 



cough. . 535 

and is one of the most efficient remedies in cough of any kind, whether from 
bronchitis, pneumonia, phthisis or emphysema, but especially in nervous 
coughs and periodic coughs which come on in evening and stay all night. 
(Jour, de Med.) Pulsatilla, as anemonine, l / 2 gr. and gr. doses, very useful 
in irritative cough, asthma, whooping-cough (P.). Iodine, by inhalation for 
children in hoarse, hollow cough, wheezing (R.) ; the tincture, 5-10 drops, 
inhaled from boiling water, for five minutes at bedtime, often gives most signal 
relief in the irritating cough of phthisis. Apomorphine Hydrochlorate, very 
valuable in cough where a persistent hacking without expectoration, or with 
difficult expectoration. The dose is only gr. -^ to ^- s in the 24 hours. The 
solution rapidly alters unless a few drops of hydrochloric acid are added 
(Stocquardt). Terpine Hydrate, in bronchial cough, and night-cough from 
habit, is very efficient in a 2-grain dose at bedtime, repeated early in the 
morning (Boyland). See under Bronchitis, Chronic, for formula. Aconite, 
irritable, tickling throat-cough ; short, dry cough of asthmatics, with anxious 
look, full, strong pulse (P.). Belladonna, often useful. No indications (R.). 
Internally and externally as plaster to the chest, very serviceable in spasmodic 
and nervous coughs (Wa.). Hyoscyamus, very useful in spasmodic, tickling 
night coughs (P.). Hydrocyanic Acid, for nervous, irritable cough, and cough 
of phthisis and mother's sympathetic cough (B.) ; no more certain palliative 
for simple, nervous cough due to irritable state of the system (Stille) ; a valuable 
adjunct to ordinary remedies in cough of phthisis (Wa.). Potassium Cyanide, 
is equally useful, gr. iij with %} each of Ext. Grindelias FL, Syr. Scillae and Syr. 
Tolutan., makes a good non-opiate cough mixture, of which the dose is 3j 
every 4 hours (Waugh). Prunus Virginiana, has some influence due to its 
hydrocyanic acid ; is much used in cough-mixtures (B., P.). Laurocerasus, 
used as substitute for hydrocyanic acid in spasmodic coughs (B.). Conium, 
supposed to be useful (R.) ; is very useful in spasmodic cough (Wa.). Ipe- 
cacuanha, the fl. ext. for troublesome night-cough (B.) ; in obstinate winter- 
cough, with wheezing, the wine as spray to fauces efficacious (R.) ; in coughs of 
childhood ipecac is one of the most generally serviceable expectorants we can 
use (Wa.). Lobelia, dry cough, continued tickling sensation, even in sleep 
(P.). Sanguinaria, combined with hyoscyamus, in nervous, spasmodic cough 
(P.). Senega, as a stimulant expectorant in the cough of chronic bronchitis 
and subacute chest affections. Gelsemium, excessive irritability of the respi- 
ratory centre (R.) ; often remarkably relieves convulsive or spasmodic, reflex, 
nervous coughs (B.). Alum, internally in spasmodic cough, gr. x to ^j aq. as 
spray, in chronic cough also (R.). Drosera Rotundifolia, the fluid extract in 
% teaspoonful dose to an adult every 2 or 3 hours, of high value when spasm 
predominates. See ante, page 207. Potassium Bromide, serviceable in various 
reflex coughs (uterine, renal, etc.), and in cough of phthisis occasionally ame- 
liorative as a gargle (B.). Cubebs, gss-j of the tinct. in half-glass of linseed 
tea thrice daily, often cures like a charm the coughs of chronic catarrh, of 
emphysema, or acute catarrh, or following an attack of influenza (R.). Asafce- 
tida, Garrod ascribes its value to the sulphur in it (P.). Very serviceable in 
after-cough from habit, and in mother's sympathetic whooping-cough (B.). 
Carbolic Acid, as spray, a 5 per cent, solution in a steam atomizer will often 
prevent as well as cure a cough from cold. Valerian, in asthmatical and hys- 
terical coughs (P.). Chloroform, with morphine and molasses in paroxysmal 
dry cough. May be painted on throat also (R.) ; in irritable reflex cough the 
vapor of a teaspoonful of the spirit may be inhaled from the surface of hot 
water and repeated every five minutes for four or five times (B). Chloral, in 
convulsive coughs, ameliorates symptoms after hypnotic effect (Wa.). Cam- 
phor, equal parts of camphor and chloral triturated together are said to allav 
spasmodic cough when painted over larynx (B.). Glycerin of Tannin, applied 
to throat when chronically inflamed and so producing cough ; often the case 
with children (R.). Grindelia, used in cough of habit and spasmodic cough 
(B.). Squill, in catarrhal cough, should not be employed until active inflam- 
mation has subsided (Wa.) ; the syrup or vinegar of squill is the best prepara- 
tion for cough with tickling in the throat (P.). Cod-liver Oil, in chronic 



536 



COXALGIA CROUP, CATARRHAL. 



coughs (R., Wa.). Lactucarium, the syrup as vehicle in cough-mixtures (B.). 
Chamomile Oil, gtt. ij-viij, in coughs due to heightened reflex irritability, 
especially in hysterical women (P.). Pix, Tar-water, in winter cough, especially 
when paroxysmal (R.). Allays the cough of bronchitis and phthisis (P.). 
Emplastrum Picis, as rubefacient and counter-irritant in chronic coughs (Wa.). 
The frequency and violence of nervous coughs may be controlled by a deter- 
mined effort of the patient's will. [Compare Bronchitis, Pertussis, Phthisis.] 



Prescript! o ns for 
Adults. 
R. Spiritus Etheris Nitrosi, . . gij. 

Vini] Ipecac, ^ ss. 

Tinct. Opii Deodorat., . . 55 j. 

Syrupi Tolutani ad Jij. 

M. Sig. — A teaspoonful twice or thrice 
daily. {Bowditch ) 

R. Liq. Morph. (Magendie), . %j. 
Syr. Scillae Comp , 

Syr. Tolutani, aa 3jj. 

Syr. Ipecac, 

Spt. Lavand. Co., . . . aa ^ss. 

Spt. Limonis, gj. 

Syr. Pruni Virgin., . . . ad ( !§vj. 
M. Sig. — A teasp. as required. 
Each dose has of Morph. gr. A-. 



Cough Mixtures. 

Children. 
R . Mist. Glycyrrh. Co., . . . g ij. 
Syr. Pruni Virginian., 
Syr. Tolutan. . . . aa ^j. 
M. Sig. — Half teaspoonful 3 or 4 times 
daily for infants, teaspoonful doses at I to 
2 years, larger doses for older children. 

{Potter.) 

R . Tinct. Opii Deodorat., 

Vini Antimonii, . . . . aa 3 ss. 

Ext. Valerianae FL, 

Syr. Simplicis, aa sjij. 

Aquae, ,1J SS - 

M. Sig. — A teaspoonful every hour or 
two until cough controlled. For those 4 
years and upward. {Meigs 6° Pepper.) 



Coxalgia. 

Barium Chloride, in considerable doses (gr. j-ij) persevered in for a month, 
thought to be a most valuable remedy in scrofulous diseases of joints (Wa.). 
Sulphuric Acid, 3j ad ^j adipis, as ointment, persevered in, has resulted in 
great benefit. A powerful irritant (Wa.). Counter-irritation, by blisters around 
the hip, with perfect rest in the straight posture, cod-liver oil, etc. (D.). Iodide 
of Iron, in scrofulous disease of the joints, with cod-liver oil and nutritious 
diet (Wa.). Iodoform, very successfully used by many continental practitioners 
in scrofulous diseases of the joints (Wa.). Cod-liver Oil, the remedy on which 
most reliance is to be placed (R.). [Compare Abscess, Caries, Suppuration, 
Synovitis.] 

Croup, Catarrhal. 
Aconite, valuable (R., Wa.) ; has been employed with the best results (P.) ; 
from gtt. y z to j every half hour, until an impression is made on the fever 
movement, then every hour or two (B.). Hot Water, applications beneath the 
chin and along the whole course of the larynx (Wa.). Hot fomentations or 
turpentine stupe to throat (El.) ; hot bath (95°-io2°) in the paroxysm a good 
method (M. & P.). Potassium Bromide, locally, a solution by atomization has 
proved highly efficient in spasmodic croup (Wa.). Lobelia, has been used with 
occasional success (P.). Ipecacuanha, the syrup or fluid extract as an emetic 
at the outset (El.); is a slower emetic than tartar emetic (P.) ; the syrup to 
vomiting during the paroxysm, and rr\,v-x every 2 or 3 hours next day (M. & 
P.). [Compare Laryngismus Stridulus.] 






Prescriptions. 



R. Potassii Citratis, gj. 

Syr. Ipecac, 3 ij- 

Tr. Opii Deodorat., . . . gtt. xij. 

Svr. Simplicis, gij. 

Aquae, . . • ,f jss. 

M. Sig. — Teaspoonful every two hours 
at 2 years of age. In severe form of spas- 
modic laryngitis. {M. &° P.) 



gtt. IV. 
gtt. 1. 
gr. vj. 

*ss. 



R . Tinct. Belladon , . . 

Tinct. Opii Camph., 

Pulv. Aluminis, . 

Syr. Acacise, .... 

Aquae, 3J SS - 

M. Sig. — Teaspoonful every 2 or 3 
hours at 6 months old when cough fre- 
quent and harassing. {A/. £f P.) 



CROUP — CYANOS IS — CYSTITIS. 



537 



Croup, Membranous. 

Mercury, a remedy of established value, gr. ss-j of calomel, with gr. Y%-% 
of ipecac, according to age, every 2 hours, with local and other general meas- 
ures, especially the use of a hot (70°-75°) and moist atmosphere (Wa.). The 
sub sulphate, given early, is the best emetic, gr. iij-v ; calomel is strongly urged 
as a laryngeal sedative and aplastic agent, allaying laryngeal spasm and pre- 
venting formation of membrane (B.). Alum, one of the best emetics in this 
disease, a teasp. in honey or syrup, repeated every 10 or 15 minutes until it ope- 
rates (M. & P.) ; a very useful and non-depressant emetic (B.). Sanguinaria, 
by many considered specific, is undoubtedly the best emetic for this disease 
(P.) ; is too harsh and too uncertain in action (B.). Tartar Emetic, as an 
emetic, has established value in croup (Wa.). Is injurious; too depres- 
sant (B.). Potassium Chlorate, as alkali, after emetics, the most reliable inter- 
nal remedy, gr. ij-iij every 2 hours to a child of 4 years (M. & P.). Chloride 
of Iron, may be combined with the preceding, in doses of 3-5 drops of the 
tincture, at the same age (M. & P.). Emetics, besides the above : Copper Sul- 
phate, in small frequent doses (R.). Ipecacuanha, inferior to mercury (B.). In 
severe cases, vomiting should be caused 3 or 4 times a day, and should be com- 
menced early (R.). Apomorphine, effective, but highly dangerous (B.). Senega, 
is considered a valuable auxiliary (P.), has been employed (R.). Quinine, in 
full doses is highly useful (B.). Sulphurous Acid, as spray, hourly or more fre- 
quently (R.). Tannin, a 5 per cent, spray, several times a day for 15 or 20 
minutes (R.). Lactic Acid, as solvent of membrane (B.). Iodine, the tincture, 
externally, affords great relief, and tends to prevent formation of false mem- 
branes (Wa.). Water. — Warm bath, hot fomentations or compress to throat. 
Watery vapor in room. Steam inhalations, with a few drops of Iodine or Bro- 
mine. Diet. — Water only in small quantities during attack. Supporting diet 
may be required afterward. Lime-water, by vaporization, or inhalations of the 
vapor of slaking lime for a few minutes in every hour, or some other alkaline 
solution during the whole treatment (M. & P.). Tracheotomy fully justifiable, 
i\Yz per cent., recovered, out of 1024 operations; should be done when par- 
oxysms become very frequent, and dyspnoea is rather persistent than par- 
oxysmal (M. & P.). [Compare Laryngitis, Diphtheria.] 

Prescriptions. 



R . Pulv. Sanguinarise, . . . . gr. xx. 

Pulv. Ipecac, gr. v. 

Syr. Ipecac, t !|ij. 

M. Sig. — A teasp. every )£ hour until 
emesis, then y z teasp. every hour. (P.) 



R. Acidi Lactici, ^iijss. 

Aq. Destillat., ..... ]f x. 
M. Sig. — To be used as a spray, or ap- 
plied by a mop. 

{London Throat Hospital.') 



Cyanosis. 

Amyl Nitrite, by inhalation, often gives marked relief (P.). Quebracho, in 
that from asthmatic attacks of consumptives, lessened the cyanosis or entirely 
relieved it (Rohrer). Leeching is of service, in a manner not easily understood 
(P.). Treatment must depend on the nature of the lesion or disease giving 
rise to the cyanotic condition (A.). 



Cystitis, Acute. 

Belladonna, is a good remedy in almost every form of vesical irritation (G.) ; 
when the vesical mucous membrane is irritable (B.) ; very useful in recent 
catarrh from chill, with pain (P.). Cantharis, in large doses causes inflamma- 
tion of th-i urinary tract, but gtt. j of the tincture every hour will often relieve 
vesical catarrh (A. A. Smith) ; in small doses continued, very efficient (B.) ; 
gtt. j-v of the tincture thrice daily, when bladder is irritable, its sphincter weak, 
and pain along the urethra (P.) ; may be employed in cystitis with benefit (R.) ; 



538 CYSTITIS, CHRONIC. 

the best remedy in small doses for acute cystitis. Aconite, for febrile symptoms 
(R., P.). Quinine, often useful for acute symptoms (B.). Iodoform, in sup- 
pository for painful cystitis (R.). Opium, a rectal injection of starch and lau- 
danum will subdue pain and prevent the frequent micturition (R.) ; opium is 
dangerous if kidneys are diseased (P.). Alkalies, the citrates and bicarbonates 
if urine is highly acid ; stop when it becomes alkaline (R.)- Liquor Potassae in 
barley-water or in a decoction of Triticum repens, preferred to all other alka- 
lies ; urine must be maintained at a neutral or very slightly acid reaction 
(Thompson). Cannabis Indica, an excellent anodyne in all bladder cases, 
having specific effect on that organ. Rest in horizontal posture, mucilaginous 
drinks, hot fomentations and hip-baths, from ioo° to no°, laxatives for the 
bowels, light food. Milk-diet often necessary, especially in children. [Com- 
pare Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.] 

Prescriptions. 






R . Atropinae Sulphatis, . . . gr. j. 

Acidi Acetici, gtt. xx. 

Alcoholis, 

Aquae, aa ^ss. 

M. Sig. — Four drops in a winegl. of 
water before each meal. (G.) 



U . Pulv. Opii, gr. xij. 

Campborse, gr. xxx. 

Ext. Belladon., gr. iij. 

01. Theobrom., q s. 
M. et div. in suppo^it. no vj. 
Sig. — One at bed-time. 



Cystitis, Chronic. 

Benzoic Acid, and the benzoates, in chronic cystitis, from any cause, when 
urine is alkaline (B.) ; has some balsamic character, and is useful in some cases 
of chronic cystitis ; gr. xxiv at least in the day, in pills made with glycerin 
(Thompson). Sodii Benzoas Z] in Tinct. Gelsemii 3ij-iij and water to ^vj 
makes an excellent wash for painful cystitis of old men with enlarged prostate. 
A fluidounce should be warmed and injected, and retained 20 to 30 minutes 
(Copeland). Alkalies, when urine is acid ; the liquor potassae, with hyoscyamus 
as an anodyne, preferred notwithstanding its chemical incompatibility, to con- 
trol painful and frequent micturition (Thompson) ; bicarbonates or citrates 
better, as the strong reaction of liq. potassae unfits it to be given in doses suf- 
ficiently large to affect in any great degree the reaction of the urine (R). 
Triticum, is very efficient as an internal remedy, ^ij-iv of the rhizome boiled in 
a quart of water until reduced to a pint, this strained to be taken in four doses 
in the 24 hours (Thompson) ; a very useful remedy (Pancoast). Buchu, is 
probably the most efficient of the urino-genital remedies, the fluid extract in 
doses of tr^x-^j (B.) ; the best drug in chronic cystitis, especially when the 
catarrh implicates the ureters or the kidneys themselves, producing consider- 
able muco-purulent discharge (P.). Uva Ursi, is decidedly effective (P.); is less 
so than Buchu (B.). Stigmata Maydis, an infusion, ^ij ad Oj, wineglassful 
every 3 or 4 hours, has been used internally with considerable success (Des- 
sein). Pareira, considered superior to Uva Ursi (Brodie); often very successfnl 
(P.). Chimaphila, is often very efficient, but is more actively diuretic than the 
preceding named remedies (B.) ; by many practitioners it is considered the best 
remedy for chronic cystitis. Copaiba, is very useful by virtue of its local action 
on the mucous membrane, but objectionable for its nauseous taste and resulting 
gastric disturbance (B.). Cubeb, is often useful from its stimulating effect (P.). 
Turpentine, has been useful in many cases (R., P.) ; when cystitis due to 
urethral inflammation or prostatic disease (B.). Juniper, the oil is indicated 
under the same conditions as is turpentine (B.). Eucalyptus, there is no more 
efficient remedy in chronic cystitis than this (B.) ; the oxygenated oil of Merck 
is best in doses of 3 drops on sugar every 6 or 8 hours. Salicylic Acid, in large 
doses, either internally or by injection into the bladder, is most efficient (B.) ; 
the acid or salicylates often useful to prevent decomposition (P.). Carbolic Acid, 
and sulpho-carbolates to preserve the urine sweet (R.)- Sulphites will accom- 
plish the same object (B.). Silver Nitrate, by intra-vesical injection, gr. j ad 






CYSTS — DEAFNESS. 



539 



giv to begin with, increased gradually to gr. }£ ad %} at most (Thompson). 
Stronger solutions are advocated by Professor Richardson of New Orleans, and 
Prof. Gardner of McGill College, Montreal. In the writer's experience a 
5 gr. to ^j solution, used as a vesical wash, has been promptly efficient in curing 
many cases which resisted other treatment for months. It sometimes produces 
serious symptoms, and it is therefore well to have a neutralizing solution of 
sodium chloride on hand for use if required. Other Injections which may be 
used to wash out the bladder are — Lead Acetate, gr. j to ^iv of warm water, 
once daily ; Nitric Acid, dilute, TT\j-ij to the ^j of water ; Tannic Acid, gr. j to 
|;j ; Borax, jfj in ^ij of glycerin and £ij of water, of which ^ss to ^iv of warm 
water for one injection ; Quinine, gr. j-ij to the ^ of water, with a drop of acetic 
acid. All injections must be used with great care, not more than ^ij forced in 
at once and that very slowly. Use flexible catheter, warm solutions, and a 
rubber injecting-bottle with a long nozzle and stop-cock (Thompson). Washing 
the bladder is of great value (R.). Evacuation of the urine, some of which is 
often retained in the bladder, is a matter of great importance. Ergotin, hypo- 
dermically, increases the contractile power of the bladder, and enables it to 
empty itself more perfectly (Langenbeck). Pichi, the fluid extract, rr^xx to xxx 
four times daily, gave excellent results in bad cases of long standing, urine 
being alkaline, ammoniacal, ropy and purulent (Delamere). [Compare Blad- 
der Irritable, Calculus, Dysuria, Enuresis, Hematuria.] 



Prescriptions. 



R . Uvae Ursae Fol., 

Pareirae Radicis, . . . aa J j-ij. 
Sig. — Boil in 3 pints of water until re- 
duced to a quart, then strain, and take I or 
2 wineglassfuls 3 or 4 times daily. 

( Thompson?) 



R . Ext. Tritici Fluidi, . . . . 5 ij. 

Syr. Amygdalae, 3 ij. 

M. Sig. — A dessertsp. in water 5 or 6 
times daily. [Pancoast.) 



R-. 01. Terebinth., gss. 

Camphorae, gr. xv. 

Ext. Hyoscyami, gr. ss. 

Fiat massa. Sig. — Take a piece the size 
of a cherry-stone morning and evening. 

( Chauvel ) 



R . Quininae Sulphatis, . . . . 3 ss. 

Acaciae, gij. 

Morphinae Sulphatis, . . . gr. jss. 

Aquae, q. s. ad % iij. 

M. Sig. — A tablesp. to y/ 2 ounces of 
warm water, which inject in 3 parts, daily 



R. Sodii Boratis, ^j. 

Glycerini, 

Aquae, aa !|ij. 

M. Sig. — Tablesp. in four ounces 
warm water as an injection. 



of 



R- . Argenti Nitratis,' gr. vij. 

Aquae Destiilat , J iijss. 

M. Sig. — Injection every third or fourth 
day after washing the bladder out with 
warm water. (Ricord.) 



Cysts. 

Iodine, injection very effective in cysts of neck, and sometimes in unilocular 
ovarian (B.) ; %x after tapping (R.). Silver Nitrate, gtt. v-x of solution, 9j-ij 
as injection, will cure after setting up inflammation (B.). Galvano-puncture, 
will permanently occlude cysts of neck (B.). Aurum Chloride, may sometimes 
cure ovarian dropsy (B.). Remedies internally have all been proved worth- 
less (E.). 

Deafness. 

Quinine, cures some forms, and often causes deafness (Brown-Sequard). 
Glycerin, for dryness of meatus ; also to form a film to ruptured tympanum 
(R.) ; either alone or in combination with olive oil (P.) ; effects are temporary 
(Wa.). Tannin, the glycerite as application for throat deafness (R., Wa.). 
Gelsemium, the tincture, rrLxv-xx, repeated 2 or 3 times a day, is often useful 



540 DELIRIUM DELIRIUM TREMENS. 

in the treatment of nervous deafness, and seems to have an influence on the 
organ of hearing similar to that of Nux Vomica on the organ of sight. 
Colchicum, when from gout in ear (A.). Cantharides, as ointment; gr. xxx 
ad ^j adipis, below and behind the ear bis die, with alterative mercurial treat- 
ment, in deafness from thickened tympanum (Wa.). Gargles, in throat-deaf- 
ness, are of great value; potassium nitrate, borax, etc., in sthenic; tincture of 
capsicum added in nervous forms ; hydrargyrum perchloride, when from 
secondary syphilis (Wa.). Water, washing in warm water, in deafness from 
general debility (Toynbee). Faradization, of the ear in nervous deafness, in 
which slight results only to be expected from the treatment (R.). Demands 
the utmost caution (Wa.). Collodion, contractile, applied to the membrana 
tympani, in deafness from relaxation of the membrane, has exerted a perma- 
nently beneficial influence, even in cases of long standing (Wa.). Turpentine, 
gtt. xl in ^ss glycerin, a few drops into the meatus, in deafness depending on 
deficient secretion of cerumen, results in much benefit (Wa.). Morphine, 
gr. ss sprinkled on surface behind the ear denuded by a small blister, has 
proved curative in chronic deafness, after all other remedies had failed (Wa.). 



Delirium. 

Belladonna, delirium of typhus and other fevers (R.) ; severe forms of de- 
lirium (P.) Hyoscyamus, delirium of typhus; mild, less inflammatory form, 
hallucinations, nervous excitement, little cerebral congestion (P.). Stramo- 
nium, in wild and furious delirium of puerperal mania, with general restless- 
ness and suicidal or destructive tendency (Wa.) ; no drug deserving of more 
confidence in the greater number of maniacal cases (Cullen). Opium, in 
traumatic delirium, as a rectal injection, combined with tartar emetic in fevers, 
or, better still, morphine hypoder. Laudanum in low, muttering delirium (R.), 
is regarded with suspicion (P.). Cannabis Indica, the extract in doses of gr. 
%-% in nocturnal delirium occurring in softening of the brain (Wa.). Potas- 
sium Bromide, in delirium resembling delirium tremens (R.). Camphor Mono- 
bromide, useful in rambling delirium (Wa.). Camphor, in 20-gr. doses, every 2 
or 3 hours, especially in low, muttering delirium (R.). Chloral, in violent deli- 
rium of fevers (R.). Antimony, delirium of fevers (R.). [See Fevers.] 
Water, the cold douche in maniacal delirium ; place patient in warm bath 
during application (R.). [Compare Cerebral Congestion, Fever, Mania.] 



Delirium Tremens. 

Belladonna, of proven efficacy when congestion of the brain (E.) ; useful 
for the insomnia when coma vigil, cold surface, cyanosis (B.). Stramonium 
can do all that Bell, can do, and is more powerful (Tr.). Hyoscyamus, in 
some forms admirable (P.). Opium, cautiously, if at all (B.) ; as rectal injec- 
tion, hypodermically, or with spirits. If patient strong, delirium boisterous, 
and pulse full, add Tartar Emetic or Aconite (R.). Bromides in the " hor- 
rors " preceding the delirium, Z] every 4 to 6 hours. Are of less value in the 
delirium and in subsequent attacks (B., R.). Ammonium Bromide has been 
used with very good results (Wa.). Chloral, at outset (R.) ; very successful, 
but dangerous to old drunkards, or when heart disease exists (B.). If long 
continued to produce sleep chloral will produce a condition of insomnia. 
Chloroform, inhalations to procure sleep (R.). Anaesthetics dangerous (B.). 
Cannabis Indica, gr. ss-j of extract, one of the least dangerous and most use- 
ful hypnotics (P.). Tartar Emetic, as hypnotic (B.) ; combined with opium to 
control mania and insomnia (R.). Capsicum, to induce sleep in early stages, 
gr. xx-xxx in a bolus with honey, repeated after three hours (R.). In 20-30 gr. 
doses has remarkable success (P.). The tincture in £ss doses every three 
hours of great benefit (Wa.). Nux Vomica, or Strychnine, should be more 
freely used than it is in alcoholism, and in delirium tremens may be used hypo- 



DEMENTIA AND INSANITY. 



541 



dermically almost to the commencement of tetanic action (Luton). Arnica, 
the tincture is exceptionally serviceable in cases where there is depression (B.). 
Coffee, often exceedingly useful (P.). Digitalis, 3ss of tinct. repeated in 4 to 6 
hours (R.) ; a tablesp. of the infusion every 4 hours in pale subjects, ansemia 
of brain, with effusion and oedema (B.) has cured many cases promptly with- 
out producing any unfavorable symptoms. Its safety and efficacy are alike 
questionable (Wa.). Cimicifuga, an excellent tonic for the nervous system, 
very successful (P.). Quinine, with a mineral acid to restore digestion, in the 
"horrors," and in adynamic states (B.) ; gr. j two or three times daily as a 
tonic, the best to produce nervous tranquillity (Anstie). Sumbul, very efficient 
for insomnia (P.). Zinc Phosphide, gr. jss daily, in divided doses, for many 
weeks, is used with decided benefit. Zinc Oxide, is of essential benefit as a 
nerve tonic and sedative, gr. ij-viij, twice daily, gradually increased to the 
higher dose named (Wa.). Lupulin, the tinct. or oleo-resin, useful in mild 
cases as stomachic tonic and cerebral sedative (B.). Ammonium Carbonate, 
when anaemia of brain and feeble heart-action (B.). Conium, combined with 
Opium, useful (P.). Alcohol, of undoubted use where failure of stomach to ap- 
propriate food (B.). Water, about 6o° with ice to head, to reduce temperature 
in the hyperpyrexia (B., R.). Treatment, should tend to nourishment, and 
establishing of digestion. Concentrated liquid nourishment, with moderate 
use of stimulants (H.). Diet and Hygiene. The immediate source of danger 
is exhaustion, hence animalized and nutritious, digestible diet in fluid form, 
small quantities frequently repeated ; beef-tea, soups, yolk of eggs, warm milk, 
cocoa, cayenne pepper or stimulants in soups ; coffee, to still nervous excite- 
ment ; hot baths and wet pack to eliminate the poison. A quiet, dark room, 
sleep a necessity, often induced by Belladonna. [Compare Alcoholism.] 



Prescriptions. 



R . Tinct. Capsici, 

Ext. Lupulini Fl., . . . aa ^j. 

Mucil. Acacias, % ss. 

Aquae Cinnamomi, .... Jjjss. 
M. Sig. — Dessertsp. as required for the 
wakefulness and excitement which precedes 
an attack. 



R. Chloralis Hydrat., . . . . ^vj. 

Ext. Conii Fl., . . . . . . giij. 

Ext. Hyoscyami Fl., . . . giv. 

Mucil. Acacise gij. 

Aquas Menth. Virid., . . ad Jij. 
M. Sig. — Teaspoonful in water s 
each meal. 



fter 



Dementia and Insanity. 

Moral or Mental Treatment in recent times, is confided in greatly. With 
correct management from the start, nearly all cases of insanity unattended by 
paralysis or physical decay may be cured (Savage). This can be best admin- 
istered in a well-conducted asylum or hospital for the insane, where security 
and the prospect of recovery will be better than in the best home. The total 
abolition of any one plan of treatment in favor of another would be a great 
mistake. More than half of first attacks of insanity are recovered from under 
good management, which is best attained under the direction of persons trained 
in this specialty (H.). Recently, efforts have been made at the improvement 
of the insane condition by requiring them to attend school daily, with remark- 
ably good results. Tonics and Hypnotics, should be used in cases requiring 
them. Food, of good quality is at the basis of treatment. Opium, morphine 
the best form, especially for melancholies, climacteric and senile cases, which 
improve under its use ; is hurtful in mania. Chloral, does as much harm as 
good, is best suited to wildly maniacal and erotic patients. Potassium Bromide, 
is almost discarded, except for epileptic cases. Conium, is useful, sparingly, 
for noisy patients, so also is Hyoscyamine. Colchicum, for gouty cases, which 
are numerous. Cure the gout, and you may cure the insanity. Shower-bath, 
suitable for cases due to self-abuse, and the wet pack in the mania of hystero- 
epilepsy. Stimulants rank high, next to quiet and absence from home. Kou- 
miss, a good food in hysterical dyspepsia and anorexia, being easily digested 



542 



DEMENTIA PARALYTICA DENGUE — DENTITION. 



and preventing waste {Dr. Savage, Bethlehem Asylum). [Compare Delirium, 
Hypochondriasis, Mania, Melancholia.] 

Dementia Paralytica. 

Physostigma, has seemed to* retard the progress of the disease in some few 
cases (B.). Paraldehyde, in one or two drachm doses as a calmative and hyp- 
notic is as efficient as chloral and without danger (B.). Tonics, may be used, 
though treatment is only palliative. Lacto-phosphate of Calcium, Cod-liver 
Oil, etc. No remedies have hitherto been of any avail (B.). 



Dengue. 

Emetics and Purgatives are indicated at the outset, also free diaphoresis. 
Treatment is entirely symptomatic. Quinine, in five-grain doses every four or 
five hours for the fever (Da Costa) ; should be given more for its tonic than 
for its antiperiodic effects (Fayrer). Opium, in some form for the pains and 
nocturnal restlessness. Salicylic Acid or salicylates for the pains in joints and 
muscles. Carbolic Acid, as lotion, a 5 per cent, solution, for the itching, or 
camphorated oil. Belladonna confers great relief in this disease, rr\,x-xv of 
the tincture may be given every hour for two or three doses (Fayrer). Aconite, 
with salines and nitric ether, during the pyrexia, which may be so high that 
cold sponging or the cold bath may be required. Bitter Tonics, as gentian and 
calumba, with quinine and a mineral acid or strychnine during convalescence. 



Prescriptions. 



R 



Tinct. Colchici Sem., . . . gij. 

Spt. Athens Nitrosi, . . . giv. 

Potassii Nitratis, gr. xl. 

Aquae, ad ^ vj. 

M. Sig. — Tablespoonful well diluted 
every hour or two until profuse dia- 
phoresis occurs. For relief of the violent 
pains. 



R. Tinct. Accniti, Vf\x\], 

Morph. Acetatis, . . . . gr. ij. 

Spt. ^Etheris Nitrosi, . . . 2fiv. 

Liq. Ammon. Acetat., . . ^iij. 

Aquae Camphorae, . . ad % iv. 
M. Sig. — Teasp. to dessertsp. according 
to age, every hour for three hours, then 
every two hours. 



Dentition. 

Belladonna, in convulsions of dentition rarely fail to relieve (P.). Hyoscy- 
amus, to alleviate pain and subdue irritation ; better than opium for children 
(P.). Chamomilla, nvj of the tincture every % hour, an excellent sedative for 
children (A. A. Smith). Potassium Bromide for irritability and convulsions in 
teething (R.). Dulcamara, the infusion, in diarrhoea of dentition quickly 
checks symptoms (P.). Calumba, excellent for the accompanying vomiting and 
diarrhoea (P.). Hypophosphites, of lime or sodium, as a general tonic, are 
highly recommended (R.). Rhubarb, with soda, internally for the aphthae, with 
perfect cleanliness of the mouth and a wash of Borax or Potassium Chlorate 
in glycerin, gr. x ad ^j (E. Smith). Castor Oil, for the diarrhoea of dentition 
to clear out the bowels, then a mixture of Chalk and Catechu, or Oxide of 
Zinc, gr. j to the dose, with gtt. j of Laudanum if required to reduce peristalsis 
(E. Smith). Lancing the Gums to relieve tension when gum is actually 
swollen : should not be indulged in indiscriminately. 



Prescriptions. 



R. Potassii Bromidi, £j. 

Olei Anisi, TT^ij. 

Mucil. Acaciae, 

Aq. Menth. Pip., . . . . aa gj. 
M. Sig. — Teasp. every half-hour until 
relieved. (B.) 



R . Sodii Bromidi, 

Sodii Bicarbonat., 

Chloralis, aa gr. xx. 

Aq. Menth. Viridis, . . . ^jss. 

Syr. Zingiberis, ^ ss. 

M. Sig. — Half-teasp. to dessertsp. ac- 
cording to age. 



DIABETES INSIPIDUS DIABETES MELLITUS. 543 

Diabetes Insipidus. 

Opium, large doses necessary, gr. vj-xij a day (B.) ; combined with gallic 
acid the most generally useful remedy (W.). Ergot has cured many cases, the 
fluid extract in doses of 3ss-j thrice daily (Da Costa) ; one of the most efficient 
remedies (B.) ; is the most useful remedy (R.). Iron and Strychnine are very 
useful for tonic effects (Da C). Valerian restrains the flow of urine but does 
not cure (B.). Muscarine has been used with apparent success (R.). Potassium 
Iodide is curative in many cases of syphilitic origin (B.). Alum has produced 
good results (B.). Jaborandi, used successfully to reduce the quantity of urine 
(B.). Valerian, large, increasing doses (R.). Krameria lessens the quantity of 
urine (P.)- Diet, a dry diet beneficial (B.). 

Prescriptions. 



& . Ext. Ergots Fl., % iij. 

Sig. — Half-teasp. thrice daily, gradually 
increased to a dessertspoonful. 



R. Acidi Gallici, 3 iij. 

Div. in chartulas xij. 
Sig. — One thrice daily. 



Diabetes Mellitus. 

Phosphoric Acid, largely diluted, assuages the inordinate thirst. In one case 
it seemed to act as a curative agent (Wa.). Arsenic, when from faulty assimi- 
lation, in diabetes of hepatic origin, and in thin subjects (B.) ; the Bromide of 
Arsenic is credited with several cures. The Lithiated Arsenical Water, used 
in 70 cases with cure of 96 per cent. (Martineau). See infra for formulae. 
Morphine, is very efficient in reducing sugar when used by mouth, but is of no 
value when employed subcutaneously, even in the same case (Bruce). Opium 
in large doses (gr. vj-xij a day), ameliorative. Codeine, is especially service- 
able (B.). Abates thirst and controls appetite (R.). Its value much disputed 
(P.) ; is of great value in many cases (W.). Codeine gr. X~/^ one of the best 
remedies (Da Costa). Sodium Salicylate has cured when all other drugs have 
failed (R.) ; gr. x-xv in compound spirit of lavender, and water, thrice daily, is 
my favorite remedy (Da Costa). Ergot is one of the useful drugs (DaC.) ; 
decreases the quantity of sugar and the volume of urine. Potassium Bromide, 
gr. xx ter die, cured two cases in six weeks (Begbie, R.) ; useless (Da C). 
Krameria lessens the quantity of urine (P.). Phosphates, to avert failure of nutri- 
tion (B.). Glycerin has produced good results (B.). Used in place of sugar 
(W.). Aurum Chloride is one of the promising remedies (B.). Iodoform, in 
doses of gr. j-ij, rapidly reduced the sugar and caused its disappearance in 4 or 
5 days, in five cases, without any change in diet being made (Moleschott) ; the 
amount of testimony for its value in this disease is quite considerable (B.). 
Iodol, can be advantageously substituted for Iodoform in all the diseases to 
which the latter is applicable (B.). Oxygen, as oxygenated water, instead of 
carbonated, very successfully used (Le Blond). Uranium Nitrate, gr. i-iij, 
thrice daily has caused decided improvement in several cases (Hughes). Alka- 
lies are used on theoretical grounds, but have not produced much benefit. One 
case apparently cured by the diligent use of Ammonium Carbonate (B.) ; are 
serviceable (Da Costa). Alkaline mineral waters for diabetes of hepatic origin 
and in obese subjects, are extremely useful (B.). Salines, a warm solution of 
phosphate and chloride of sodium, by intravenous injection, in diabetic coma, 
produced astonishing results in one case (B ). Aloin, for the accompanying 
constipation (Da C). Nux Vomica, or Strychnine, is generally beneficial. 
Calcium Lactophosphate benefits the thin, nervous type of diabetes remarkably 
(B.). Aliment. All saccharine and farinaceous foods forbidden. Use fats, 
animal food, and gluten or almond bread. Milk-cure, buttermilk best, to be 
the only food until cessation of symptoms. Alkaline Waters, when of hepatic 
origin and in obese subjects. Tepid drinks in the intense thirst (B.). Diet and 
Hygiene are of the utmost importance. Avoid amylaceous food, and everything 
containing sugar, especially ordinary bread. Use fresh, nutritious animal food, 



544 



DIARRHOEA. 



with bread of bran or almonds. Warm baths, warm climate, flannel under- 
clothing. Milk-cure, by skimmed milk, very successful, 6 to 10 pints daily. 
No other food for six weeks, then animal food. Caution, — the urine of patients 
taking salicylic acid gives the reaction of sugar with Trommer's test (R.). 



R . Liq. Potassii Arsenitis, . . gjss. 
Tinct. Opii Deodorat., . . % v. 
Syrupi Zingiberis, . . . . %']. 
Aquae Cinnamomi, . . ad ^ iv. 
M. Sig. — Teasp. thrice daily. 



Prescriptions. 



a 



xl. 



Lithii Carbonat., .... 

Sodii Arseniat., gr. j. 

Ext. Gentianse, gr. xx. 

Ft. pil. no. xxv. Sig. — One night and 
morning until sugar disappears from urine. 

( Vigier.) More convenient than Marti- 
neau's liquid. 



Codeinse, gr. viij. 

Syrupi, et Aqua;, .... t ^ij. 
M. Sig. — Half teasp. thrice daily, grad- 
ually increased up to two teaspoonfuls. 

{Pavy.) 



R. 



in. 



Sodii Arseniat., gr. 

Aquae, Oj. 

A tablesp. of this with Lithii Carbonat. 
gr. iij into a quart siphon filled with car- 
bonated water, which is to be taken freely, 
as daily beverage. (Martineau.) 



Diarrhoea. 

Aconite, when from chill, high fever, cutting abdominal pains (P.). Anti- 
pyrine, in doses of gr. ss to gr. jss, has rendered signal service in the diarrhoea 
ot children. Mercury : Calomel for infantile diarrhoea (ileo-colitis), gr. -fa to ^ 
every half-hour (B.). The bichloride, gr. j in ^x aquae, a teasp. frequently in 
acute or chronic diarrhoea of adults or children with slimy, bloody stools, pain 
and straining. Gr. y& of gray powder hourly, or gr. y^ of corrosive sublimate 
every two or three hours (R.) ; gr. j of the bichloride to the quart of water, of this 
a teasp. every hour in mucous diarrhoea (A. A. Smith). Camphor, in summer 
diarrhoea and the preliminary diarrhoea of Asiatic Cholera (B.) ; when from 
effluvia of drains or exposure to cold (R.) ; useful in many forms (P.). Ipecac- 
uanha, in summer diarrhoea and dysentery of children with greenish stools (B.) ; 
hourly drop-doses of the wine especially if vomiting (R.) ; when from nervous 
irritation, especially young children (P.). Dulcamara, in diarrhoea of children 
from damp, or with dentition (P.). Pulsatilla, dyspeptic diarrhoea, mucous 
discharges, active piles (P.). Quinine, in periodic diarrhoea, with dysentery 
and jaundice (B.). Veratrum Album, in the vomiting and purging of summer 
diarrhoea (R.). Podophyllum, in chronic, with high-colored motions and cutting 
pains, also, in morning diarrhoea (R.). Gr. -^ to ^ , with occasional doses of 
aconite, for vomiting and diarrhoea of gastro-ententis and prolapse of rectum 
(P.). Chamomile, an infusion in summer diarrhoea of adults, or in that of 
dentition (R.). The oil in diarrhoea of children, especially from worms (P.). 
Arsenic, for evacuation of undigested food (B.) ; gtt. j of liq. arsen. before 
meals when diarrhoea excited by food ; also in chronic and membranous forms 
(R.). Nux Vomica, a very useful adjunct to other remedies (B.) ; often of much 
service in epidemic diarrhoea (P.). Sulphuric Acid, in summer and choleraic 
diarrhoea. Small doses in the chronic form and in the straining diarrhoea of 
children (R.). Iron, sol. of pernitrate in army diarrhoea (B.). Lime Carbon- 
ate, in later stages, as chalk mixture in diarrhoea of typhoid or phthisis (R.). 
Zinc Salts, very efficient in summer diarrhoea of children (B.). Rhubarb, in 
early stages to get rid of irritant, afterward to check the diarrhoea (R.) ; when 
torrefied it has no purgative power, but its astringency is retained. Rumex, in 
morning diarrhoea (R.). Arnica checks exhausting diarrhoea with great cer- 
tainty (P.). Silver Nitrate, m diarrhoea of children. White, pasty, and offensive 
stools. Combined with opium the most effective remedy for that of phthisis 
and typhoid (B.). Mineral Acids, in painless, watery stools, light color and 
alkaline (B.). Alkalies, mistura cretae in sour-smelling stools (B.). Sodium, 
potassium or magnesium bicarbonates when acid canal (R.). Lead Acetate is 
excellent in all forms (B.) ; with opium as an injection (R.). Bismuth is effect- 



DIARRHOEA. 



545 



ive, requires large doses. Gr. xxx-lx every three or four hours ; is especially 
indicated when desire for stool is felt immediately after eating (B.). Gr. j 
hourly with milk, sometimes with gr. ]/e gray powder, in various forms of 
infantile diarrhoea (R.). Opium, commonly used, but is best in watery evacu- 
ations, combined with mineral acids or acetate of lead (B.). An injection with 
starch in severe cases (R.). Calumba, when not inflammatory (B.). Coto Bark, 
the fluid ext. or Cotoin is one of the new remedies for atonic diarrhoea. Pur- 
gatives, Saline, a teasp. of Epsom salts (magnes. sulph.) in a wineglass of water 
every three hours when intestinal inflam'n (B.). Copper Sulphate, the most 
effective astringent in chronic diarrhoea and that of phthisis (B.). Ergot, in 
persistent, chronic diarrhoea (B.). Iodine, one or two drops of tinct. in diarrhoea 
from atony of mucous membrane (B.). Tannic Acid, very useful in profuse 
and chronic diarrhoea. Stille advises tannic acid and milk diet for chronic 
diarrhoea and dysentery (B.). Thymol, gr. xx to gij in 24 hours in divided 
doses for adults, is a very efficient internal antiseptic in all cases of diarrhoea, 
especially that of phthisis, teething children, chronic diarrhoea, etc. (Martini). 
Carbolic Acid, very useful in fermentative diarrhoeas, especially when combined 
with bismuth in cholera nostras and cholera infantum (B.). Diet. Cool or 
cold, light, bland food. Gruel, rice, arrow-root, whey, barley-water, in recent 
cases. In chronic cases the most digestible but nutritious food, as fresh fish, 
game, raw eggs, rice, mucilaginous drinks. Milk-and-lime-water or soda-water 
very useful. Also raw meat pulp. Avoid beef, pork, veal, and much starchy 
food. [Compare Dysentery, Cholera.] 



Prescriptions. 



R. Bismuthi Subnit., .^j-ij- 

Pepsini Saccharat., . . . . £ss. 

Zinci Oxidi, gr.vj-xij. 

Trit. et. div. in chartulas xij. 
Sig. — One every four hours in summer 
diarrhoea of children. 



3 ss. 



R . Sodii Bromidi, . . 

Mucil. Acacias, 

Aquae Purse, . . aa q. s. ad ^ij. 
M. Sig. — Teasp. every three hours in 
the diarrhoea of dentition, for child less than 
a year old. {A. A. Smith.) 



R . Zinci Sulphatis, 

Pulv. Opii, 

Pulv. Ipecac, aa gr. xij. 

M. Fiant pil. no. xij. Sig. — One 3 or 4 
times daily in chronic diarrhoea of adults. 



R. Tinct. Opii Camph., 
Tinct. Catechu, . . . 
Mist. Cretae, .... 
M. Sig. — A teasp. four 

daily for children. 



3 n J- 
five times 



R. Spt. ^Etheris Co., 

Tinct. Opii Camph., . . aa ^j. 

Syr. Simplicis, Jij. 

M. Sig. — Dessertsp. after each move- 
ment. 

35 



R. Tinct. Opii Deod., .... gj. 
Tinct. Calumbae, . . . ad ^ij. 
M. Sig. — Teasp. in a winegl. of water 
before meals. 



R. Cupri Sulphat., gr. j. 

Morph. Sulphat., . . . . gr. ij. 

Quininae Sulph., . . . . ». gr. xxiv. 
Fiant. pil. no. xij. Sig. — One pill thrice 
daily. 



R . Zinc Oxidi, 

Sodii Bicarb., . . . . 
M. et div. in chartulas iv. 
Sig. — One every 6 hours. 



. gr. xvij. 
- gr- viij. 



li 



. Plumbi Acetat., gr. xx. 

Pulv. Opii, gr. x. 

Fiat massa, et div. in pil. x. 
Sig. — One twice daily. 



3>J- 



R. Ac. Nitrici Diluti, .... 

Tinct. Camphorae, 

Tinct. Opii, aa gj. 

Syr. Zingiberis, % iv. 

Aq. Menthse Pip., . . . ad £ vj. 
M. Sig. — Tablesp. doses to be used after 
a cathartic. {Hope 1 s Mixture modified by 
Thompson.') 

R. Tinct. Opii Camph., 

Syr. Rhei Aromat., . . aa Sj ss. 

Aquae Calcis, ad ^ ij. 

M. Sig. — A teasp. for children. 



546 DIPHTHERIA. 

Diphtheria. 

Belladonna, an excellent remedy ; if given early will abort the exudation and 
later is useful to sustain the heart (B.) ; especially when throat and tonsils 
acutely inflamed and much swollen (R.)- Corrosive Sublimate, gr. 2V~i every 

2 or 3 hours, has given me most success, with Thymol or Boric Acid gargle ; 
and Potassium Chlorate, Iron and Quinine together, where the membrane is 
not spreading (Da Costa) ; gr. jss in ^iv of glycerin and water, of which Z] 
every ]/z hour for 6 doses, then every hour night and day, to a child of 4 years 
(Grant-Bey) ; locally very efficient, gr. ij to Oj of water, applied on a cotton 
swab, which should be burned after one using ; this hourly night and day (Oat- 
man). Hydrarg. Cyanide, in solution of gr. -^ to the %, of which a teasp. every 
Yz hour day and night to older children and adults, with a gargle of the same 
solution (Sellden) ; gr. gV-^g-. according to age, every hour or two (Erichsen). 
Calomel is next in importance to quinine and iron, has proved successful in 
cases where other means failed, gr. Y%~ l A every 3 hours, with a little Dover's 
powder (Da Costa), checks plastic exudation ; its use limited to children of good 
constitution, with sthenic symptoms. Gr. Y to j every 2 or 3 hours with or 
without Dover's powder (gr. j) or ipecac (gr. j) till bowels become relaxed, with 
greenish stools (Wa.), Gr. v repeated boldly every hour to 3'iv, for a child of 

3 years, until the stools appear like polyps in water-troughs, gelatinous, and of 
a bright, dark-green hue. Then a dose of castor oil if salivation is feared 
(Reiter's Monograph). The safest and most efficient germicide with which we 
can saturate the system ; nothing like it in diphtheria, — gr. }i~Y every hour, 
even gr. j every 2 hours has no bad effects, no salivation (Fowler). Calcium 
Chlorate, solution locally as lotion for the mouth. Considered almost specific 
by some; its chief utility is in removing fetor ; may influence germs (R., B). 
Potassium Chlorate, grain-doses every Y hour (A. A. Smith) ; is more largely 
used than any remedy, both internally and locally (B.) ; in full doses with Liq. 
Cinchonas, seems to be of service in some cases (Wa.), Pilocarpine, used in 80 
cases without a single death ; produces free salivary discharge but is depressant 
to the heart (Guttmann) ; many opinions for and against it. Is decidedly inju- 
rious in adynamic cases (B.). Quinine, in tonic doses recommended from my 
experience (Da C.) ; when headache with high temperature, vomiting, and 
symptoms of septic poisoning, then in full doses (Wa.) ; is most useful after 
serious symptoms have abated, then with Iron and a mineral acid (Mackenzie). 
Carbolic Acid, in spray, locally to the fauces, to remove fetor and destroy disease- 
germs (B.). As caustic, the concentrated acid in glycerin on a mop or brush 
(W.). With iodine to prevent systemic infection (B.). Arsenic, in medicinal 
doses, when sloughing of throat, or malignant diph. (R.)- Salicylic Acid, locally 
and internally (gr. x), has produced good results (B.). Sulphurous Acid Gas, 
recommended by a royal commission in Victoria, as a means of arresting the 
disease. Crude sulphur burned in the room, all apertures being closed (R-). 
Sulphurous Acid, in full and frequent doses, causes rapid disappearance of the 
exudation, and improvement in the general condition. 3j every Y hour to an 
adult in severe cases, in ordinary ones every two hours. An 8-ounce mixture 
should have 2 or 3 ounces of syrup, and should be given in milk to very young 
children (Snow). Sodium Sulphite, 3j-^j aquae, locally, an easily managed 
application (B.) ; an injection for nares in nasal diphtheria (Da C). See for- 
mula below. Sodium Hyposulphite, in solution of 3j to ^ij of water, of which 
hourly doses of 3j, to be retained in throat several minutes before being swal- 
lowed, an excellent local and constitutional remedy, which may also be used 
by a brush or spray to the throat, and by a syringe to the nares (Fruitnight). 
Sodium Benzoate, is highly efficient, 75 to 100 grains daily, according to age, 
also used locally (B.). Sodium Sulpho-Carbolate, has been found useful in lieu 
of carbolic acid (Wa.). Lime Water, dissolves false membrane. The vapors 
of slacking lime inhaled ; or, better, lime water by atomizer to back of fauces 
while patient respires deeply (W.). Ferric Chloride, as solution painted on or 
applied by spray to the throat (R.). Of no advantage locally, internally may 
serve by supporting the organism (B.) ; tinct. of the chloride, gtt. xx every 
2 or 3 hours; or better the perchloride, gr. Y to J every 2 hours in syrup and 



DIPHTHERIA. 547 

water, is easier to take and doesn't hurt the throat (Da C). Strychnine, hypo- 
dermically, for the subsequent paralysis (R.). Tartaric Acid, locally, converts 
membrane into a gelatinous mass, easily expelled (Vidal). Thymol, gr. xx to 
the 5 of water, with a little glycerin, is the best gargle ; may need weakening 
(Da C). Boracic Acid in solution, is next best as gargle (Da C). Alum and 
Sulphur, equal parts, powdered and blown into the throat at moment of deep 
inspiration, as often as asphyxia is threatened, has been found efficient (Jones.) 
Trypsin, is a good solvent of the false membrane ; of all remedies used with 
the spray-atomizer, it has given me the largest percentage of recoveries (Fruit- 
night). Chinolin, a 5 per cent, solution painted over the affected parts with 
great advantage (Seifert) ; the tartrate in 10-grain doses internally (B.). Bro- 
mine, the vapor by inhalation, is useful (Wa.) ; a y^- solution in distilled water, 
of which gtt. j-iij every x / 2 hour in a teasp. of sweetened water, using a glass 
spoon ; and a saucer full of bromine water in the room, renewed every 12 hours, 
has seemed to be extremely efficient in a number of cases. Iodine as inhala- 
tion frequently (see formula below) ; with use the solution may be increased to 
5SS at each inhalation (R.). Potassium Permanganate, gr. y z in distilled water, 
internally, and also used locally, is of undoubted benefit (B.) ; is credited with 
brilliant results even in malignant cases. Sanguinaria, the best emetic, and by 
many is considered specific in this disease (P.). See formula below. Lactic 
Acid, 3iijss to ^x of distilled water, as gargle, on mop or by spray, to dissolve 
membrane (B.). Tannin, a 5 per cent, solution, as spray (R.). Alcohol, is 
probably as good a local antiseptic as any ; diluted with equal parts of water, 
by hand-ball atomizer every %, hour. Is the prince of antiseptics, and the most 
perfect and reliable medicine in diphtheria of which we have any knowledge 
(Hills). Stimulation, freely, the essential part of the treatment ; infants are not 
injuriously affected by even teasp. doses of whiskey every yi hour. Stimulate 
for effect and not by dose ; those cases do best which are stimulated freely and 
early (Da C). There is more danger from giving too little alcohol than from 
too much. A three-year-old child can comfortably take from ^j-^v of Cognac, 
or gr. xv of Musk or Camphor, or gr. xv-3j of Ammonium Carbonate in 24 
hours. In the septic form especially, the intoxicating action of alcohol is out 
of the question. Young children with general sepsis began to improve when 
their ^iv of brandy were increased to ^xvj daily (Jacobi). Turpentine, 5j of 
the od thrice daily, with rnjv of Spiritus ^Etheris as a corrective, at the same 
time using ice-bags, and a gargle of Potas. Chlorate solution, and internally y 2 - 
ounce doses every 2 hours of a 2 per cent, solution of Sodium Salicylate 
(Roesse, Baruch). Tar and Turpentine vapor, made by burning in the room 
coal-tar 7 parts to 01. Terebinth. 3 (Delthil). Chlorine-Water, tablesp. doses 
internally and as a gargle, highly efficient. Cubebs, are very efficient in the 
catarrhal forms of diphtheria (B. Robinson) : the freshly ground berries irt large 
doses in early stages of the disease, a very successful treatment (Trideau). Water. 
Ice in the mouth, and the wet pack to the throat are extremely serviceable 
(B.). Ice sucked, especially at commencement, and continued until the 
disease declines (R.). Ice packed in bladders or thin india-rubber bags, to the 
throat (W.). Aliment. Good foods, wines or brandy necessary from the start 
to maintain the patient's strength (R.). A teasp. of glycerin every 3 or 4 hours, 
plenty of good soup and wine, nutritive enemata, are necessary to sustain sys- 
tem. Moist inhalations. Temp, of room 68° Fah. Removal from the house 
wherein attacked is advisable. Ice very grateful to the patient. Tracheotomy, 
only in extremis (R.) ; is not successful in diphtheria, though very much so in 
membranous croup (Da C). Intubation of the Larynx, as an alternative to 
tracheotomy, is enthusiastically advocated by many operators. 

Prescriptions. 

R. Tinct. Ferri Chloridi, . . . §j. j R. Acidi Lactici, 

Syrupi Tolutani, .... .^ijss. vel Tartarici, .... ^ ijss. 

Liq. Potassii Citratis, . . . 31JSS. Glycerini., giv. 

M. Sig. — Teasp. to dessertsp. accord- Aq. Menth. Pip., 3 V 'J« 

ing to age, every 3 hours, 3J = rr^x of the M. Sig. — Locally 1.0 patches every 3 

tincture. [Anderson.) \ hours. 



54§ 



DIPHTHERIA. 



R . Hydrarg. Chlor. Corros., gr. j, may be 
added to the above formula, which should 
then be given in teasp. doses. 



R. 



. . gr. xl. 



Potassii Chloratis, . , 
Syrupi Simplicis, calid. 
Solve, et adde — 

Ac. Sulphur. Aromat., 
Tinct. Ferri Chloridi, . aa z, j. 
M. Sig. — Teasp. doses for adults, every 
2 to 4 hours, reduced as improvement ad- 
vances, but kept up throughout disease. 



R. Hydrarg. Bichlor., . . . . gr. jss. 

Glycerini, . %). 

Aquae Destillat., ^iij. 

M. Sig. — A teasp. every ]/ z hour for 6 
doses, then every hour night and day to a 
child of 4 years. Also — 

R. Ung. Iodoformi, I in io, rubbed in 
over swollen glands every 3 hours. 

( Grant-Bey.') 



R. Pulv. Potass. Chlorat., . . zj. 
Ac. Hydrochlor., . . . . 3 ij. 

Mix in a strong pint bottle, cork until 
effervescence ceases. Add ^ xvj of Water, 
Jj at a time, shaking at each time. Cork 
tightly. Paint the bottle. 

Sig. — Chlorine-water. A tablesp. or two 
to be taken frequently, according to age. 



R . Pilocarpine Muriatis, . . . gr. )4~%' 

Pepsini, gr. x-xx. 

Acidi Hydrochlor., , . . gtt. ij. 
Aquae Destill., ^ vilj . 

M. Sig. — Teasp. every hour for a child. 



R. Pulv. Sanguinariae, . . . . gr. xx. 

Pulv. Ipecac, gr. v. 

Syrupi Ipecac, ^ij. 

M. Sig. — Teasp. every ^ hour until 
vomiting; afterwards,^ teasp. every hour. 

{Phillips.) 

R. Liq. Ferri Subsul ph., . . . zjj. 
Glycerini, ... q. s. ad 31J. 
M. Sig. — Apply with brush to throat 2 
or 3 times a day. 



R. Thymol, ........ zj. 

Glycerini, ^j. 

Aquae, ^iij. 

M. Sig.— Gargle. (Da Costa.) 

R. Sodii Sulphit., z,iij. 

Glycerini, ........ 3; ij. 

Aquae, q. s. ad % iv. 

M. Sig. — Nasal injection. (Da Costa.) 






• 5" 



R . Tinct. Ferri Chloridi, 
Potassii Chloratis, . 
Misce et adde — 

Aquae, q. s. ad ^viij. 

Sig. — Gargle. (Jacobi.) 

For the chemistry of this combination 
see under Chlorum, ante, page 178. Gly- 
cerin should not be added, as in Dr. Ja- 
cobi' s original R , which makes an explo- 
sive mixture. 



R. Bromi, gr. j. 

Potass. Iodidi, zj. 

Aquae 3jj. 

M. Sig. — Inhale from a cone, as sol- 
vent of membrane. 



R . Acidi Carbolici, ^xv. 

Aquae Calcis, ^vj. 

M. Sig. — Spray. To be used with a 
hand-ball atomizer several times daily, for 
5 minutes each time. 



R. Ac. Tartarici, 25 j. 

Glycerini, ifj ss - 

Aquae Menth. Pip., . . ad ^iv. 
M. Sig. — Gargle frequently. ( Vidal.) 



R. Ac. Salicylici, 

Sodii Boratis, aa Z,ij. 

Ac. Carbolici, zj. 

Aquae, Jiv. 

M. Sig. — Use as a gargle or wash. 

R . Iodi, . . gr. iv. 

Potassii Iodidi, > gr. iv. 

Alcoholis, ^iv. 

Aquae, ad ^iv. 

M. Sig. — Teasp. in boiling water as in- 
halation. (Waring- Cur ran.) 



dropsy. 549 

Dropsy. 

Arsenic, in dropsy from feebleness of heart, and in old age (B.) ; swelled 
feet from debility (R.). Digitalis, one of the best remedies, esp. in renal dropsy 
from acute desquamative nephritis. The infusion in doses of ^ss (B.). The 
fresh infusion best for heart disease, esp. when tricuspid regurgitation (R.). In- 
duces striking effects in cardiac dropsy, when scanty urine' and venous engorge- 
ment. Has high rank as a diuretic (P.). Apocynum Cannabinum, actively 
diuretic (P.). Diuretin has been employed with marked benefit in both cardiac 
and renal dropsy, in hepatic cirrhosis, and in various diseases of the heart 
and kidneys accompanied by oedema : gr. xv several times daily, in aqueous 
solution, avoiding acids or acid vegetable juices. Caffeine, the citrate in 5-grain 
doses is eminently diuretic. Hydrargyrum, a classical pill in dropsy with 
dyspnoea from cardiac disease is the combination of Dr. Baillie, containing 
Mercury, Digitalis and Squill (see formula below). Calomel in doses of gr. 
ss-ij is eminently diuretic, especially in cardiac dropsy ; but by many it is 
thought to act by aiding the action of other diuretics. Bryonia, as a drastic 
purgative and diuretic ; care necessary as it depresses the heart. The 
infusion best (P.). Hellebore, the tinct. in doses of gtt. v-xv, every 2 or 3 
hours, very successful in dropsical effusions, especially in general anasarca 
after scarlatina (P.). Senega, as a diuretic when dependent on kidney 
disease ; has been praised (P.). Chimaphila, is useful as a diuretic in renal 
dropsy esp. when with loss of appetite and debility (P.) ; may be substituted 
for Scoparius (B.). Juniper, largely used as a diuretic in cardiac and renal 
dropsy (B.) ; esteemed in post-scarlatinal dropsy (R.). Iron, purgative chaly- 
beate waters (B.) : the Mistura Ferri et Ammonii Acetatis (Basham's Mixture), 
in anaemic dropsy (Da C). Pilocarpus, very valuable in renal dropsy when 
secretion of urine is much reduced or suppressed (B.). Jalap, the compound 
jalap powder, gr. xv-xx, with 3'\\) of potas. bitart. and a little ginger, early in 
the morning, 2 or 3 times a week ; no hydragogue superior, in dropsy from 
Bright's disease (Wa.). Turpentine, controls dropsy with albuminous urine, 
from non-desq. renal disease. Gtt. ss. every 2 to 4 hours (P.). Colchicum, as 
a hydragogue in hepatic and cardiac dropsy when patient is vigorous, also in 
post-scarlatinal dropsy (B.). Scoparius, esteemed by English physicians (B.) ; 
is most useful in cardiac dropsy. Cullen found it the most certain diuretic. 
Diluents should be freely used with it (P.). Squill, in cardiac dropsy ; cautiously 
if from kidney disease. If anaemic add iron (B., R.). Taraxacum, is occa- 
sionally used as a diuretic, with limited utility (B.). Copaiba, gives good results, 
especially in Ascites, which see for formula (B.). Potassium Bitartrate and 
Acetate, are very certain as diuretics when largely diluted with water. " Cream - 
of-tartar lemonade." Indicated in desquamative nephritis, and general dropsy 
from valvular disease of the heart (B., R.). Elaterium, of unquestionable value 
as a derivative in many passive forms of dropsy ; though many fear it (P.). Acu- 
puncture, or better still, incisions from ^ to an inch long, one over each exter- 
nal malleolus generally sufficient. A hot sponge, moist with weak carbolic 
acid solution kept to incisions (R.). Aliment : dry diet is of advantage in dropsy 
of serous cavities (B.). Diet. Should be light in acute dropsies ; in chronic, 
nourishing. Water not injurious but beneficial as drink. Warm baths, Hol- 
land gin in small doses, tapping, for alleviation in incurable cases. A moder- 
ately warm, dry atmosphere. Skim-milk diet said to be of very great value in 
renal dropsy. [Compare Ascites, Hydrocele, Hydrocephalus, Hydro- 
thorax, etc.] 

Prescriptions. 

R- . Vini Colchici Seminis, . . ^ ss. 

Liq. Ammonii Acetat., . . gijss. R . . «... - 

Infusi Petroselini, . . . . 2v. ** • t / . £• ■/ ! • ; if' 

, T o- t> u a Infusi Digitalis, ... ad ziv. 

M. Sig. — Teasp. every 4 hours. An ,, . °, , ' " „ .• °, ^„;i„ 

11 x j- *• j 1 7 j 4. a M. Sig. — A tablesp. 2 or 3 times daily, 

excellent diuretic, esp. adapted to dropsy b r ~> j 

of scarlatina. (B.) 



55o 



DUODENAL CATARRH DYSENTERY. 



R . Elaterini, gr. j. 

Spt. Etheris Nitrosi, . . . ^ij. 

Tinct. Scillse, 

Tinct. Colchici, ... aa 5SS. 

Syr. Simplicis, ^j. 

M. Sig. — Teasp. 3 or 4 times daily, in 
hepatic and cardiac dropsy in sthenic sub- 
jects. 



R. Pulv. Digitalis, gr. j-jss. 

Pulv. Scillae, gr. j. 

Hydrarg. c. creta. vel 
Pil. Hydrargyri, . . . . gr. j-iij. 
Ft. pil. no. j. Sig. — One thrice daily. 



R. Pulv. Scillse, 

Pulv. Digitalis, . . . aa £ss. 

Potassii Nitratis, gj. 

M. Fiat massa, et div. in pil. xxx. 
Sig. — One pill thrice daily. 



R . Potassii Acetatis, .... 3 vss. 
Spt. Etheris Nitrosi, . . . ^ij. 

Aquae,* q. s. ad ^viij. 

M. Sig. — Tablesp. every 3 or 4 hours. 

R. Potassii Bitartrat., . . . . gj. 

Ext. Taraxaci, 3 ss. 

Decocti Taraxaci, .... ^viij. 

M. Sig. — x / z winegl. twice or thrice 
daily. 

R. Tinct. Digitalis, 3J-ij- 

Tinct. Scillse, gij. 

Spt. Juniperi Comp., . . . 3;iv-vj. 
Potassii Acetatis, . . . . 3 iv. 
Vini Albi, . . . . q. s. ad !|vj. 
M. Sig. — A tablesp. 3 or 4 times daily. 



R . Mist. Ferri et Ammonii Ace- 
tatis (U. S. P.), . . . . gvj. 
Sig. — Dessertsp. or two three or four 
times daily. ^Basha??i's Mixt.) 



Duodenal Catarrh. 

Sodium Phosphate, 3j four times daily, extremely efficient in catarrhal con- 
ditions of the duodenum and bile-ducts, resulting in jaundice, hepatic colic, 
etc. (B.). Vichy Water, in .similar conditions, probably owes its efficacy to 
the phosphate of sodium contained in it (B.). Potassium Bichromate, in doses 
of gr. 10-5, two or three times a day, is an excellent remedy in so-called duo- 
denal dyspepsia, manifested by a bitter taste, coated tongue, pale stools, vom- 
iting of glairy fluid and dull pain in right hypochondrium. Arsenic, has been 
used with success in jaundice from catarrh of bile-ducts after duodenal 
catarrh (B.). Podophyllum, in catarrhal and malarial duodenitis. Nitro- 
muriatic Acid, in mucous duodenitis; also as bath to right hypochondrium 
(giij-gall. j), temp, of bath 96 (B.). Aliment. No starches or fats ; milk, eggs, 
oysters, beef-broth, broiled or raw beefsteak, whitefish (B.). Diet should be 
exclusively animal, in order to let the stomach deal with it. [Compare Jaun- 
dice, Biliousness.] 



Dysentery. 

Aconite, fever and cutting pains (P.). Mercury, in minute doses for the ileo- 
colitis of children. Gr. ^ to -^ of calomel or hydrargyrum cum creta every 
half hour (B.). Gr. y^- of the bichloride hourly or every 2 hours, in acute or 
chronic dysentery if stools are slimy or bloody (R.)- Ipecacuanha, is par excel- 
lence the remedy for acute dysentery of the ordinary type ; large doses. Gr. 
xxv-xxx (P.) ; gr. xv in milk (B.). Valuable in acute or epidemic, also in 
summer dysentery of children, with greenish stools, mucus and blood, gr. 
ij-v every 2 hours in milk (B.). Dysenteric diarrhoea of children, especially 
with vomiting, will often yield to hourly drop doses of ipecacuanha wine (R.). 
Hamamelis, when the discharges contain much blood (R.). Nux Vomica, in 
epidemic dysentery (P.) ; prune-juice stools, much gas, vital depression (B.). 
Arsenic, Fowler's solution gtt. ij with gtt. v of opium often benefits (B.). 
Quinine, when periodic (B.) ; in malarial subjects is as successful as ipecacu- 
anha in dysentery of the ordinary type (P.). Gamboge, gr. % in 24 hours, 
exceedingly valuable, especially in young persons (P.). Castor Oil, as a mild 
cathartic, is very valuable in appropriate cases (Wa.) ; gtt. v every hour, in 
water with sugar and gum, is excellent for dysenteric diarrhoea of children 



DYSMENORRHEA. 



551 



(A. A. Smith). Arnica, when vital powers are greatly depressed, is highly- 
extolled (Wa.). Saline Purgatives, Epsom salts the best treatment for acute 
dysentery, especially when fever, pain, tenesmus and stools of mucus and 
blood (B.). Silver Nitrate, in pill, gr. %-}, with opium, in acute dysentery 
after subsidence of acute symptoms. Also as enema beyond the sigmoid flexure 
(gr. x-xx ad Oj aquas). Also as escharotic through speculum to ulcer of rectum 
(B.). Opium, as enema, with starch and milk, after canal is emptied by salines. 
Indispensable in chronic dysentery (B.). For tbe purging (R.). A remedy of 
great value, and applicable to every stage and every form of the disease, allaying 
pain and vascular excitement, moderating peristalsis, promoting the cutaneous 
secretion. Is inferior to ipecac, in acute dysentery, and is most valuable in the 
chronic form (Wa.). Glycerin, with infusion of flaxseed (1 to 4), to allay 
tenesmus (B.). Lead Acetate, as enemata in acute and chronic dysentery, 
to allay tenesmus (B.) ; with ipecac, and opium in pill, for acute form. See 
formula (Da C). Sulphuric Acid, with saline purgatives (B.). Copper Sul- 
phate, useful in acute dysentery ; in chronic the most valuable astringent (B.). 
Gr. x-xx ad Oj aquae (R.). Ergot, in chronic, after acute ; and also in the 
acute form (R.). Grape-cure, is used successfully in the chronic form (P.). 
Iron Pernitrate, sometimes in chronic (army) dysentery (B.). Calumba, is 
of great value in chronic, with ulceration of colon (P.). Injections of muci- 
laginous enemata (as flaxseed) are of great value (R.). Diet is of prime 
importance (B.). Avoid animal food and stimulants. Liquid foods best ; all 
cold (R.). [Compare Diarrhcea, Enteritis.] 

Prescriptions. 



R. 



g r - 



Plumbi Acetat., . . , 

Ipecacuanhas, gr. nj. 

Pulv. Opii, gr. llj . 

Fiant pil. no. xij. Sig. — One every 2 
hours until blood ceases, then at longer 
intervals. (Da Costa.) 



R . Plumbi Acetat., gr. iv. 

Morph. Acetat., gr. ss. 

Aq. Fervid., ^j. 

M. Sig. — Enema to allay tenesmus. 



gr. ij. 
g r - X- 



R. Morphinae Sulph., . . 

Strychninae Sulph., . . 

Ac. Sulphurici Dil., . 

Aquae Camphorae, . . . . § iijss. 
M. Sig. — Teasp. well diluted, every 
hour or two. In epidemic dysentery with 
prune-juice stools and marked depression. 



R. Bismuthi Submit, . . . . gij. 

Spt. Ammon. Aromat., . . 7,]. 

Tinct. Opii, gtt. xvj. 

Syrupi Simplicis, . . . . ^ ss. 

Misturae Cretae, 3 jss. 

M. Sig. — Dessertsp. to child over one 
year; tablesp. or more to an adult, every 2 
or 3 hours, after emptying bowels by a 
laxative. 



R. Magnesii Sulph., .... ^viij. 

Ac. Sulph. Dil., 'Jss. 

Aquae, ^ v "j. 

M. Sig. — Tablesp. in a winegl. of water 
every hour or two until it operates. (B. 



R. Ergotini, gr. xx. 

Ext. Nucis Vom., . . . . gr. v. 

Ext. Opii, gr. x. 

Fiant pil. no; xx. Sig. — One every 6 
hours. (King.) 

R . Liq. Ferri Nitratis, 

Ac. Nitrici Dil., aa 3 ss. 

Syr. Zingiberis, jf j. 

Aquae, q. s. ad 'Jiij. 

M. Sig. — Teasp. thrice daily for a child 
of 2 years. Tonic to follow palliative treat- 
ment. (Starr.) 



R 



R 



. Ext. Ergotae Fl., ^ iijss. 

Tinct. Opii Deodor., . . . ^ss. 
M. Sig. — Teasp. thrice daily. 

(Andrew.) 



Ferri Subsulphatis, . . . . gr. xl. 

Pulv. Opii, . gr. xx. 

Fiant pil. no. xx. Sig. — One thrice daily. 
Chronic dysentery. 



Dysmenorrhcea. 
Pulsatilla, in the functional form, is of much benefit when discharge is 
scanty or profuse, black and clotted ; should be persevered in for. 2 months or 
more (P.); gtt. ij every hour is most effective when the affection is not of mem- 



552 



DYSMENORRHEA. 



branous, obstructive, or neuralgic character (A. A. Smith). Belladonna, in 
neuralgic or spasmodic forms, dark and fetid discharge, crampy pains, and 
cold chills, a suppository or mild injection, together with internal administra- 
tion, will relieve (P.) ; in neuralgic dysmenorrhea it will permanently relieve 
(B.). Aconite, a valuable remedy when commenced early (P.) ; for the con- 
gestive form in plethoric subjects (B.). Cimicifuga, relieves the pain in con- 
gestive variety, and is decidedly useful (P.) ; is said to be very efficient (R.) ; is 
valuable (Wa.). Opium, necessary when pain is very severe ; one hypodermic 
of morphine at each period is often sufficient (Wa.). Codeine, when morphine 
is not well borne, has given very complete satisfaction in several cases ; gr. % 
morning and evening (Oliver). Gelsemium, relieves pain in the neuralgic form, 
rr^v-x of the fluid extract every 2 hours (B.). Chloroform, as the liniment on a 
flannel wrung out of hot water, or by inhalation as anaesthetic when pains very 
severe ; sometimes exerts a permanent influence (Wa.). Ergot, given when 
the molimen begins, is useful in the congestive form (B.). Amyl Nitrite, may 
be inhaled with benefit in the neuralgic variety, especially in chlorotic girls 
(Wa.). Sodium Borate, in the membranous form, has been used with great 
benefit combined with ext. belladonnas (Wa.). Ammonium Acetate, has 
remarkable power over many forms of dysmenorrhcea. The liq. ammonii 
acetatis, in ^ss doses, with gr. ]^ of ipecac, every 2 or 3 hours, to keep up the 
action of the .skin until the flow is well established (E.). Camphor, is my 
favorite remedy, gr. x in mucilage and cinnamon-water; repeat the dose in 
an hour or two if necessary (Dewees). Guaiacum, is very useful (P.) ; drachm 
doses of the ammoniated tincture in the neuralgic or rheumatic forms (B.). 
Caulophyllum, is by many considered the best curative remedy for spasmodic 
dysmenorrhcea, if given in the intervals. Viburnum Opulus, the fluid extract, 
in half-drachm doses, has considerable reputation in some sections for uterine 
pains of various kinds, and is useful in the spasmodic variety of this affection ; 
may be used in combination with cannabis indica (Thomas). Arsenic, gtt. iij-x 
of Fowler's sol. with gtt. x of tinct. digitalis, ter die between the periods, gives 
excellent results (Athill) ; indicated when copious membranous discharge from 
bowels and uterus (R.). Cannabis Indica, is very useful as a palliative in 
painful menstruation (B.) ; gr. ss-j thrice daily to relieve the pain (R.). Nux 
Vomica, in neuralgic form. Syrup or elixir of iron, quinine, and strychnine 
(B.). Apiol, neuralgic form (B.) ; as emmenagogue, night and morning, for 
several days near the period (Wa.). Electricity: in neuralgic, a galvanic cur- 
rent; in congestive, inverse current (B.). Croton-Chloral, in neuralgic form 
(R.). Iron, if depending on anaemia (B.). [See Amenorrhcea for formula.] 
Cajuput Oil, said to relieve the pains (R.). Rue and Sumbul, are reported 
useful (P.). Emetic of ipecac, with warm covering in bed, feet in hot water, 
hot ginger tea, liquor ammonii acetat. If pain very severe, a suppository of 
morphine and belladonna per rectum ; best to avoid anodynes (E.). Acces- 
sories, spinal ice-bag, when scanty discharge ; when menorrhagic, hot water 
spinal-bag. Sitz-baths, either hot or cold, or cold alone, during intervals. 






R. 



Ext. Cimicifugse Fl., . . . giv. 
Ext. Pulsatilla Fl., ... 3Jss. 
Ext. EriodyctiiFl., . . . . 3J. 
Syr. Aurantii, . . q. s. ad ^ iv. 
M. Sig. — One or two teasp. every 
hours to six doses. 



Prescriptions, 

R. 



Fl. 



5* 



R . Ext. Belladonna, . . . . gr. iv. 

Ext. Stramonii, 

Ext. Hyoscyami, . . . aa gr. v. 

Quininse Sulpharis, . . . . gr. xl. 
Fiant pil. no. xx. Sig. — One pill thrice 
daily. Neuralgic dysmenorrhoea. 



Ext. Viburni Prunifol. 
Ext. Senec. Aurei, . , 
Tinct. Guaiaci Volat., 
(Dewees.) See U. S. Disp., 

P- H56, gxij. 

Sig. — A teasp. in new milk, thrice daily, 
between attacks, gj every hour during at- 
tack, and a hot sitz-bath. 



R. Ext. Ergotae Fluidi, . . . gvij. 

Tinct. Gelsemii, 3J. 

Tinct. Aconiti, .... tr^xvj. 
M. Sig. — Teasp. every 2, 3, or 4 hours. 
In congestive dysmenorrhcea. 



H- Ext. Opii, gr. 

Ext. Cannabis Ind., 

Ext. Hyoscyami, . . aa gr. 



DYSPEPSIA. 553 

R. Ext. Cannabis Ind. Fl., . . .^jss. 
Ext. Viburni Op. FL, . . . gvj. 
Mucil. Acacise, ^iij. 



Camphorae, gr. xxv. Aq. Cinnamomi, ... aa £ iv. 

M. Fiant. pil. no. x. Sig. — One pill 2 M. Sig. — Dessertsp. every 4 to 6 hours. 

3 times daily. {McLane.) \ 



Dyspepsia. 

Nux Vomica, gtt. v-x ter in die before meals as stomachic tonic (B.) ; when 
flatulence, weight on head, and heartburn (R.). Often of the highest possible 
value in simple atonic form, or in the dyspepsia of drunkards (P.). Arsenic, 
drop doses of Fowler's solution before meals in irritative dyspepsia (B.) ; also 
when diarrhoea is excited by food (R.). Bryonia, in dyspepsia of liver origin, 
"bilious" headache with vomiting (P.). Charcoal, when flatulence; nux 
vomica in 5-TTb doses before meals, better (R.). Mercury, gray powder gr. j, 
3 or 4 times a day, when dyspepsia during chronic disease or convalescence. 
If constipated, calomel, gr. ss with extract hyoscy. gr. iij in pill for 3 nights (R.). 
The yellow oxide, in doses of gr. ^—^, for dyspepsia septica and kindred 
disorders of the alimentary canal ; remarkably efficient in Austrian navy 
(Schaffer). . Ipecacuanha, rr^v-x of the wine most valuable in atonic and 
chronic catarrhal dyspepsia (P.); constipation, depression, food "like a heavy 
weight" (R.). Hydrastis, gtt. v-xv of the tincture before meals, a good stom- 
achic tonic (B.) ; in chronic dyspepsia, sluggish liver (P.). Pulsatilla, a good 
remedy when depression with fear of death, white-coated tongue, little or greasy 
taste, nausea, flatulency, heartburn ; gtt. v in water every 4 hours (P.). Cin- 
chona, with mineral acids in atonic dyspepsia (P.). Quinine, especially for 
town-dwellers and elderly people ; checks excessive fermentation in aliment- 
ary canal (R., P.). Chamomile, TTLij of oil, very useful in atonic dyspepsia (P.). 
Ignatia, useful in nervous dyspepsia (P.). Taraxacum, certainly does good in 
simple atonic dyspepsia (P.). Belladonna, gr. l /e to % of the extract, once a 
day when there is constipation (R.). Bismuth, mixed with vegetable charcoal 
in flatulent dyspepsia (R.) ; gr. x with same quantity of calcined magnesia, in 
chronic gastric catarrh, where diet cannot be regulated (Rose). Manganese, 
gr. x-xv of the black oxide in gastrodynia and pyrosis (B.). Sanguinaria, 
gtt. ij-v of tincture or gr. -^ of alkaloid, in atonic dyspepsia promotes secretion 
and increases the appetite (B.). Silver Oxide, ^ -grain doses with same quan- 
tity of ext. hyoscyami before meals in nervous dyspepsia (B.). Xanthoxylum, 
as stomachic tonic, Z) A. ext. in atonic dyspepsia (B.). Simple Bitters, calumba 
best, quassia or gentian or infusions of them as vehicles for acids and alkalies 
(B.). Calumba easily tolerated when stomach weak (R.). Gentian as stom- 
achic and tonic very useful in atonic dyspepsia, and that of gouty subjects. 
The tinct. in some aromatic water, or in combination with alkalies and seda- 
tives (Wa.). Pepsin, very beneficial. Scheffer's or Beale's saccharated pepsin 
with hydrochloric acid. Ingluvin also promotes digestion (B.). Mineral 
Acids. Hydrochloric or lactic with pepsin after meals in atonic dyspepsia. 
Hydrochloric after meals for acid pyrosis. Nitro-muriatic for dyspepsia with 
mental despondency, oxalate of lime in urine, offensive gas, sallow complexion 
(B., R.) ; Phosphoric, dilute, very efficient before meals (Da C). Sulphurous 
Acid, Trrv-^j well diluted, for acid pyrosis (B.). Alkaline Mineral Waters, 
before meals in atonic dyspepsia, and highly useful in the dyspepsia of obese 
subjects (B.). Alkalies, shortly before a meal increase the gastric juice, and 
are usually better than acids in atonic dyspepsia. Sodium bicarbonate is the 
best (R.) ; a full dose (gr. xl-lx) in dyspeptic attacks, with flatulence, etc., 
usually affords speedy relief (Wa.). Cascara Sagrada, in all cases of dys- 
pepsia, associated with a torpid liver and constipation ; small doses at first, 
gradually increased ( Wa.). Chloroform, gtt. xv-xx in sweetened water, when 
rapid fermentation of food and evolution of gas soon after eating ; is promptly 
efficient in giving relief (Willis). Aloes, combined with other agents, where 



554 



DYSPEPSIA. 



habitual constipation accompanies dyspepsia (R.) ; especially indicated in 
duodenal dyspepsia, gr. ij-iv with ipecac, gr. j-ij, two or three times a week 
(Wa.). Water. A dry diet will entirely relieve the ice-water dyspepsia, or 
that due to excessive beer-drinking (B.) ; half a tumbler of cold water y z hour 
before breakfast acts to some people as a purgative and removes many dys- 
peptic symptoms, but flatulent dyspepsia is often traceable to excessive water 
drinking at meals, especially that of iced beverages (R.). Hot Water, ]/ z a 
pint to a pint at iio°-i5o F. an hour before each meal and Yz an hour before 
going to bed, each draught sipped slowly during 1 5-30 minutes. As a cure 
for dyspepsia this is an old and efficient practice (Wa.). Milk-cure, has suc- 
ceeded admirably (B.) ; fresh buttermilk a most excellent article for dyspep- 
tics, as also is koomis. Alcohol, in any form, especially good wines, is useful 
in the atonic dyspepsia of sedentary livers (B.) ; when loss of appetite and of 
digestive power from fatigue, a glass of wine or brandy-and-water before eating 
is very appropriate ; useful also in indigestion of town dwellers, or during con- 
valescence from acute disease (R.). Diet. Avoid tea and hot beverages, 
over-cooked food, over-feeding and iced-water; masticate all food well, eat 
slowly, small quantities and frequently. Active out-of-door habits should be 
cultivated, and all articles of food known to disagree should be strictly avoided. 
[Compare Acidity, Biliousness, Flatulence, Gastralgia, Pyrosis.] 



Prescriptions. 



R. Acidi Hydroch. Diluti, . . ^jss. 

Glycerini, % ij. 

Syr. Rubi Idaei, ^j ss - 

Liq. Pepsini (Fairchild), . % iij. 

Spt. Chloroformi, . . . . ^ss. 

Vini Albi vel Xerici, q. s. ad 3 xij. 
M. Sig. — A tablesp. thrice daily after 
meals. 

R. Tinct. Nucis Vom., . . . . .^jss. 

Ac. Hydrochlorici DiL, . . % ijss. 

Glycerini, 5J. 

Aquae Lauro-cerasi, . . . £iv. 
M. Sig. — Dessertsp. before meals, to 
improve appetite and digestion. 



R. Bismuthi Subnit., .... £jss. 
Pepsini, £j. 

Strych. Sulph., gr. j. 

Tinct. Cardam. Co., . . ad g iv. 
M. Sig. — Teasp. thrice daily in water. 
For bilious dyspepsia. 



R . Creasoti, ^L v iij- 

Bism. Subcarb., 5jij. 

Glycerini, 

Aq. Menth. Pip., . . . aa ^j. 
M. Sig. — To be well shaken. A teasp. 
every 3, 4 or 6 hours, for pain in stomach 
and wind. (B.) 

R. Ac. Hydrochlorici Dil., . . gj. 

Tinct. Capsici, 3 ss. 

Tinct. Calumbae, 3J SS - 

Vini Pepsini, ad £ iv. 

M. Sig. — Dessertsp. after meals. In 

atonic dyspepsia. . (Pancoast.) 



R. Tinct. Capsici tr^xv]. 

Tinct. Nucis Vom., . . . . gij. 

Tinct. Gentianae Co., . . ad ^ ij. 

M. Sig. — A teasp. in water thrice daily y 

with gr. l Aloin at bedtime, avoiding a 

starchy diet. For aggravated dyspepsia 

with constipation. (Da Costa.) 



R. Sodii Bicarb., s^ij. 

Spt. Amnion. Aromat., . . 3^ ij. 

Tinct. Zingib., 5J. 

Infusi Gentianae Co., 

U. S. P. 1870. q. s. ad gviij. 
M. Sig. — Teasp. or two thrice daily. 
For acid dyspepsia. 



. Pepsini (Jensen), .... giijss. 

Ac. Tartarici, gr. v. 

Glycerini, 3j ss - 

Vini Xerici, ad ,^viij. 

M. Sig. — Teasp. after meals. 



R . Rhei, Gentianae, et Carda- 

momi, contus aa £rj. 

Spt. Vini Gallici, . . . . ,^ij. 

Aquae, gvj. 

Macera per horas 48, cola, et adde — 
Tinct. Nucis Vom., .... gj. 
Potassii Carbonat., . . . . %]. 
M. Sig. — Tablesp. in water thrice daily, 
before meals. 



R. Tinct. Gentianae Co., . . . t ^ij. 
Sig. — Teasp. in water thrice daily. 



DYSPHAGIA DYSPNOEA DYSURIA. 555 

Dysphagia. 

Cocaine, the hydrochlorate in solution, 20 per cent., as spray or by swab, re- 
lieves the dysphagia of phthisical laryngitis (P.). Cajuput Oil, in nervous dys- 
phagia, used in India with considerable success (P.). Potassium Bromide, for 
congenital dysphagia of liquids in children, when no diphtheria or malforma- 
tion (R.) ; in hysterical dysphagia (Wa.) ; benefits a curious affection sometimes 
seen in children, who from their birth can swallow solids with ease but choke 
at liquids (R.). Sprays of ammonium bromide, chlorine water, or other sedative 
agents in warm solution, for the dysphagia depending on specific disease of the 
larynx (Muirhead). Galvanism, in the vicinity of the oesophagus will speedily 
remove hysterical dysphagia (Muirhead). Tonics, as strychnine, iron and qui- 
nine, for post-diphtheritic dysphagia. Iced Fluids, slowly swallowed, will often 
remove spasmodic dysphagia (Wa.). 



Dyspnoea. 

Morphine, hypodermically, the most efficient agent in relieving dyspnoea 
from cardiac disease, or any other form ; but if albumen in the urine it must be 
withheld (Allbutt) ; controls dyspnoea from any cause, more energetically than 
any other agent, giving the very power to breathe (Huchard). Grindelia, of 
great service in dyspnoea with cough, occurring in emphysema (W.). Cimici- 
fuga, has often relieved most distressing cases from cardiac disease ( P.). Spigelia 
Anthelmia, produces and often relieves it when with palpitations (P.). Valerian 
proved useful when nervous (P.). Prunus Virginiana, has proved very effica- 
cious in cardiac dyspnoea (P.). Amyl Nitrite, serviceable in cardiac dyspnoea 
and other forms (Wa.). Asafoetida, in combination with other antispasmodics, 
often very beneficial in the dyspnoea of chronic bronchitis (Wa.). Chloroform, 
a few whiffs give temporary relief in the cough and dyspnoea of phthisis and 
bronchitis (Wa.). Iodide of Ethyl, by inhalation, is very serviceable in many 
forms (See). Terpine Hydrate, of especial value in asthmatic dyspnoea, gr. ij 
every % hour until gr. x are taken (Boyland). Terebene, for the dyspnoea 
of chronic emphysema of the lungs; efficient in combating this symptom 
of various pulmonary affections. Arsenic, for the dyspnoea of weak heart. 
Dyspnoea is a symptom, and may be referable to cardiac, pulmonary, pharyn- 
geal, laryngeal or tracheal disease (T.). [Compare Asthma, Bronchitis, 
Croup, Emphysema, Phthisis, etc.] 

Prescriptions. 

i&. Potassii Iodidi, gj. R . Liq. Morph. (Magendie), . gj. 

Tinct. Lobelke, giv. Spt. Etheris Compos., . . gij. 

Syr. Sanguinarice, .... 3J. Syr. et Aquas, . ... ad ^ij. 

M. Sig. — Teasp. every hour. M. Sig. — 3 ss-j thrice daily. 



Dysuria. 

Cantharis, gtt. j (sometimes v) of tinct. ter die, for frequent micturition with 
pain (R.). Irritable bladder, vesical tenesmus (B.). Cannabis Indica, relieves 
dysuria (R.) ; when bloody urine (P.) ; an excellent anodyne in painful affec- 
tions of the bladder, having specific action on that organ. Belladonna and 
Hyoscyamus have similar sedative effects in vesical and urethral irritation (P.). 
Linseed, as infusion, is often a valuable adjunct (P.). Opium, in suppository, 
combined with hyoscyamus, gr. ij. with gr. x, an excellent palliative (P.); an 
enema of laudanum ormorphine hypodermically to relieve the strangury caused 
by blisters (B.). Camphor, is said to relieve strangury (R.). Chimaphila, has 
undoubted power (P.). Squill often produces the best effects, especially a com- 
bination of the acetum with spt. etheris nitrosi, equal parts, of which 3$s in ^ij 



556 ECCHYMOSIS ECZEMA. 

anise water, every hour or oftener (Wa.). Gelsemium, a useful remedy (B.). 
Ergot, in paralytic dysuria, with sensation of bladder being imperfectly emptied 
(P.). Alkalies, the citrates, when dysuria from uric acid crystals in young male 
children (R.). Nitrous Ether. Spt. etheris nitrosi 3j-jss in any convenient 
vehicle, a popular and efficacious remedy (Wa.). Diluent Drinks, freely, 
especially a decoction of uva ursi, or of cotton-root (P.). [Compare Vesical 
Sedatives, page 45, also, Bladder, Irritable, page 504, and Cystitis, 
page 537.] 

Ecchymosis. 

Arnica, rapidly disperses, if administered shortly after injury, ttly-x in water 
every two or three hours (P.). Alcohol, diluted more or less, according to the 
amount of irritation present, is a good lotion (P.). Hamamelis, the tincture 
diluted with 5 to 8 parts of water, as lotion when much discoloration. Ammo- 
nium Chloride, in solution, as lotion on lint, or with bread or linseed to form a 
poultice, in ecchymosis of the eyelids (Wa.). [Compare Bruises, Purpura.] 



Ecthyma. 

Quinine, cures, though in many subjects will cause it (B.) ; malnutrition (R.). 
Lead, the liquor plumbi subacet., Z] ad Oj aquae, a soothing application (Wa.). 
Zinc Oxide, the glycerite, with a little camphor, an excellent application (Wa.). 
Cod-liver Oil, internally and locally (B.). Grape-cure, often happily modifies 
(P.). Borax, a solution in rose or elder-flower water (Wa.). Chlorinated Lime, 
a solution as a lotion (Wilson). Chrysarobin, internally, half-grain doses, in 
water or pill, given with good results (Stocquart). 



Ectropium and Entropium. 

Silver Nitrate, freely to the exposed surface, in ectropium of lower lid due to 
hypertrophy of conjunctiva after inflammation (C). Collodion, successfully 
used in entropium to restore position of the lid by its contraction. Should be 
concentrated (Wa.). Faradization, in paralytic ectropium (C). Operative 
Measures, of great variety, are in use, Arlt's being the best for bad cases in the 
upper lid (Roosa). Epilation of lashes gives temporary relief in entropium. 



Eczema. 

Aristol, is an excellent application. Mercury, as black and yellow wash in 
early vesicular and pustular conditions. Mercurial ointments are the most 
efficient of the local applications, especially those of white precipitate, nitrate, 
mild chloride, and black oxide. Ointments of the biniodide or bichloride as 
irritating application in chronic indolent form (Pf.). Brown citrine ointment 
nightly in eczema of the margin of the eyelids after detaching scales (B.) ; very 
useful when eczema on hairy parts of face, often is best mixed with a tar oint. 
(R.). Arsenic, rtiv of Fowler's solution thrice daily on a full stomach, gradu- 
ally diminishing the dose for chronic type (B.) ; especially in eczema of vulva, 
anus and scrotum (R.). Small doses for acute, full doses for chronic form ; the 
urine to be closely watched and the drug discontinued on the least sign of renal 
irritation (Pf.). Arseniate of Sodium, hypodermically into an eczematous patch, 
to change the indolent form into an active one (Pf.). Rhus Tox., externally and 
internally, when burning and itching, quickly subdues in some cases (P.) ; in 
chronic form with rheumatism, worse at night-time; also in acute cases if given 
at the very beginning, i^x^^ of a good tincture enough dose to begin with (Pf.)- 
Phosphorus, of undoubted service in eczema of long standing, probably acts as 



ECZEMA. 557 

a hepatic stimulant, gr. y^y to -fa in oil, or reliable pill (Pf.). Viola Tricolor, 
an infusion the best form, with purgative doses of senna for a few days, then 
alone, in eczema of the head and face ; gives prompt results (good or bad) , often 
aggravating, which, though good in chronic forms, must be avoided in acute types 
(Pf.). Calcium Sulphide, gr. -j-^ to -^ in acute and chronic cases of pustular 
character, the impetigo of old writers ; small doses in acute form, larger ones in 
chronic cases (Pf.). Sulphur, internally and sulphides as baths, but not in the 
acute stage (R.) ; solution of potassium sulphide in water locally (B.). Liquor 
Potassae, or a stronger solution of potash, to infiltrated patch of chronic eczema, 
before attempting to heal it (Pf.). Croton Tiglium, the seeds bruised in alco- 
hol, as liniment (Wa.) ; the oil as basis of stimulating applications in the chronic 
form (Pf.). Glycerite of Tannin, locally (R.). Potassium Iodide, is often effi- 
cient where a syphilitic history or inheritance can be traced. Salicylic Acid, 
locally, in eczema of hands and feet has been very successful (B.); in plaster 
is of very great value, and becoming more recognized every day, especially by 
Unna, Pick, etc. The best form is asalicylated soap-plaster (see formula below). 
Belladonna, gr. % of extract with gr. iij of quinine sulphate thrice daily in ec- 
zema of the hand, with bismuth subcarbonate as a dusting powder (B.). Zinc 
Salts, the oxide and carbonate as dusting powder, or the sulphate, etc., in astrin- 
gent ointments (Bulkley). Buckwheat Flour, one of the best dressings ; a limb 
may be enveloped in a bag filled with the flour (Bulkley). Tar, internally, the 
pix liquida in doses of gr. ij-v thrice daily, when arsenic fails to relieve or is 
contraindicated ; locally in third stage when redness, dryness and scaling. 
Oleum Cadini, when genuine, is the best form of tar, mixed with simple oint- 
ment (o^ss-j ad 5). 01. Rusci or Pix Liquida may be used (Pf.). Conium, the 
tincture may be added to one of the ointments for the pruritus, which is 
usually very obstinate. So also Stramonium or crude Petroleum (Pf.). Hama- 
melis, locally as antipruritic, and in chronic eczema marked by decided venous 
retardation (Pf.). Benzoin, to allay itching, the compound tincture painted on 
the skin (R.). Lead, soluble salts as lotions when much inflammation and dis- 
charge (R.) ; also in early vesicular and pustular conditions. Diachylon oint- 
ment comes next in efficiency to mercurial ointments (Pf.). Zinc, the oxide and 
carbonate as dusting powders (R.) ; the sulphate with alum, glycerin, and rose- 
water, an excellent lotion (B.); the oxide is not curative, but as a protective is 
the best ointment when freshly and well made, for use over a large surface (Pf.). 
Lime-water, as sedative application and to check discharge ; after inflamma- 
tion is subdued, lime-water and glycerin (R.). Carbolic Acid, externally and 
internally in chronic forms (B.) ; is analogous to tar, and suitable to the same 
types of the affection as the latter is given for (Pf.). Phytolacca has cured ob- 
stinate cases (B.). Graphite, in ointment, 1 to 10, or with some inert powder, 
as lycopodium or precipitated phosphate of calcium, in fissured eczema, espe- 
cially that of the hands and behind ears (Pf.). Bismuth, the subnitrate or sub- 
carbonate locally (R.). Anacardium Orientale (oil of Cashew), as ointment in 
patches of indolent chronic eczema (Pf.). Iris Versicolor, in chronic eczema of 
gouty patients invaluable as a hepatic stimulant, nLv-x of tincture from the fresh 
root twice daily (P.). Glycerin, locally at night when caustic lotions have been 
used (R.). Electricity has cured obstinate cases (B.). Milk-cure, when acid 
indigestion present (B.). Water, locally is injurious, unless its sp. gr. approaches 
that of the blood serum. Rose-water with a little glycerin and sodium chloride 
when ablution necessary in second stage, that of exudation and crusting (Pf.). 
Soaps, petroleum, cade or carbolic (R.) ; sapo viridis, to soften up infiltrated 
patches of chronic form, instead of the potash solutions mentioned above (Pf.). 
Diet should be largely vegetable, especially those which are eaten raw. Cod- 
liver oil as a supplemental article of diet. Chaulmoogra Oil, in old cases is 
often of great benefit, as an ointment. The oil 1 part to 2 or more of vaseline 
(Wa.). Oil of Cajuput, put up by mistake of druggist for oil of cade made a 
remarkable cure in a case which had resisted treatment for some time. 
(Claiborne.) 



558 



EMACIATION EMISSIONS. 



Prescriptions. 



Internal. 



5J- 
3ss. 



& . Violae Tricolor, . . . 

Sennae, 

M. Fiant chartulae no. iv. 
Sig. — Make an infusion with hot water 
from each paper, and take every night. 

{Piffard.) 



R 



. Emplas. Diachyli Simplicis, 

Emplas. Saponat., . . aa p. xl. 

Petrolati, p. xv. 

Acidi Salicylici, p. v. 

Sig. — Emplas. Salicyl. Compos. [Pick. 



R. Picis Liquidae, 

Pulv. Sem. Anisi, 
Magnesiae Calcin., 
M. Ft. pil. no. c. 

pills daily. 



q. s. 



3 'J ss . 

to ten 

(Miguet.) 



R 



Vini Ferri Amari, .... ^ jss. 
Syrupi Tolutani, ... giij. 
Liq. Potass. Arsenit., . . gj. 

Aquae Anethi, ^ij. 

M. Sig. — Teasp. to dessertsp. thrice 
daily. (Wilson.) 



R . Ferri et Aramon. Citrat., . gj. 

Potassii Citratis, . . . . ^ij. 

Liq. Potassii Arsenit., . . ^j-ij. 

Tinct. Nucis Vom., . . . sjij. 

Tinct. Cinchon. Comp., ad 5 iv. 
M. Sig. — Teasp. in water, after meals, 
as tonic and alterative. (Bulkley.) 



Local. 



B 



Ung. Zinci Oxidi, , . . . ? ss. 

Ung. Plumbi Subacet., . . ^ ss. 

Chloi-alis Camphorae, . aa gr. xv. 
M. Sig. — Use as oint. 2 or 3 times 
daily after bathing with warm water. For 
local use in general eczema. ( Gross.) 



R. Olei Cadini, 5 ss ~j- 

Zinci Oxidi, 3 ss-j. 

Ung. Aquae Rosae, . . . %j. 
M. Sig. — Ointment, antipruritic and 

mildly astringent. (Bulkley.) 



R. Aluminis, gr. xx. 

Zinci Sulphat., gr. x. 

Glycerini, zj. 

Aquae Rosae, ^ iv. 

M. Sig.— Lotion. (B.) 

R. Liq. Plumbi Subacet., . . !|j. 

Glycerini, j|-ss. 

Aq. Laurocerasi, .... ^ijss. 
M. Sig. — Lotion, when there is much 
weeping. (B.) 

R. 01. Cadini, ^ss. 

Glycerini, zj. 

^Ung. Diachylon, .... Hjijss. 
M. Ft. unguentum. In squamous ec- 
zema with thickened skin. (Fox.) 



R . Hydrarg. Ammoniat. 
Glyceriti Amyli, 
M. Ft. unguentum. 



gr. xv. 

(Muller. 



Emaciation. 

Calcium Phosphate, is especially useful in chronic Wasting disease (R.). 
Arsenic, is used by cattle-breeders to fatten oxen, etc., quickly (Tr.). Iodine, 
improves the appetite and digestion, and gives strength and plumpness to the 
body (Wa.). Cinchona, in small doses improves the appetite, and the general 
tone (Wa.). Iron Salts, cause marked gain in flesh and color (Wa.) ; remark- 
ably promote the appetite and digestion (B.). Cod-liver Oil, internally and 
externally with friction, often very effective in the mal-nutrition and marasmus 
of children (P.) Olive Oil, by friction, daily inunctions are of value in many 
wasting diseases (P.). Pepsin, to promote digestion of food (P.). [Compare 
Tabes Mesenterica.1 



Emissions and Erections. 

Belladonna, when emissions, genitalia relaxed, atonic state (B.) ; in gradu- 
ally increasing doses produces good results, even in extreme cases of emis- 
sions (Wa.). Camphor, fails as often as it succeeds (P.). Potassium Bromide, 
exercises special influence as a sedative in irritable states of the genito-urinary 
organs (Wa.). Cimicifuga, as tonic to the nervous system, removes irritation 
and melancholy, procures sound and refreshing sleep (Wa., P.). Lupulin, 



EMPHYSEMA EMPYEMA ENDOCARDITIS. 559 

useful to check emissions (P.) ; gr. v-x, or xv, to keep penis at rest (Wa.). 
Ruta, in small doses to limit discharge (P.). Chloral, at bed-time, repeated 
every night until the habit is broken off (Wa.). Iron, the tincture of the chlo- 
ride in 3 doses at bed-time, sometimes conquers nocturnal emissions (Wa.). 
Cocaine, a few drops of a 4 per cent, solution upon the glans penis, promptly 
controls an erection. [Compare Anaphrodisiacs, page 47, also Chordee, 
Spermatorrhoea.] 

Emphysema of the Lungs. 

Morphine, gr. Ye, and Atropine, gr. T ^ 15 , hypodermically for the asthmatic 
attacks : no remedy so efficient. The disease being incurable, treatment must 
be chiefly palliative (B.). Potassium Iodide, in full doses alone, or combined 
with the bromide, affords most relief next to morphine (B.). Strychnine, is 
a valuable respiratory stimulant ; useful where there is constant dyspnoea with 
prolonged expiration (Wa-.). Stramonium, the leaves smoked for the asthma 
and dyspnoea before retiring, will often give a good night's rest (Wa.). Am- 
monium Iodide, with arsenic, for the bronchitis, with copaiba, turpentine or 
eucalyptol, continued for some time (B.). Digitalis, or hydragogue cathartics 
as pulvis jalapse comp. for the dropsy (Da C). Arsenic, when connected with 
recession of a rash is esp. useful (R.). Long-continued it ameliorates (B.). 
Terebene, gives good results upon the dyspnoea. Lobelia, allays the dyspnoea 
which accompanies capillary bronchitis in emphysema (R.). Senega, often 
acts beneficially (P.). Cod-liver Oil, continued for a long time (R.). Hypo- 
phosphites, are useful (B.). Chalybeates, the phosphate of iron, quinine and 
strychnine (B.). Grindelia, for asthmatic breathing and bronchitis (B.) ; of 
great service (Wa.). Chloral, for the short breath of such patients brought on 
by catching cold. If obstructed circulation, caution required (R.). Bleeding 
and Purging, have been used with great success in many emphysematous con- 
ditions (R.). Compressed Air, the only scientific remedy yet brought forward 
for this disease ; affords much relief which is sometimes permanent (B.) ; the 
apparatus of Waldenberg is the best for this purpose. [Compare Asthma, 
Bronchitis, Dyspncea.] 

Prescriptions. 



R. Potassii Iodidi, giij. 

Strychninae Sulph., . . . . gr. j. 
Liq. Potassii Arsenit., . . .^ijss. 
Aquae Laurocerasi, . . ad g iv. 
M. Sig. — Teasp. 4 times daily. For 



R. Potassii Chlorat., .... ^jss. 
Tinct. Belladon., .... ^jss. 
Ext. Pruni Virgin. Fluidi, 
Tinct. Cinchonae Comp., aa ^ij. 
M. Sig. — A dessertsp. 4 times a day. 



relief of dyspnoea, toning the cardiac action, ] Where chronic bronchitis and anorexia. 



removing the bronchial catarrh, and pre- 
venting the progress of the affection. 

{Hughes?) 



Dry cups also to chest night and morning. 
[Da Costa. 



Empyema. 

Carbolic Acid, a weak solution to be injected after evacuating the pus (R.). 
Carbolate of Iodine, has been injected with benefit (B.). Iodine, in solution to 
be injected after tapping (R.) ; the undiluted tincture may be thrown in without 
risk and with great benefit ; or the compound solution ^j to ^xv aquae, as wash 
for the cavity to prevent re-formation of pus (B.). Chlorine-Water, or solution 
of Quinine, to wash out the cavity (R.). Salicylic Acid, in solution, answers 
well for the same purpose (P.). Ammonium Acetate. The official mistura 
ferri et ammonii acetatis, with quinine and stimulants, if the affection shows a 
tendency to linger (Da Costa). 

Endocarditis. 

Aconite, should be given early in all inflammations of serous membranes 
(Wa.) ; gtt. y 2 or less, frequently (R.) ; it is rare to meet with permanent organic 
heart disease as a result of rheumatic fever when the disorder is treated with 



560 ENDOMETRITIS ENEMATA. 

aconite from its commencement (P.). Spigelia Anthelmia, is very useful in 
rheumatic endocarditis (P.). Opium, in inflammation of serous membranes 
(B.). Digitalis, to control the circulation, especially where irregular heart 
action (Da C). Veratrum Viride, has been used with remarkable effect on the 
pulse (Wa.). Alkalies, as potassium or ammonium carbonate, freely until urine 
is alkaline, to prevent permanent changes about the valves or orifices (Da C). 
Potassium Iodide, to promote absorption of the exuded lymph. Quinine, at 
the onset, may check the inflammation (B.). Salicylic Acid, is useful in the 
rheumatic form (P.). Rest for some days after active signs have abated, with 
agents to lower the blood-pressure within the heart and vessels (Fothergill). 
Leeching, in the acute inflammation is to be recommended if done early, later 
is useless. Use cups if no leeches are at hand (Da Costa). Poultices, give great 
relief and are of decided benefit (Da C). Stimulants, as ammonium carbonate, 
etc., freely, if signs of oppressed circulation appear (Da C). Iron, the tincture 
of the chloride with alkalies, if pysemic symptoms are manifested (Da C). 
[Compare Pericarditis.] 

Endometritis. 

Carbolic Acid, undiluted, on cotton-wrapped probe ; no better method of 
treating uterine catarrh (B.). Iodine, the most valuable of all local remedies 
(E.) ; Churchill's tincture (Iod. gr. 75, Pot. Iod. gr. 90, Alcohol %}), one of the 
most useful applications to the endometrium (Munde). Iodine Phenol (Iod. j, 
Ac. Carbol. iv), on cotton-wound probes, applied to the uterine cavity, has given 
the best results of any agent used for 8 years past (Battey). Chromic Acid, as 
caustic, when slough is required ; should only be used after dilatation of cervi- 
cal canal, and at the patient's house (Munde) ; a solution of gr. xv to 3j of hot 
water applied with success to the uterine cavity for catarrh (Wooster). Nitric 
Acid, fuming, to uterine cavity through intra-uterine speculum (Atthill) ; is con- 
sidered by many the one agent for all forms of intra-uterine medication. Is 
efficient and comparatively safe, but produces too much cicatrical tissue 
(Munde). Iodoform, as suppository in rectum (B.) ; in pencils to uterine canal. 
Iodo-tannin, locally in chronic cases (B.). Ergot, or better Ergotine, gr. j, sub- 
cutaneously, for the train of uterine disorders depending on passive congestion 
of the organ (P.). See Hysteria for formula. Glycerin, as a local application 
introduced by Sims, is of great value ; esp. as vehicle for impure carbolic acid, 
iodine, on cotton, or oakum (E.). Hot Water injections in large quantity about 
the os uteri, are of great value (E.) ; as usually made are of no value, must be 
applied by special syringe, in the dorsal recumbent posture with elevated hips, 
at a temperature of ioo° to 120 F. twice daily for at least 20 minutes each time, 
and persevered in for months and years (Munde). [Compare Uterine Con- 
gestion and Hypertrophy.] 

Prescriptions. 



U . Potassii Iodidi, 

Potassii Bromidi, . . . aa gr. xx. 

Tinct. Iodi, gss. 

Aquae, . . 31J. 

M. For Hypodermic injection into cer- 
vix, in chronic cervical metritis. 

{Bennett.) 



R. Ergotini, gr. xx. 

Tinct. Iodi, gj- 

Glycerini, ad 3J. 

M. Sig. — Apply twice daily with cam- 
el's-hair brush, in cervical metritis. 

(Dabney. ) 



Enemata. 

Enemata, for an infant, ^ss-j ; child 2 to 5 years, ^ij-vj ; 5 to 15 years, 
^vj-Oj ; adult, Oj-i quart. A simple domestic enema consists of soapsuds with 
a little common salt, or a pint of cold water (B.). Simple warm water or gruel 
sometimes ; or, to one or the other of these add soap, turpentine or castor oil, 
with soap or gruel to suspend the two latter. Very cold water may be used 
without inconvenience. Starch, boiled or raw, of cream consistence, tempera- 
ture ioo°, with a few drops of tinct. opii, in extreme cases of choleraic diar- 
rhoea, or that of phthisis, or typhoid fever (R.) Nutrient Enemata, should 



ENTERITIS ENURESIS. 56 1 

contain materials for artificial digestion, as the rectum is not an organ of diges- 
tion, and to secure rapid osmosis should have an acid reaction. A suitable 
formula is appended below. Inject slowly and not frequently; five times in 
twenty-four hours should be the maximum. Defibrinated blood has also been 
used 'as a rectal injection with good results, being completely absorbed (B.). 
Should not exceed three or four ounces of bland material, injected slowly, after 
ascertaining that the rectum is not filled with feces (R.). [Compare Enemata, 
ante, page 470.] 

Prescriptions. 



Nutrient Enema. 



Enema Ricini et Terebinth. 



R. 01. Ricini, . . . . . . ■ . £jss. 

01. Terebinth, ^ss. 



R. Infusi Carnis (Beef-tea), . gitf. 

Acidi Hydrochlorici, . . . n\x. 

Glyceriti Pepsini (Scheffer), gij. Ovum, no. j. 

If rectum irritable add 10 to 20 drops of \ Decocti Hordei, vel 
Laudanum. Aq. Fervid., 3 xiv. 



Enteritis. 

Opium, to the point of tolerance, is the remedy, the deodorized tincture in 
10-drop doses every second or third hour, according to age (Da Costa) ; of 
great value to control inflammation and quiet the intestines (B.) ; proves of 
signal use (Wa.). Aconite, of great utility in acute inflammation with high 
temperature, sthenic condition, resisting pulse (R., P.). Arsenic, surprisingly 
curative ; small doses, with opium (B.). Pod6phyllum, with occasional doses 
of aconite, will often allay the vomiting and diarrhoea (P.). Ricinus Communis, 
is employed with great advantage (P.). Turpentine, stupes, hot, over seat of 
disease, are of manifest advantage (Wa.). Skim-milk, is of the highest value 
as sole diet in acute inflammation of digestive organs (B.). Water, cold and 
hot, principally cold, or ice, of unquestionable advantage (B.). Poultices, 
linseed, large and hot (Wa.) ; may be used or not, as the patient feels benefit 
from them or otherwise (Da C). Water, hot fomentations constantly, fol- 
lowed by a wet compress. Perfect quiet in bed. Ice or cold water freely 
swallowed. No food until inflammation subsides, then beef-tea, milk, gum- 
water, etc., the very mildest and most bland diet for four or five days (Da C). 
[Compare Diarrhcea, Dysentery, Cholera, Peritonitis, Typhlitis.] 



Enuresis. 

Belladonna, no single remedy so uniformly successful. Children require 
large doses, A solution of atropine, best, gr. y^ to -£$ (B.). The best 
remedy for children, gtt. x-xx of the tinct. three times a day. If unsuccess- 
ful, and no worms or other irritation exist, try strychnine, cantharides, turpen- 
tine, santonin or galvanism (R.). Small doses are useless (P.). Santonin, 
in over doses produces incontinence of urine in children, but curiously will 
sometimes stay the habit, even when not dependent on worms, and in cases 
where belladonna fails (R.); in the enuresis from worms (P.) Cantharides, 
one or two drops of the tinct. three or four times a day in middle-aged women 
or the aged, even when due to paralysis ; sometimes also in children, but for 
them belladonna is generally better (R.). Chloral Hydrate, enuresis in chil- 
dren (R.) ; three-grain doses thrice daily for infantile incontinence (DaC). 
Strychnine, may succeed when above remedies fail (B.) ; sometimes useful 
for old people with paralysis of bladder, also for children (R., P.). Buchu, 
often successful in chronic enuresis (P.). Turpentine, small doses sometimes 
remove the trouble (B.). Lupulin, said to be useful ; Herzfelder used it with 
advantage. Rhus Aromatica, has proven curative in 75 per cent, of cases 
treated with it, and of great benefit in the other 25 per cent. The fluid ex- 
tract, ttlx-xv four times daily in glycerin and water (Stein). Scutellaria, re- 
36 



562 EPIDIDYMITIS EPILEPSY. 

markably efficient in many instances, Z doses of the fluid extract thrice daily 
for a child of 12 years old. Potassium Nitrate, has been recommended for 
children (R.). Potassium Bromide, succeeds in some cases (Wa.). Collodion, 
painted to form a cap over end of prepuce (R.). Ergot, when from paralytic 
state of sphincter (B.) ; said to be useful (R.). Iron Iodide, the syrup tt^xv-xx, 
well diluted with water, ter die, in pale, delicate, strumous children (B.) ; some- 
times useful even when no worms (R.). Habits. Children to be taught to 
retain water as long as possible during the day ; little salt to be eaten ; absti- 
nence from fluids not necessary ; bland fluids diminish acridity of the urine. 
Stopping meat from the diet has cured several cases permanently, after all 
remedies had been tried without success. 



Prescriptions. 



R. Strychninae Sulph., . . . . gr. j. 

Pulv. Cantharidis, . . . . gr. lj. 

Morphine Sulph., . . . . gr. jss. 

Ferri Reducti, gr. xx. 

Ft. pil. no. xl. Sig. — One thrice daily 
to a child of 10 years. [Gross.) 



R. Tinct. Ferri Chloridi, . . . gij. 

Ext. Ergotse Fluidi, . . . 3 v. 

Spt. Chloroformi, . . . . gij. 

Tinct. Quassiae, . . . . ad J iv. 
M. Sig. — A teasp. in a winegl. of water 
thrice daily for children. 



Epididymitis. 

Aconite, alternately with Pulsatilla, the latter in very small doses, a few 
drops of tinct. in a glass of water, a teasp. every 2 or 3 hours produces the 
happiest effects (Pf., St.). Belladonna, the extract, ST j — ij ad ^j of glycerin and 
water, on lint, applied to the inflamed testicle (Bumstead). Tobacco, with lin- 
seed meal, as poultice, cautiously (P.). Mercury and Morphine, locally, a 20 
per cent, oleate by inunction, in cases of syphilitic origin (R.). Silver Nitrate. 
Qiv ad ^iv aq. destil. freely applied to the scrotum will sometimes abort an 
epididymitis (Wa.). Strapping and suspensory bandage to support the testi- 
cle, and rest it in the recumbent posture from the beginning, with a saline 
cathartic to clear the bowels, are all measures of great importance (Bum- 
stead). [Compare Orchitis.] 

Epilepsy. 

Bromides, should be first employed in all cases, there being no remedy equal 
to large doses of bromine salts, which should be persistently continued for 
many months, and with short periods of rest may be kept up for years. Potas- 
sium Bromide, gr. xl ter die before meals, double dose at bedtime, for two or 
more years after all epileptic indications have ceased. Is generally useful, 
especially in daytime seizures and grand mal of sexual origin ; also for infantile 
convulsions (B.) ; especially in convulsive form, but often powerless (R.). 
Sodium Bromide, gr. xx ter die, will arrest epilepsy without producing the cere- 
bral symptoms of bromism (Clymer). Lithium Bromide, gss daily, acts in 
some cases after pot. brom. has failed, and is generally efficient in about one- 
half the dose of the latter salt (S. Weir Mitchell). Nickel Bromide, gr. v thrice 
daily, is remarkably efficient in the epilepsy occurring at the menstrual epoch, 
and those which have withstood the action of the other bromides (Da Costa). 
Ferrum Bromide, will often cure cases in weak and anaemic subjects ; also with 
potassium bromide to combat the anaemia and depression produced by the 
latter (B.). Ammonium Bromide, preferred in petit mal by many authorities. 
Combined with other bromides, as in Brown-Sequard's mixture (see formula 
below), before meals, with a tonic of strychnine or arsenic and a vegetable bit- 
ter, after meals. The combination mixture of bromides has been taken by 
patients for 8 or 10 years without harm (Brown-Sequard) ; taken for long periods 
without a physician's supervision, has caused profound muscular depression, 
mental alienation and death (Hammond). 

Sodium Borate, Borax, in doses of gr. xx 3 or 4 times a day, has produced 
very good results in nocturnal epilepsy. Is of real value and better than bro- 
mides in symptomatic epilepsy, also may be found useful in nervous forms after 



EPILEPSY. 563 

the bromides have failed (Mairet) ; if beginning with small doses may be 
gradually increased to 90 grains a day ; when dose exceeds 60 grains daily it is 
advisable to add glycerin to the water and syrup used as excipients (Dijoud). 
Amylene Hydrate, in 10 per cent, solution, of which a tablesp. or two (gr. 30 
to 90) a day, of value in petit mal and nocturnal epilepsy, also when bromides 
have failed, and where the attacks are not only very frequent but severe 
(Nache). Acetanilide, is being tried with a view to moderating reflex excita- 
bility. 

Strychnine, idiopathic epilepsy, injurious in symptomatic. Benefits when 
bromide of potassium fails. Cerebral anaemia ; nocturnal epilepsy (S., Pf.) ; if 
bromides fail and case is anaemic, give Strychnine, gr. -g^ ter die, and push it 
(B.). Picrotoxin, anaemic subjects, attacks occurring at night, ^ to ^ of a 
grain hypoderm., or -^ to y 1 - by stomach (B.). Benefits cases resulting from 
onanism (P.). Cannabis Indica, has given good results ; is suitable for petit 
mal, the nocturnal variety, and with strychnine, belladonna, or picrotoxin, for 
cases characterized by anaemia and depression (B.). Quinine, when of malarial 
origin (P.) ; often useful in intermittent epilepsy (Ros.). Silver Nitrate is not 
without efficacy, and was formerly much used, but the danger of staining the 
skin has caused its disuse, especially as better agents have been found (Wa.). 
Copper Salts, may be useful in cases originating from stomach, formerly much 
used (B.); the nitrate or oxide often given with benefit (R.) ; the ammonio-sul- 
phate, gr. }£ in pill, thrice daily to begin with ; should not be continued beyond 
3 or 4 months at a time (Brown-Sequard). Zinc Salts, have been much used 
in place of silver and copper salts, not having the serious drawbacks attending 
the latter agents. Zinc Bromide, gr. v in water and glycerin, four times daily ; 
may be combined with the other bromides. Zinc Oxide, probably useful only 
in cases originating from the stomach. Much said for and against it (B., R.). 
Amyl Nitrite, inhaled at the beginning of the aura will prevent an attack (B.) ; 
or tt\jj-v in mucilage, when fits are very frequent (R.). Nitro-glycerin, t\ t ^q, 
slower in action than amyl nitrite, but more enduring (Pf.). Ignatia, convul- 
sions unattended with cerebral congestion (P.). Par excellence the controller 
of functional phenomena of the cerebro-spinal axis (Pf.). Belladonna, in petit 
mal and nocturnal epilepsy, in pale anaemic subjects, should be given for a 
year or more (B., Tr.) ; extr. and leaves \ of each in pill, every day at same 
hour, one additional pill every month (Tr.). Useful, especially when from 
fright (P.). Atropine better, drop-doses of a 1 per cent, solution of the neutral 
sulphate in white brandy (Tr.). Arsenic, in epileptiform vertigo from stomach 
disorder (B.) ; sometimes useful (R.). Chloroform, by inhalation during parox- 
ysm and also in interval (Wa.) ; is of high value especially in cases of an hys- 
terical character (Brown-Sequard). Chloral, the most suitable remedy for the 
nocturnal variety, in full doses at bedtime (B.). Digitalis, rr\,x of the tincture, 
with gr. xx of potas. brom. thrice daily, in cases complicated with cardiac dila- 
tation (Gowers). Turpentine, has long been used, when due to reflex impres- 
sion of intestinal parasites (B.). Conium, not equal to the bromides (B.) ; not 
of much value (P.). Valerian, has been used with some advantage (R.). 
Bryonia, has an ancient reputation (P.). Rue, may benefit when seminal 
emissions (P.). Anaesthetics, are rarely called for (W.). Fats and Oils, espe- 
cially cod-liver oil when faulty assimilation exists (B.). Galvanism, only in 
idiopathic epilepsy (B.). Meat Diet, in many cases must be prohibited entirely 
(B.). [Compare Convulsions.] 



Prescriptions. 



R- . Potassii Bromidi, . . . . ^ ss. 

Sodii Bromidi, ,1 ss - 

Liq. Potas. Arsenitis, . . . 5 ss. 

Ext. Conii Fl., mj. 

Aquae Cinnamonii, . . . . ^ij. 
Infus. Gentian. Co., . . ad ^viij. 



R. Potassii Bromidi, 

Ammonii Brom., . . . aa Jfij. 

Ext. Ergotae Fl., 5j. 

Aq. Cinnamomi, . . .ad 3 viij. 
M. Sig. — Dessertsp. in water thrice 
daily. When maniacal excitement and 



M. Sig.— Tablesp. two hours after each | danger of cerebral hemorrhage. (Smithy 
meal. 



564 EPISTAXIS ERUPTIONS. 

R. Potassii Bromidi, . . . . jfj. J „ .. 

Ferri Bromidi, Sr. iv. »■ £otassn Bromidi 



gr. iv. 

Aquae, ^ij. 

Syrupi Simplicis, ^vj. 

M. Sig. — Tablesp. twice daily. 



R- . Strychninae Sulphatis, . . . gr. j. 

Acidi Sulph. Dil., .... rr\x. 

Aquae Destill., giv. 

M. Sig. — Teasp. after each meal, gradu- 
ally increased to a dessertsp. 



Sodii Bromidi, 

Ammonii Bromidi, . . . aa giij. 

Potassii Iodidi, 

Ammonii Iodidi, . . . aa gjss. 

Ammonii Carbonat., . . . ^j. 

Tinct. Calumbae, E) ss - 

Aquae, q. s. ad jfviij. 

M. Sig. — A teasp. and a half before 
each meal, and three teasp. at bed-time. 

( Brown - Sequard. ) 



Epistaxis. 

Aconite, has been used with the best results (P.) ; small frequent doses 
quickly check epistaxis in children and plethoric people (R.). Arnica, is of 
great service when from mechanical violence (P.). Belladonna, when of con- 
gestive origin (P.) Ipecacuanha, has been highly praised (R.) ; acts upon the 
vessels (B.) ; gr. j-ij every quarter hour until nausea is felt, but vomiting need 
not be excited (Wa.). Hamamelis, venous hemorrhage (Pf., R.). Ergot, 
3ss-3j of fresh powdered ergot, or 3j-3ij of flu. ext. every half hour or hour, 
necessary in urgent cases (B.). Alum, injected or snuffed up in powder (R.). 
Iron Spray, in obstinate cases liq. ferri subsulph. 3j-3 vn j aquae by spray or 
injection. The tinct. of the chloride also useful (B.) ; diluted Z'\] in E v ) injected 
into the nostrils is often effectual (Wa.). Tannin, finely powdered, blown into 
the nostrils through a quill (Wa.) ; a strong solution, gij ad ^iv, by nasal 
syringe (B.). Turpentine, may be given internally with advantage (Wa.) ; 
especially in debilitated conditions (B.). Lead Acetate, gr. ij-iv with opium 
gr. ss-j, proves signally useful (Wa.). Vinegar, on lint introduced into the 
nostrils, sometimes highly efficient (Wa.). Digitalis, is of undoubted benefit 
(B.) ; the infusion best (R.). Transfusion, when death from exhaustion is ap- 
parently imminent (B.). Facial Artery, compression of (R.). Sundry. Keep 
head elevated and cool ; warm the feet and hands by plunging into hot water ; 
apply ice over the nose ; resort at once to the tampon, if bleeding becomes 
alarming. [Compare Hemorrhage, for formulae.] 



Eruptions. 

The following-named Drugs produce the eruptions indicated respectively 
after each, viz. — Aconite — vesicular exanthemata. Arsenic — erythema and 
papules, vesicles and pustules. Belladonna — as Quinine. Borax — papular, 
scarlatiniform. Bromide of Potassium — papules, pustules, deep tubercles with 
ecchymoses, ulcers, pemphigus. Castor-oil — urticaria. Cinchona — as Quinine. 
Carbolic Acid — erythema. Chloral — erythema on face and neck, itching, des- 
quamation, eczema, purpura and petechia. Copaiba and Cubebs — pemphigus 
erythema, eczema. The copaiba rash has a preference for the ankles and 
wrist. Cod-liver Oil — acne. Digitalis — erythema after long usage. Iodide of 
Potassium — papules, vesicles, pustules, eczema, ecthyma, ecchymoses and pur- 
pura. The Iodide rash prefers the face and back of neck and shoulders. Mercury — 
erythema, eczema, Opium and Morphine — erythema, papular eruption with 
marked desquamation and itching. Phosphorus — purpura. Quinine — erythema, 
scarlatina, papular erythema, hemorrhagic purpura, pemphigus and prurigo. 
The prevailing type of the Quinine eruption is erythema, or exceptionally 
eczema or purpura, and is essentially ephemeral. It is of a bright vivid hue, 
disappearing on pressure, and resembles scarlatinal rash, first appearing on face 
and neck, and thence spreads over the body. In some instances it comes in dis- 
tinct spots and resembles measles ; in others it is an urticaria, with some cedema, 
and distressing burning, tingling, and itching. Five cases of purpura are 



ERYSIPELAS. 565 

authentically reported. Rhus Toxicodendron (and other varieties of Sumac) — 
vesicles, perhaps pustules, with redness, swelling and intolerable itching. Sali- 
cylic Acid — purpura, pemphigus, vesicular angina. Santonin — pemphigus, 
vesicles. Stramonium — as Quinine. Strychnine — as Quinine. Turpentine — 
as Copaiba. 

Articles of Food producing eruptions are — Acid Fruits — may cause acute 
eczema. Strawberries — urticaria. Apples — acneform efflorescence about the 
mouth. Walnuts — inflammation of buccal mucous membrane. Shell-fish — 
urticaria. Roast Turkey — in one case caused great urticaria. Lager Beer — 
acne in some. Alcohol — aggravates cutaneous inflammations. Butter, Oat- 
meal, Buckwheat, Fish — are popularly credited with causing eruptions, but 
there is no evidence therefor. 

Erysipelas. 

Pilocarpine, to abort the disease, very efficient if used early, gr. ]/e hypoder- 
mically, or fluid extract of Jaborandi internally; when free diaphoresis occurs, 
the temperature and pulse fall to normal, and the disease is checked. Not 
suitable to debilitated cases, or those with a weak heart (Da Costa). Aconite, 
a favorite remedy with Liston, if used at beginning, when fever high (Wa.) ; 
no more useful agent in idiopathic erysipelas, especially facial, and cases of 
sthenic type (B.) ; at onset, often cuts the attack short ; is very useful in the 
erysipelas following vaccination (R.) ; very valuable in sthenic cases (P.) ; espe- 
cially so in traumatic erysipelas (Tr.). Belladonna, rr\,v of tincture in water 
every hour for five or six doses, also locally ; has astonishing power in super- 
ficial and non-vesicular forms, also when erysipelas attacks the brain, and in 
the phlegmonous type (P.) ; for similar indications as noted under Aconite, also 
when adynamia ; if much fever, combine it with digitalis or aconite ; when much 
depression, give it with quinine ; gr. % of the extract with gr. ij of quininas 
sulph. every 3 or 4 hours (B.) ; the extract with glycerin, equal parts, spread 
thickly over the surface (Quain) ; should be used both internally and externally, 
and may be combined with aconite (R.). Iron, Tincture of the Chloride, the 
nearest to a specific yet discovered ; the remedy of most service, any man 
being decidedly to blame who neglects its use ; requires decided doses, gtt. xl 
every 4 hours (Da Costa) ; treatment by it very general, but questionable (B.) ; 
should be given with shorter intervals than 4 hours (R.) ; is very successful in 
this disease (P.) ; [ten-drop doses every hour, or "HT,xl every 4 hours (Quain). Is 
also used locally with much success, being painted over the surface in full 
strength. Quinine, may be given with the iron ; also alone if thoracic compli- 
cations, wherein iron might be contra-indicated (Da Costa) ; if pulse soft and 
tremulous, or very rapid, low muttering delirium (D.) ; a combination of qui- 
nine and tincture of the chloride of iron offers special advantages (Wa.) ; in 
the more severe cases to sustain the vital powers, and prevent cerebral embol- 
ism ; but large doses, gr. v-xx every 4 hours, are alone of any use (B.). Am- 
monium Carbonate, when feeble circulation, cyanosis and delirium; also when 
any signs of embolism appear (B.) ; highly useful in debilitated subjects (Wa.); 
after free purgation the continued use of this salt is all that is needed in most 
cases (Sir T. Watson). Potassium Iodide, with agents to secure free action of 
the bowels, skin and kidneys, the only efficient treatment in erysipelas ambu- 
lans, in which iron and quinine are useless (Da C). Antipyrin, is particularly 
efficient when hyperpyrexia (Ernst). Rhus Tox., a very useful remedy in the 
vesjcular form (P.). Tartar Emetic, in doses of gr. -^ frequently repeated, 
renders incontestable service (B.). Calomel and Jalap, as purgative at onset, 
followed in 4 or 5 hours by magnesium sulphate, gss (Da C.). Chloral, is an 
admirable adjunct to give sleep at night (Da C). Turpentine, as a stimulant 
in traumatic erysipelas, more generally serviceable than alcohol (B.). 

Local Applications. Silver Nitrate, by Higginbotham's method in trau- 
matic form ; gr. lxxx of the brittle stick dissolved in £iv of water and painted 
2 or 3 times over inflamed surface and beyond, after careful washing and drying 
(R.) ; no agent more useful in subduing external inflammation. Iodine, painted 



566 



ERYTHEMA. 



over affected and neighboring surface, to prevent spreading (R.). Iodized 
Collodion, very successful as a local application, see formula below. Collo- 
dion, a thick coating relieves (B.). Digitalis, an infusion locally is of much 
service applied as a lotion (R.). Sulphurous Acid, and glycerin, equal parts, 
or a solution of Sodium Bisulphite (Dewar). Zinc, Benzoated, as ointment, or 
the unguentum zinci oxidi, anything to exclude the air, and whichever one is 
most agreeable to the patient (Da C). Bismuth, the ointment of the oleate, a 
very certain application to allay itching and burning, lessen pain, etc. (Shoe- 
maker). Oil, by inunction, is very grateful in simple erysipelas (B.). Oil of 
Turpentine, painted over surface is said to be remarkably efficient. Vaseline, 
lard, or mercurial ointment, diluted, Z) to ^j of vaseline ; the simplest applica- 
tions are the best (B.). Carbolic Acid, one part, with 8 to 14 parts of oleic acid, 
locally by inunction for 3 or 4 minutes every % hour, all around the edge of 
the diseased part until it ceases to spread (Jacobi). Cotton Wool, sprinkled 
with flour or a mixture of starch and zinc oxide, is a good application (B.). 
Earth, clean yellow clay, free from grit or sand, and powdered, applied directly 
to the skin in the form of a smooth paste, made by mixing it with water, the 
best of all applications, having properties of antiseptic, antiphlogistic, anti- 
pyretic, and antimorbific nature (Hewson).' 

Tracheotomy, promptly if oedema of glottis occurs, the operation giving time 
for inflammation to subside (Da C). Incisions, may be necessary in traumatic 
erysipelas when limb is greatly swollen and inflamed; also in the phlegmonous 
variety (Da C). Diet, a milk-diet is generally suitable ; should be light but 
nutritious (R.) ; feed the patient well (Da Costa). [Compare Phlegmon.] 



Prescriptions. 



R. 



Quininae Sulphatis, . . . . gss. 

Ext. Belladonnae gr. ijss. 

Ft. pil. no. xx. Sig. — Two pills every 
4 hours, where much depression. (B.) 



3J- 



R . Quininae Sulphatis, . . 

Ac. Sulphuric! Dil., q. s. 

Aquae, ^ij. 

Tincturse Ferri Chlor., . . t ^ss. 

Spt. Chloroformi, . . . . gvj. 

Glycerini, . . . . q. s. ad ^iv. 

M. Sig. — A teasp. in water every two 

hours. [Loomis.) 



]& . Tinct. Ferri Chloridi, . . . 3 j. 

Syrupi Tolutani, Sj. 

Liq. Potassii Citratis, . . . giv. 
M. Sig. — Teasp. to tablesp. according 
to age, every 3 hours, gj = rr\x, gij = 
n\xx, ^ ss — . TT^xl. [Anderson.) 



R. Tinct. Ferri Chlor., . . . gij-iij. 
Glycerini, Aquae, . . , aa 3;j. 
M. Sig. — Teasp. every 2 hours for chil- 
dren. [Gibney.) 



For Local Use. 



Eh 

gr- 



xl. 



$ . ^Etheris, 

Alcoholis, ..... 

Pyroxylini, ..... 
Solve, et adde — 

Ammonii Iod., . . . 

Cadmii Iod., 

Cadmii Brom., . . . aa gr. xx. 

M. Sig. — For local use with a camel' s- 

hair pencil. If the cadmium salts are not 

to be had use gj Amm. Iod., and gr. xx 

Pot. 01 Amm. Bromide. [Humphreys.) 



R . Plumbi Acetatis, 

Ammonii Carb., . . . aa ^j. 

Aquae Rosae, if vn j- 

Ft. lotio. Sig. — Apply on lint, to allay 
irritation. [Peart.) 



R . Acid. Carbol., 

Alcoholis, . . . . . aa gij. 

01. Terebinth., ^iv. 

Tinct. Iodi, 55 ij. 

Glycerini, gx. 

M. Sig. — Brush over surface every 2 
hours, and cover with a thin layer of wad- 
ding. 



Erythema. 

Antipyrine, internally, for the itching, is efficient. Belladonna, useful in 
cases resisting ordinary treatment \B.). Quinine, the most valued remedy 
in erythema nodosum (B.). Rhus Toxicodendron, a valuable remedy (P.). 



EXHAUSTION EXOPHTHALMOS EXOSTOSIS. 5 6j 

Zinc Sulphate, as lotion, with alum and glycerin. See Eczema, for formula; 
or the Acetate, in ointment, see below. Bismuth, dusted over erythema about 
genitals of infants soothes pain and promotes healing (B.). Mineral Acids, 
nitric and nitro-hydrochloric, have been advantageously used when from im- 
perfect digestion (B.). Dusting Powders, of starch, lycopodium or buckwheat 
flour are verv useful. 



R 



Prescriptions. 




. Plumbi Carbonatis, R . Zinci Acetatis, . . . . 


• • g r - U 


Bismuthi Subnit., . . aa gj. Aqua? Rosae, . . , . 


• • 3j- 


Sodii Bicarbonat., . . . . ^ss. Ung. Aquae Rosa?, ... 


• • 3J- 


Ung. Zinci Oxidi B'enz., . gij. M. Sig. — Ointment. 




Ft. unguentum. Sig. — Local use. 





Exhaustion. 

Arnica, a few drops internally for aching of the muscles (R.) ; in nerve pros- 
tration with general aching from over-fatigue (P.). Phosphorus, for physical 
or mental exhaustion ; also in depression from over-work (R.). Calcium Phos- 
phate, combined with Calcium Carbonate and Phosphate of Iron, gr. j of each 
for a dose (R.). Potassium Bromide, when insomnia, bad dreams and irritability 
(R.). Opium, gtt. j of laudanum with 2 or 3 of the tinctura nucis vomicae, 3 or 
4 times a day, for symptoms of exhaustion with headaches, flushing and dys- 
pepsia (R.). Ammonia, internally ; its influence is but brief (R.). Coffee or Tea, 
in hot or cold climates (R.). Castor, is serviceable, but seldom used (P.). Musk, 
benefits all forms of nerve-exhaustion (P.). Cimicifuga, for headache from 
over-study or excessive fatigue (R.). Alcohol, of value in all conditions of 
fatigue (P.). Coca, lessens the sense of fatigue under exertion, relieves thirst, 
and obviates the effects of a too rarefied atmosphere ; is suitable for weakly 
subjects easily fatigued, and to convalescents (P.). Cocaine, has been used 
successfully in exhaustion from sunstroke, loss of blood, and diarrhoea (P.). 
Wet Sheet, dripping, cold, as a restorative, and to prevent aching of muscles 
(R.). Sea Bathing, is also valuable (R.). Habits, change of occupation 
better than absolute rest. [Compare Adynamia, Convalescence, Insomnia, 
Myalgia.] 

Exophthalmos. 

Belladonna, ni,v of tincture hourly, of great service (R.) ; results recorded from 
its use are very remarkable, but Digitalis will usually answer better (P.). Duboi- 
sine, gr. j^ of the sulphate 2 or 3 times daily, has produced remarkable results 
in one case (Hunt). Opium, may be of use in some cases (P.). Digitalis, to 
raise the arterial tension and slow the heart, decidedly ameliorative in young 
subjects (B.). To tranquillize the heart is the main indication. Iron, with Digi- 
talis, seems to do more good than any other medicines (Da Costa). Chalybeate 
Waters, are beneficial (B.). Convallaria, ameliorates the painful palpitation 
(Wa.). Galvanism, of the cervical sympathetic and pneumogastric, and eyes 
and thyroid gland, is decidedly curative in uncomplicated cases (B.).- 



Exostosis. 

Potassium Iodide, may promote absorption when recent ; also friction with 
ointment of Mercury or Iodine (D.). Aconite, was used by Storck (P.). Mer- 
cury, a moderate course of mercurials may be effectual, when exostoses due to 
a blow or from syphilis (D.). Exostoses of clavicles in children almost always 
disappear themselves (D.). Excision if required (MacCormac). 



568 EYE-DISEASES EYELIDS FACE. 

Eye-Diseases. 

Belladonna, locally and internally in iritis, conjunctivitis and other inflam- 
mations. Atropine, in iritis, locally ; hypodermically, in glaucoma (R.) ; the 
best application in inflammatory conditions generally. Euphrasia, had an 
extended reputation in Germany, is a mild astringent, and of service in catar- 
rhal conjunctivitis (P.). Pulsatilla, as lotion in inflammations and ophthalmic 
cases (P.). Santonin, gives good results in inflammatory and atrophic condi- 
tions of the retina and optic nerve, and the stage of effusion of many other 
inflammations (Wa.). Ruta, minim doses, night and morning, in dimness of 
vision depending on functional amaurotic condition, produces good results (P.). 
Physostigma, topically, to contract pupils ; to reduce excessive atropinization. 
Stimulates the third nerve (P.). Strychnine, hypodermically in muscular 
asthenopia, amblyopia, amaurosis, and in progressive nerve-atrophy not de- 
pendent on intercranial diseases (R.). Increases the sensibility of the eye, the 
field of vision becoming extended, and the vision more acute (Br.). Ergot, 
useful in many eye affections, especially disturbances of accommodation, acute 
and chronic inflammations, and the blepharitis and pustular conjunctivitis of 
children (Wa.). Is myotic. Pilocarpus, 1 is used with great benefit in many eye- 
affections, particularly amblyopia from alcohol and tobacco, detachment of the 
retina, chronic iritis, keratitis, hemorrhage into the vitreous, glaucoma, muscae, 
atrophic choroiditis, hemorrhages of the retina, white atrophy of the optic 
nerves, and inflammatory affections with effusion and exudation to promote 
resolution and absorption (Wecker). Cocaine, as a local anaesthetic in oph- 
thalmic surgery, a 4 per cent, solution, by instillation, sometimes injection 
required, as into the muscles for squint operation. Is mydriatic, and in rare 
cases panophthalmitis has resulted after operations under cocaine (R.). Chlo- 
roform, vapor, close to a photophobic eye, relieves (R.). Oleate of Mercury 
and Morphine, outside the eye in palpebral conjunctivitis, and stye ; also in 
syphilitic iritis (R.). Silver Nitrate, Copper and Zinc Salts, are much used 
(B.). [See Conjunctivitis, etc. Compare Mydriatics, Myotics, pages 28, 29 ; 
also in this section the titles Amaurosis, Asthenopia, Cataract, Conjuncti- 
vitis, Corneal Opacities, Glaucoma, Iritis, Keratitis, Myopia, Ophthal- 
mia, Photophobia, Retina, Strabismus, etc.] 

Eyelids. 

Calomel, locally, or brown citrine ointment, as application in many diseases 
(B.). Mercury and Morphine, the 20 per cent, ointment with lard, outside lid, 
for stye (R.). Pulsatilla, internally, and externally as wash, in ophthalmic 
cases and inflammations ; the so-called "stye" may often be aborted by this 
treatment (P.) Cadmium, much esteemed as collyrium, gr. ij of sulphate to 
5J aquas rosae (R.). Zinc and Copper Sulphates, are esteemed applications 
(B.). [See Conjunctivitis for formulae.] Ergot, an aqueous infusion, as a 
collyrium, in ptosis and paralysis of the eyelids (Wa.). Tannin, a strong 
solution (1 to 3 aquae), locally; or a weaker solution (1 to 20, 30 or 50 aquae), 
is much employed. Also used in pomade, or as fine powder (Wa.). Veratrine, 
in solution, brushed over lids once daily in painful spasmodic contraction of the 
orbicularis (Wa.). Ammonium Chloride, in solution as lotion, for ecchymosis 
of eyelids, vulgarly known as " black eye." [See Ecchymosis, Blepharitis, 
Conjunctivitis, Ptosis, Ectropium, etc.] 

Face. 

Amyl Nitrite, ttl^ to ^3, in 30 times its volume of spirits, for flushing of face, 
or sensation of flushing, with cold feet and hands, and great prostration, chiefly, 
in women at change of life (R.). Curare, effective in facial spasm, when other 
remedies failed (P.). Blisters, behind the ear, in facial palsy, followed by warm 
covering to part (H.). Strychnine, has improved some cases of facial palsy 
(P.). [Compare Neuralgia, Odontalgia, Tic-Douloureux.] 



FALSE PAINS FEET FEVERS. 569 

False Pains. 

Tartar Emetic, combined with small doses of opium, together with external 
fomentations, where evidence of congestion (L.). Opiates, to allay uterine 
irritation, after rectifying any derangement of bowels (L.). Opium, is valuable, 
having specific action on uterine muscular fibres, relaxing some, stimulating 
others (Wa.). 

Feet. 

Arsenic, swelled feet of old or weak persons (R.) ; oedema of feet and ankles 
in the old, from feebleness of the heart (B.). Lead", as ointment of equal parts 
of emplastrum plumbi and linseed oil spread on linen, and wrapped round the 
feet when they sweat — to be renewed every third day for nine days (R.). 
Potassium Permanganate, gr. j-^j, as wash, will remove fetor of feet (B.) ; tem- 
porarily discolors the skin. Boracic Acid, in strong solution, is used with good 
results. Chloral, 1 in 50 of water, as bath, efficient. Sodium Bicarbonate, a 
solution freely applied will remove fetor (B.). Belladonna, will check fetid 
secretions (R.). Salicylic Acid, in solution with borax, the most agreeable and 
efficient deodorant for fetid perspirations (B.). 3jss-iij with jfiij of dried alum, 
in powder, applied freely to foot after washing and drying. Acid, salicylic. 3, 
magnesium salicylate 87, is the composition of the powder used in the German 
army for sweating of the feet. Ice, to the spine, or heat and cold alternately, 
to equalize the circulation, has been strongly advocated (Wa.). Stockings, 
should be changed every day, and if dipped in a strong solution of boracic acid 
and dried will effectually check fetid perspirations. Cold Foot-Bath, and dry- 
ing with friction, for cold feet (R.). 

Prescriptions. 

R-. Ac. Salicylici, gr. xv. I R. Ac. Borici (pulv.), . . . . ^jss. 

Amyli, gr. cl. Vaselini, ^j. 

Talci, ^iij. M. Sig. — Ointment for bromidrosis. 

M. et trit. Sig. — Locally for sweating I (Championniere.) 

feet. (Kohnhorn). 



Fevers. 

[See also the titles of the various fevers, in their respective alphabetical 

order.] 

Aconite, has the highest value in the eruptive fevers., also in all hyperpyrexias 
(B.). Always indicated in early stage of simple inflammatory fevers, pneu- 
monia, and in most acute congestions (P.). Has marvellous power over sthenic 
fevers. Thermometer should go hand in hand with Aconite (R.). Veratrum 
Viride, possesses considerable power as an antipyretic ; useful in rheumatism, 
pneumonia (P.) ; in delirium ferox of fevers it is of value (B.). Strongly recom- 
mended in both sthenic and asthenic fevers (R.). Belladonna, in the'eruptive 
fevers, especially scarlatina (B.). In typhus, with delirium, insomnia, painful 
sensitiveness to light and sound. In all hyperasmic states of brain and spinal 
cord (P.). Is prophylactic often against scarlet fever (P., Pf.). In delirium ; 
also excellent in typhus (R.). Gelsemium, in remittent and typho-malarial, of 
real benefit. Is antipyretic (B.). In bilious remittent, of value (Pf.)- Arsenic, 
in prostrating acute fevers to strengthen pulse and invigorate patient. Except 
quinine, no drug subdues intermittents so well (R.). In malarial, especially 
typho-malarial, it is of great value (B.). Cinchona. Quinine in the eruptive, 
and all malarial, remittent, and intermittent ; as apyretic, less effective and 
more dangerous than cold baths. Useless in typhus and typhoid, except for 
hyperpyrexia (B.). It is anti-miasmatic, antiseptic, and antiphlogistic ; of great 
value in intermittent, septicemic, and hectic fevers (P.). Large doses at night 



5/0 FEVERS. 

to reduce temperature in typhoid and other fevers strongly urged in Germany. 
Cinchonine best as prophylactic against ague (R.). Antipyrine, the type, also 
the best of the new series of synthetical antipyretics, which includes kairine, 
phenacetine, chinoline, thallin, etc. (see pp. 56, 107, 184); is antipyretic and 
diaphoretic, moderates the intensity of the febrile movement, and is especially 
indicated in self-limited diseases with persistent hyperpyrexia, especially pneu- 
monia, typhoid, etc. Phenacetine, the favorite antipyretic, among the new 
synthetical compounds ; is efficient and safe. Kairine, is an efficient antipy- 
retic, but profusely diaphoretic, also a cardiac and nerve depressant of great 
power, and highly dangerous in pneumonia, and other fevers where the heart 
is weak. It often produces nausea and vomiting with headache and tinnitus 
aurium (P.). Resorcin, has been given in acute rheumatism, typhoid, typhus, 
pneumonia, erysipelas, etc., as an antipyretic ; like Kairine, however, its action in 
lowering temperature is transient as compared with quinine or salicylic acid (P.) ; 
maybe used hypodermically as it is not irritant (B.) Salicylic Acid, or salicy- 
late of sodium, nearly equal to quinine as antipyretic. Very useful in all forms 
with high temperature and in intermittents. Especially in septicaemia, pyae- 
mia, erysipelas, and surgical fevers (B.. R.). Digitalis, the German antipy- 
retic. Very useful in scarlet fever, rheumatic, and pneumonia (B.) ; especially 
in typhoid (R.). Cimicifuga, as substitute for digitalis, but less effective ; good 
in hectic (B.). Hydrastine, intermittents, typhoid with copious sweats (P.). 
Arnica, is antipyretic, full doses in sthenic cases, small (tt^v of tincture) in 
asthenic. Large and small doses produce different results (B.). In rheumatic 
and typhoid is highly extolled (P.). Camphor, subdues reflex excitability ; 
praised as stimulant in adynamic fevers (P.). In adynamic fevers and where 
there is delirium (R.). Mercury, large doses of calomel, the German " specific " 
treatment of typhoid (B.). Small doses in typhoid at commencement; has 
marked effect on tonsils in scarlatina (R.). Rhus Tox., in rheumatic fever after 
aconite, and in scarlatina with typhoid symptoms, is invaluable (P.). Opium, 
much less used than formerly. Useful in delirium, and with quinine in remit- 
tents and intermittents (B.). For fevers characterized by prostration, insomnia 
and delirium, noisy or muttering, with picking of bed-clothes and twitching of 
the muscles ; in such cases opium, judiciously given, may save an almost 
hopeless case (R.). Morphine, hypodermically, the best form in febrile dis- 
eases, being less disturbing to the stomach and digestive power (P.). Turpen- 
tine, in typhoid, puerperal, and yellow, as a stimulant to vaso-motor nervous 
system (tiix-gss) (B.) ; as enema (^30-60 in starch mucilage with rr\,x of liq. 
opii. if pain) invaluable when in typhoid hemorrhage occurs with tympanitis 
(P., R.). Tartar Emetic, minute doses (gr. -3^) frequently repeated, and with 
opium, are of great value in many acute febrile diseases (B.) ; as a diaphoretic ; 
in ague ; in large doses to abort specific fevers (R.). Muriatic Acid, very use- 
ful in all forms, especially in typhoid and the exanthemata ; relieving dry- 
ness of the mouth and fauces, increases digestion, and restrains the diarrhoea 
(B.). Acid Drinks, such as raspberry vinegar, citric acid, etc., very grateful 
and useful (R., B.) ; two sliced limes or lemons, with ^ij of sugar, in Oj of 
boiling water, cooled and strained, make an agreeable refrigerant beverage 
(Wa.). Baptisia, useful in common continued fever, or in the first stage of 
typhoid ; drop doses of a fresh tincture every hour. Eucalyptus, has given 
varied results in malarial fevers, some observers praising it very highly (P.). 
Valerian, has done much good in fevers of a nervous character (P.). Sumbul, 
is used in Russia for low fevers of a typhoid type (P.). Cocculus, for tym- 
panitis of typhoid (P.). Ammonium Acetate, as a diaphoretic, and in simple 
forms, as catarrhal ; the Carbonate in scarlet fever and measles (R.). Purga- 
tion, by castor oil. sulphate of magnesium, etc., before exhaustion (R.). Mus- 
tard Bath, on recession of rash in eruptive fevers (R.). Aliment, milk and 
beef-tea alternately, every 3 hours. Milk only, in fevers and inflammations of 
the digestive tract (B.). Alcohol, in low conditions is useful when causes im- 
provement in symptoms, which may become worse (B., R.). Coffee better than 
alcohol (P.). Water, is a valuable adjunct to remedies in the treatment of 
fevers. Warm baths, the wet pack, hot and cold compresses, fomentations, 



FEVER, SIMPLE FISTULA FLATULENCE. 57 I 

moist inhalations, etc., have great value [see various fever titles] : a most im- 
portant agent. Cold baths or cold wet pack to reduce temperature (B.) ; cold 
affusion, baths, packing, ice, and ice-bag ; hot affusion and sponging, all of 
great value in every form (R.)- 

Prescriptions. 



R. Ext. Aconiti Fl., n\xvj. 

Spt. Etheris Nitros., . . . gij. 

Glycerini, . . . . q.s. ad 3 i j - 
M. Sig. — A teasp. every hour to an 
adult, as a febrifuge. 



R . Antipyrini, gr. xlv. 

Aquae Cinnam., ^ij. 

M. Sig. — A teasp. every 2 hours for 
children, to control pyrexia. 



Fever, Simple. 

Aconite, in small repeated doses, the best remedy for febricula, etc. (B.) ; 
in ordinary febrile conditions, if given early, will abate fever and induce free 
perspiration ; may be administered in conjunction with any other remedy indi- 
cated (R.). Veratrum Viride, in small doses, as antipyretic (P., R.). Hyoscya- 
mus or Belladonna, very useful in febricula, especially for head symptoms and 
constipation (P.). Gelsemium, with remittent or bilious symptoms (P., B.). 
Arsenic, if typho-malarial symptoms (B.). Antipyrine, in hourly doses of 
gr. iv or less, in the simple continued fever of children, as antipyretic. Even 
infants bear it well (Penzoldt). Hydrochloric Acid, in the continued fever of 
childhood, has a beneficial influence (West). Valerian, when nervous excita- 
bility (P.). Lemon-juice, as "lemonade," or with bicarbonate of potass., as 
mild diaphoretic and diuretic (P.). Pomegranate-juice is very grateful if mixed 
with sugar or honey (P.). Bromides, gr. ss-j every quarter-hour are excellent 
for the febrile disturbances of children (A. A. Smith). Baths, warm, in simple 
fevers of children (R.). Aliment, milk and beef-tea alternately every 3 hours, 
the most useful (B.). 

Prescriptions. 



R . Ac. Hydrochlor. Dil., . . 3 ss. 
Spt. /Etheris Co., . . . . ,^jss. 

Syr. Rosae, ^ ss. 

Aquae Camph., . . . ad ^iv. 
M. Sig. — Teasp. to tablesp., according 
to age, every 6 hours. 

(Modified from West.) 



R. Potassii Acetatis, . . . . 3 Ij. 

Spt. ^Etheris Nitrosi, . . . giv. 

Syr. Simplicis, 5j. 

Liq. Ammonii Acetatis, . . :fij. 

Aquae Camphorae, . . ad ^viij. 
M. Sig. — Teasp. to tablesp. doses, ac- 
cording to age. Diaphoretic and anti- 
febrile. 



Fistula. 

Piper Nigrum, the confection, as a gentle stimulant in anal fistula (P.). 
Iodine, by injection, sometimes curative, but generally fails (Wa.). Sanguinaria, 
as injection, has cured (P.). Capsicum, the weak infusion, a useful stimulant 
in fistulous ulcerations (P.). Surgical. Division of sphincter in anal fistula, by 
knife or ligature, the best treatment (D.). In fistula lachrymalis, dilatation of 
passage by probing the canaliculus, or slitting the canaliculus up (D.). In 
vesico-vaginal, or recto-vaginal, surgical methods best. Diet should be 
nourishing and digestible ; fresh air and general hygienic conditions are nec- 
essary (R.). 

Flatulence. 

Nux Vomica will remove flatulence and intestinal indigestion (B.) ; when 
constipation, heartburn, weight on head (R.). Charcoal, gr. v. or x, soon 
after or just before meals (R.) ; mixed with bismuth (R.). Chloroform, pure, 
in drop doses, benefits (R.); by far the best agent in flatulent dyspepsia to 
prevent flatulence, always given well diluted (Huchard). Carbolic Acid, 
when no acidity present (R.). Turpentine, gtt. iij-v on sugar, will quickly 



572 



FLUSHING-HEATS — FOREIGN BODIES. 



relieve (B.). Asafcetida or Valerian, quickly relieves the flatulence of hypo- 
chondriasis (B., P.). Asaf. Z] of tinct. to Oyi water, give 3j ; useful for chil- 
dren (R.). Sodium Sulpho-carbolate, gr. xxx after eating, will be found very 
serviceable (R.). Phosphoric Acid, dilute, is often promptly alleviative. Anise, 
the oil, also Ether, or any other member of the Carminative group (see page 
37), will promote the expulsion of gas from the stomach and intestines. Mercury, 
when with clayey stools (R.). Calumba, an effective remedy for flatulent dis- 
position is an infusion of ^ss each of calumba and ginger, Z) of senna, hot 
water Oj, a wineglassful ter die (B., P.). Potassium Permang., in flatulence 
attendant on obesity (B.). Physostigma, flatulence of women at climacteric 
(B.). Sulphurous Acid, in 5 to 10 minim doses, when due to fermentation 
(R.). Diet. Abstain from sugar, starchy food and tea — especially sugar; eat 
little, slowly and regularly ; as a general rule abstain from alcoholic drinks and 
vegetables, especially cabbage. Pepsin [or Ingluvin] after meals, to promote 
digestion (R.). [Compare Colic, Dyspepsia.] 



R . Tinct. Nucis Vomicae, 
Tinct. Physostigmatis, 
Tinct. Belladonnas, . . aa 5jj. 
M. Sig. — Fifteen drops twice daily in a 

little water. 



Prescriptions. 



R. Tinct. Illicii Anisati, 

Tinct. Gentianas, 

Tinct. Nucis Vomicae, aa gj. 

Chloroformi, n\xv-xxx. 

M. Sig. — 8 to 10 drops in a winegl. of 
water, before meals. 



R . Gummi Camphorae, 

Pulv. Zingiberis, 

Pulv. Capsici, . . . . aa gr. j. 
Ft. pil. no. vj. Sig. — One pill as re- 
quired for gastric and intestinal flatulence. 



R. Bismuthi Salicyl., . . . . ^iv. 

Magnes. Calcinat., . . . . 3 iv. 

Pulv. Carb. Ligni, . . . . gvj. 

Olei Anisi, 3 ij. 

Ft. pulv. Sig. — A teaspoonful before 
each meal. {Huchard.} 



Flushing-heats. 

Nux Vomica, T\\] of the tinct. with minim doses of laudanum in hysterical 
flushings of the middle-aged, with flatulence, weight on head and perspirations 
(R.). Nitrite of Amyl, n^i to l /e in thirty times its volume of rectified spirits. 
Effective for flushing of face, or sensation of flushing, followed by coldness, 
with cold feet and hands and great prostration occurring at climacteric chiefly 
(R.). Potassium Bromide, at climacteric, with mental depression (R.). Zinc 
Valerianate, or Valerian, flushings at the climacteric (R.). Eucalyptol, for 
the flushings, palpitations and flatulence incident to the change of life (R.). 



Foreign Bodies. 

In the Eye, — Remove by bathing, or wiping towards the lower inner corner 
with a soft, moistened handkerchief, or a bent bristle, the two ends being held 
in the fingers. Use tepid solution of vinegar (3ss-^j) for removing lime, tepid 
water for powder. Then apply a weak zinc or alum colly rium, or instil a 
solution of Atropine, gr. ij to the ^, or Cocaine, 4 per cent. In the Ear, — 
Examine carefully with speculum before removal ; first syringe with warm 
water, or a drop of sweet oil to drive out insects, before using forceps ; apply 
equal parts of laudanum and olive oil, a few drops on cotton, if much pain. 
In the Nose, — A current of tepid salt water, forced up one nostril, may force 
down the body through the other, if the mouth be held open. In the Larynx 
or Pharynx, — if water can be swallowed, the obstruction is in the trachea. 
Never push a body down. Remove by curved forceps or blunt hook. If 
passed into the stomach use solid diet to imbed the article. If all fail and the 
case be urgent, resort to catheterism or tracheotomy. In the Flesh, — remove 
at once by forceps, or sponge and water. 



FRACTURES AND DISLOCATIONS GANGRENE. 



573 



Fractures and Dislocations. 

Arnica, is excellent to neutralize the ill effects of mechanical injuries, rr^v-x 
in a wineglassful of water every 2 or 4 hours. When used after amputations, 
it certainly has the power of promoting the rapid union of the surfaces. The 
infusion is better than an alcoholic preparation for external use (P.). Aconite, 
quickly and repeatedly if feverish symptoms ensue (P.). Iodine, int. and 
frictions, occasionally useful in ununited fractures (Wa.). Calcium Phosphate, 
promotes formation of callus (Wa.). Opium, useless in surgical fever, and 
may do harm (CI.) ; for nervousness or muscular spasms after dressing, gr. % 
of morphine hypodermically as anodyne (Ag.). Benzoin, the tincture on lint, 
as a dressing for compound fractures and other severe injuries, leads to rapid 
and satisfactory healing (Bryant). Carbolic Acid, 1 to 20 or 1 to 40 solutions, 
for irrigation and dressings in compound fractures, obviates pyaemia and most 
of the other preventable causes of death (P.). Leadwater and Laudanum, on 
lint, or a Calendula lotion to the part, after reduction of the injury, with mor- 
phine hypodermically and perfect quiescence. Diet, should be very simple 
for a week or ten days. [Cornpare Wounds.] 



Freckles. 

Iodine, the tincture or glycerite, locally (B.). Liquor Potassae, gj to ^ij 
Aquas Rosas, as a lotion (Todd). Benzoin, the compound tincture with water, 
as cosmetic to remove freckles (P.). Sodium Borate, a saturated solution of 
borax is a safe and often efficient lotion to remove freckles (B.). Lime-water, 
and olive oil, equal parts, with a little liq. ammonias, as liniment (Wa.). Po- 
tassium Carbonate, makes a good lotion for freckles, sunburn and tan (B.). 
Mercury, the bichloride, with alcohol and glycerin, as a lotion, has been found 
effective. Donovan's solution, mjxxx to ^viij of Water, and §j every three 
hours, has been found highly successful (Wa.). 



Prescriptions. 



R . Potassii Carbonatis, . . . 3 iij . 

Sodii Chloridi, ^ij. 

Aquae Aurantii Flor., . . . ^ij. 

Aquae Rosae, ....... 3 viij. 

M. Sig. — Face-wash. 



(B. 



R. Hydrarg. Chlor. Corr., . . gr. vj. 
Ac. Hydrochloiu Dil., . . 3J- 
Alcoholis, Aq. Rosae, . aa 3f ij. 
Glycerini, Jj, Aquae, . ad jf viij. 
M. Sig. — Apply at night, and wash off 

in the morning. 



Gangrene. 

Salicylic Acid, pure, in powder locally, to destroy fetor and change the 
character of the morbid action (B.). Carbolic Acid, acts in the same way 
(B.) ; a 1 per cent, solution as lotion in gangrenous ulcers (Wa.). Sodium 
Sulphite, in solution, 1 to 5 or 10 of water, as lotion or applied on compresses, 
to destroy odor, soothe pain and restore healthy action (Wa.). Ammonium 
Chloride, in solution as bath and fomentations, very successful in one case of 
senile gangrene (Wa.). Cinchona, or better, quinine, or the hydrochlorate, 
often proved of value (P.) ; generally decoction of cinchona best (Wa.). Tur- 
pentine, locally, after removal of gangrenous part, a most efficient application 
(B.); by stomach and inhalation from hot water in gangrene of lungs; the 
oil locally in dry and chronic gangrene (P.). Sanguinaria, has been recom- 
mended (P.). Oxygen, as gaseous bath in senile gangrene (R.). Charcoal, as 
poultice, value doubtful (R.). Citric Acid, lemon-juice dropped into wound, 
which is then covered with lint steeped in a solution of chlorine. Very effec- 
tive for hospital gangrene, in Parisian hospitals \_Lancet, October, 1879J. Per- 
chloride of Iron, locally, is considered superior to the mineral acids (Wa.). 
Nitric Acid, strong, applied carefully until the ulcer is converted into a firm, 



574 GASTRALGIA AND GASTRODYNIA. 

dry mass (Wa.) ; is probably the best escharotic, next to bromine, for gan- 
grenous destruction (B.). Bromine, is the best escharotic for hospital gan- 
grene (B.). Chromic Acid, is a very efficient caustic, penetrating deeply with 
but little pain (B.). Opium, to soothe the pain, and diminish restlessness and 
irritability (Wa.). 



Gastralgia and Gastrodynia. 

Opium, in some form necessary to relieve the pain in severe cases (Da 
Costa). Morphine, is of great value (P.) ; subcutaneously in epigastrium very 
efficient, or in small doses with bismuth and milk before meals (R.). Bella- 
donna, is useful in painful affections of the stomach (R.). Atropine, often 
relieves promptly, and is excellent in neuralgic pain of the abdominal vis- 
cera (P.). Nux Vomica, an excellent stomachic, gtt. v-x of tincture before 
meals (B.); gtt. j-ij every 2 hours in many forms of gastric derangement 
(R.). Strychnine, hypodermically for gastralgia and gastrodynia (R.) ; in very 
small doses, gr. ^q - ^ , two or three times daily, a very successful remedy 
(P.). Arsenic, sometimes dissipates the pain surprisingly (B.); a drop of liquor 
arsenicalis before food in irritative dyspepsia and gastralgia with heartburn 
(R.). Bismuth, when gastralgia due to irritation of mucous membrane, acts 
well alone, but is most efficient when given with aromatic powder and a little 
morphine (R.) ; or a combination of bismuth and arsenic in more chronic'cases 
(B.) ; subcarbonate is especially adapted to gastralgia with laborious digestion 
and putrid or acid eructations (Wa.). Manganese, the black oxide in gastro- 
dynia and pyrosis (R.). Zinc Oxide, an excellent remedy when gastralgia 
after food, gr. v-x with aromatic powder and morphine, before meals (B.). 
Silver Nitrate, in solution to check the pain of many stomachal disorders (R.) ; 
a pill of gr. ss, with extr. hyoscyami gr. ij-iv (Wa.). Hydrocyanic Acid, often 
cures rapidly when gastralgia from nervous derangement (B.) ; may check 
vomiting as well as relieve pain (R.) ; cherry-laurel water a useful form (P.). 
Nitro-hydrochloric Acid, gtt. ij-iij of the dilute acid, is serviceable (Da Costa). 
^ther, a few drops of sulphuric ether or the compound spirit TTLx-xx, often 
relieves quickly (B.). Chloroform, rr\jj-v on sugar, often relieves (B.). Chlo- 
ral, sometimes relieves pain in gastralgia (R.). Pulsatilla, is efficient in many 
cases of painful dyspepsia, with coated tongue, headache and nervous depres- 
sion (P.). Pepsin, when gastrodynia from indigestion (P.). Creasote, checks 
pain after food (R.). Alum, often affords relief (B.). Ergot, of value in vis- 
ceral neuralgias (P.). Alkalies, for pain in stomach, liquor potassse generally 
employed (R.). Quinine, in cases showing periodicity, and those of neuralgic 
type (P.). Sodium Salicylate, for gastralgia with fermentation (R.). Nitro- 
glycerin allays the pain speedily (B.). Carbonic Acid Water, in painful and irri- 
table conditions ; may be mixed with milk (R.). Milk-cure, very efficacious 
in obstinate cases (B.). Galvanism of the pneumogastric, and locally to the 
organ itself (B.). Aquapuncture has given extraordinary relief (B.). Diet is of 
the greatest importance. Food should be easily digestible, varied and plainly 
cooked. Sedentary livers should refrain from much animal food. Meals 
should be regularly and frequent, eating little at a time, and that very slowly. 
Alcoholic beverages do harm as a rule, but may benefit particular cares. Eat- 
ing should be done in as agreeable a frame of mind as possible, and the patient 
should rest for a time after a meal. [Compare Acidity, Dyspepsia, Neu- 
ralgia.] 



&. Morphinae Sulph., . . . . gr. j. 

Ac. Carbolici, 3 ss. 

Aq. Menth. Pip., . . . ad ^iv. 
M. Sig. — Teasp. thrice daily. 

(Z>« Costa. 



Prescriptions. 

R. Bismuthi Subnit., . . . . ^ij. 



Aq. Hydrocy. Dil., . . . . £ss. 
Mucil. Acacise, 

Aq. Menth. Pip., . . . aa Jij. 
M. Sig. — Tablesp. thrice daily. 



GASTRIC DILATATION GASTRITIS. 



575 



&. Atropine Sulph., •. . . . gr. j. 

Zinci Sulph., g ss. 

Aquas Destill., ^j. 

M. Sig. — 3 to 5 drops two or three 
times daily. (B.) 

R. Bismuthi Subnit, 

Magnesii Carb., .... aagr. xvj. 
Ac. Hydrocy. Dil., .... nyc. 

• Aquae, 3* v * 

M. Sig. — Dessertsp. for a child of 3 
years in flatulent gastrodynia and gastralgia. 



R. Ac. Hydrocy. Dil., . . . . gij. 
Aq. Laurocerasi, . . . ad J iv. 
M. Sig. — Teasp. every 4 hours. 



R . Pepsini, ^j. 

Ac. Hydrochlor. Dil., . . . 3 ss. 

Glycerini, 25 jss. 

Aq. Cinnam., J ijss. 

M. et filtra. Sig. — Tablespoonful doses 
for slow and feeble digestion. 



Gastric Dilatation. 

Carbolic Acid, internally to allay fermentation, with an occasional washing 
by the stomach pump (Da Costa). Strychnine, hypodermically or by the 
mouth, or Nux Vomica, the best remedy, conjointly with washing of the sto- 
mach and strict diet (Da C). Bismuth, with magnesia or soda, or lime-water 
frequently, for the acidity, which is one of the most distressing symptoms (Fen- 
wick). Diet, should be free from all starch and sugar, and from vegetables of 
any kind (Fenwick). Milk not advisable, as much fluid will further dilate the 
organ ; solids better, as small quantities of dry, stale bread, qr gluten bread, 
and underdone meat (Da Costa). 



Gastritis, Acute. 

Mercury, calomel in broken doses, with ice, frequently swallowed, for the 
idiopathic form, which is occasionally seen and cannot be distinguished from 
that due to irritant poisons (Da Costa). Bismuth, subnitrate or subcarbonate 
in full doses after more acute symptoms have abated (Da C). Morphine, 
hypodermically for pain (B.). Ice, internally and externally gives great relief 
(R.). Aliment should be given per rectum ; no food, except milk and lime- 
water, being admitted to the stomach for some time (Da C.). Antidotes, in 
cases of irritant poisoning, as alkalies to neutralize acids, dialyzed iron or the 
hydrated sesquioxide for arsenic, turpentine for phosphorus, etc. [See page 
52, ante.'] Then oil, albumen or milk, to protect the mucous membrane, 
stimulants, opium, ammonia, etc., to antagonize the depression of the vital 
powers. 

Gastritis, Chronic. 

Arsenic, sometimes surprisingly curative ; for the vomiting gtt. j-ij of Fowler's 
Solution before meals (B.). Pulsatilla, in subacute gastritis of phlegmatic 
temperaments, white tongue, heartburn, nausea, flatulency, little or no taste 
(P.). Hydrastis, gtt. v-xv of tincture or fluid extract, daily before meals, espe- 
cially for gastric catarrh of acute alcoholism (B.). Nux Vomica, gtt. j of tinc- 
ture every 5 to 10 minutes for 8 or 10 doses in acute gastric catarrh, with 
headache or sick-headache ; also drop or 2-drop doses every 2 hours or 
oftener, when chronic gastric catarrh in the course of chronic disease (R.). 
Cinchona, to promote Wealthy state of mucous membrane, the infusion best 
with mineral acids, or quinine ; the red bark in gastric catarrh of drunkards 
(B.). Alkalies, either shortly before meals, to stimulate production of gastric 
juice ; or some hours after, to neutralize the acids of decomposition (Da C). 
Pepsin, gr. v immediately after a meal, to assist digestion (Da C). Podophyl- 
lum, in small doses at night, to act on upper bowel. Purgation as a method of 
treatment stands at the head (Da Costa). Ipecac, in small doses may prove 
highly useful, V(\jv-x of the wine (P.); for the nausea and vomiting (R., B.), 
Tannic Acid, in 4-grain doses with a drop of glycerin to [make a pill (B.). 



576 



GASTRIC ULCER. 



Hydrocyanic Acid, is much used (R.) ; in subacute gastritis it often proves 
useful given in an ordinary effervescing draught (Wa,). Silver Nitrate, in }( 
or y 2 -grain doses with opium if pain, or preferably belladonna, is extremely 
useful (Da C.) ; to check pain and vomiting (R.). Silver Oxide, is nearly as 
good as the nitrate, and not liable to produce staining (Da C). Opium, or 
Morphine, to quell pain in chronic gastritis from alcoholic excess (R.)- Euca- 
lyptus, a most useful stomachic, not to be used in inflammatory states (B.) ; is 
used with benefit (R.). Mercury, the yellow oxide, in doses of gr. ^~-to> m 
chronic form. [See under Dyspepsia.] Calumba, and other bitters are use- 
ful (B.). Ammonium Chloride, in high repute in Germany (B.). Caffeine, 
especially when associated with migraine (B.). Bismuth, is very useful in 
chronic gastritis, especially that of drunkards, and the chronic gastric catarrh 
of "children with vomiting (R.) ; invaluable for its sedative, alterative and 
astringent action ; 10-15-grain doses several hours after meals (Da C). Lead 
Acetate, in chronic gastritis with gastralgia and pyrosis, may be combined with 
morphine beneficially (B.). Alum, when vomiting of glairy mucus (B.). Ali- 
ment, such as will be digested in the small intestines ; requires careful atten- 
tion. The milk-cure has been very effective in bad cases ; malt liquors are 
harmful (B.). Mineral waters of purgative type, to keep the portal system 
drained. Exercise is not beneficial ; better live quietly, and occasionally 
spend a day or two in bed (Da C). Kumyss very agreeable, and tolerant to 
stomach ; the milk-cure and buttermilk have been very efficacious. The 
farinaceous vegetables, rice, tapioca, arrowroot, aerated bread. [Compare 
Dyspepsia, Gastralgia.] 



R. 



Sodii Bicarbonat., .... gjss. 

Tinct. Aurantii Cort., . . . % ss. 

Infusi Calumbae, . q. s. ad q viij. 

M. Sig. — Two tablesp. before each 

meal. In chronic gastric catarrh. 



Prescriptions. 

R. Magnesii Sulphatis, 



R . Aluminis, 3 ij. 

Ext. Gentianas, gss. 

M. Ft. pil. no. xxx. Sig. — Two twice 
daily. 



R . Argenti Oxidi, . . 

Ext. Belladonnae, . 

Olei Carophylli, . . 
M. Ft. pil. no. xxiv. 
twice daily. 



. . gr. xij. 
• • gr-iij. 
. . gtt. xx. 
Sig. — One pill 
{Da Costa.) 



Sodii et Potassii Tart., 
Ac. Tartarici, .... 
Sig. — Dissolve in a glass of water, and 
drink, an hour before breakfast. 



3ss-j. 
gr. xx. 



R. Sodii Bicarbonat., .... 

Spt. Chloroformi, .... 

Tinct. Gentianae, .... 

Infusi Rhei, 

Aq. Menth. Pip., q. s., ad 
M. Sig. — A tablesp. or two before each 
meal. In chronic gastric catarrh, with flat- 
ulence. 




Gastric Ulcer. 

Arsenic, Fowler's solution in drop doses lessens the pain and relieves the 
vomiting remarkably (B.) ; has given relief when commonly-used remedies 
failed (R.) ; gives good results when used in very small doses (Da Costa). 
Bismuth relieves pain and vomiting, and contributes to the cure (B.). [See 
under Gastralgia for formulae.] Silver Nitrate, in solution, to check pain 
and relieve the vomiting (R.) ; is next in value to bismuth, promoting cicatriza- 
tion and easing the pain (B.). Silver Oxide is equally efficient, and is not 
liable to produce staining (Da C). Atropine, often happily relieves the pain 
and vomiting, even when given in very small quantity (B.). Morphine, for the 
pain and vomiting (R.) ; in full doses if perforation occurs, to localize peritonitis 
until adhesions take place (Da C). Ergotin, j to water x, of which gtt. xv 
hypodermically several times a day for the hemorrhage. Gallic Acid, in 5- 
grain pill every hour for hemorrhage. Lead Acetate, is sedative and hemo- 
static ; gr. ss-ij in pill with opium, very useful to check hemorrhage and allay 
pain (R.)- Turpentine, 5 to 10 drops frequently repeated in hemorrhage (R.)« 



GLANDERS GLANDULAR ENLARGEMENTS. 



577 



Charcoal is said to ease the pain by preventing formation of acid products (R.). 
Mercury. Corrosive sublimate an effective remedy ; gr. ^— 3V thrice daily 
before meals (B.). Pepsin, by facilitating digestion, is useful (B.). Iron, for the 
anaemia; the lactate or ammonio-citrate if stomach irritable (Da C). Ice-bag, 
to the epigastrium, for pain and vomiting, etc. (R.). Nutrient Enemata, to rest 
the stomach. [See under Enemata for formula.] Brandy may be added, 
also laudanum, gtt. x-xx, if the rectum is irritable (B.). Milk-cure, has suc- 
ceeded admirably (B.); a strictly skimmed milk diet with lime-water, 2 parts of 
milk to 1 of aqua calcis (Da C). Diet, should be of non-irritating character, 
which, with cold or hot compresses to the epigastrium, leaves little room for 
medicine. In bad cases nourish per rectum, so as to give the stomach complete 
rest. In any case such food as is chiefly digested in the small intestines, e. g. t 
farinaceous vegetables, rice, arrow-root, etc. A nice change from milk diet is 
a warmed pancreas, chopped up with rare meat, being nutritious and well 
relished (Da C). Rest, in bed for several months is imperative (Da C). 
Defibrinated Blood, by injection into rectum, in doses of from ^iij-vj (A. H. 
Smith). [Compare Hematemesis.] 

Prescriptions. 

R- . Argenti Nitratis, . . 

Ext. Opii, 

Ft. pil. no. xx. Sig. — One pill thrice 
daily. 



R . Argenti Oxidi, 

Ext. Hyoscyami, . . . aa gr. x. 
Ft. pil. no. xx. Sig. — One pill thrice 
daily before meals. 



R. Bismuthi Subcarb., . . ^iij. 

Morphinae Sulph., . . . . gr. j-ij. 

Pulv. Aromat., gj. 

Ft. pulv. no. xij. Sig. — One powder in 
milk before each meal. 



gr. v. 
gr. iij. 



R . Argenti Oxidi, gr. v. 

velZxnci Oxidi, ^ss. 

Morphinas Sulph. gr. j-ij. 

Ft. pil. no. x. Sig. — One pill thrice 
daily, before meals. 



Glanders and Farcy. 

Ammonium Carbonate, in water, hourly, as concentrated as can be swallowed, 
followed by an opiate, and preceded by an emetic of ipecac, and an incision 
into each of Wharton's ducts; proved successful in a case of acute glanders 
(Wa.). Carbolic Acid, and the Sulphites, as sodium sulphite, are most worthy 
of trial. Creasote, or Carbolic Acid, in glycerin, locally (Wa.) ; or dilute chlori- 
nated soda, and lime-water. Escharotics, to destroy the affected spot, if inocu- 
lation occurs. Iodine, internally, also Arsenic and Strychnine, have been 
recommended. Quinine, in large doses, and Chloride of Iron, may be useful. 
No drug yet tried has any marked specific effect on the disease (Durham). 



Glandular Enlargements. 

Iodine and Iodides, no remedy more efficient, when simple hypertrophy. 
Useless (with all other medicines) when caseation or suppuration has set in. 
Iodine injected into cystic and glandular growths of neck. Syrup of the Iodide 
of Iron occupies an important place (B.). The iodide of potassium for 
mamma? and testicles, but especially for thyroid (R.). Iodoform is equal, if not 
superior to iodine, in enlarged scrofulous glands, and other glandular swellings 
(Wa.). Iodide of Lead, as an ointment. Ung. Hydrarg. Iodidi Rubri, produces 
very striking effects in goitre, enlarged spleen, etc. (B.). Sulphides, especially 
the Blue Lick water, are said to abort or to mature suppuration in glands (R.). 
Calcium Sulphide, for hard, swollen glands behind the angle of the jaw, with 
deep-seated suppuration (R.). Calcium Chloride, highly useful in strumous 
inflammation and suppuration (B.). Pilocarpus, is curative in acute affections 
of parotid and submaxillary glands (B.). Mercury, useful in acute inflamma- 
tory states, tonsillitis, parotitis, etc. Hydr. chlor. corr. gr. -fa or hydr. cum creta, 
gr. \, every 2 hours (B.). The oleate of mercury and morphine in obstinate and 
painful tonsillitis, and inflammation of lymphatic glands (R.). Belladonna, 

37 



573 



GLAUCOMA GLEET. 



especially in tonsillitis (P.). Valerian with Guaiacum, in strumous enlarge- 
ment (P.). Hydrastis, frequently controls (P.). Carbolic Acid Injections, a 2 
per cent, solution injected into substance of gland (B.). [Compare Bubo, 
Goitre, Tabes Mesenterica, Parotitis, Tonsillitis, etc.] 

Glaucoma. 

Atropine, gr. -^ hypodermically beneficial (Anstie) ; imprudently used has 
caused the disease (Von Graefe, Scelberg Wells). Eserine, lowers intra-ocular 
tension, and is indicated with Quinine in all cases of threatened glaucoma, to 
preserve the eye from the risk of consecutive glaucoma, and after iridectomy 
or sclerotomy (De Wecker). Iridectomy, the only remedy for the disease, 
medicine being worse than useless. The operation should be performed as 
soon as a state exists which can be called glaucomatous. Even when vision is 
lost, the operation will best relieve the pain (C). Almost a certain cure in early 
stages ; in later, nearly always palliative ; often curative. Drainage of Eye, 
by gold wire or catgut, has had success (De Wecker). 



Gleet. 

Cantharides, in drop doses, when frequent desire and pain in region of 
prostate (R.) ; of benefit in subjects of relaxed fibre and feeble circulation 
(B.). Blisters, to the perinaeum, of undoubted benefit (B., R.). Piper Me- 
thysticum, has cured obstinate gleet (Switzer). Bismuth, i, glycerin i, water 
6 parts, as an injection, often useful in gleet (R.). Eucalyptol, is used with 
benefit in chronic catarrh of the genito-urinary tract (R.). Iron, the tincture 
of the chloride, 3ss in Oss of water with oj of laudanum, makes a good injection 
for gleet (R.) ; internally for anaemic subjects (St.). Mercury, }4 grain of cor- 
rosive sublimate in ^vj of water, is a good injection in gleet, used every 2, 3 
or 4 hours (R). Donovan's Solution in doses of 10 minims thrice daily, so 
uniformly successful in controlling chronic urethral discharge as to be almost a 
specific for gleet. Zinc Salts, the sulphate or chloride, gr. lj of the latter to a 
pint of water, as injection every hour (R.). Bougies, of gelatin, medicated 
with astringents, are extremely efficient. Turpentine, in moderate doses, when 
due to relaxed condition (B., R.). Copper Sulphate, a solution as injection 
(R). Astringent injections may be used with benefit (Wa.). Copaiba, smeared 
on a bougie, and introduced into the urethra, will sometimes cause gleet to 
yield (Wa.). Oil of Sandalwood, rr\,xv ter die (R.)- Glycerite of Tannin, 
with equal quantity of olive oil or mucilage, as injection, gij enough. Per- 
severe 8 or 10 days after discharge ceased, and do not use at bedtime (R.)- 
Balsams of Peru and Tolu, Buchu, Canada Balsam, Copaiba, Mastic, and 
Tannin, are used with advantage (P., R.). Often kept up by over-treatment. 
Will some time or other come to an end (St.). Diet and Habits important. 
Stimulants, both solid and liquid, should be rigidly avoided, also coffee. Fre- 
quent ablutions, fresh air, good nourishment. [Compare Gonorrhoea.] 



Prescriptions. 



R. 



Tinct. Ferri Chlor., . . . gvj. 
Tinct. Cantharidis, . . . . 3 ij. 
M. Sig. — 15 drops in water three times 
daily. 

R. Zinci Sulphatis, gr. iij. 

Ac. Carbol., mjj. 

Ext. Hydrastis, 

Ext. Belladonnse, . . . aa gr. vj. 

Gelatini, q. s. 

M. Ft. bougia no. vj. Sig. — One in 
urethra at bedtime. 



R. Pulv. Cantharidis, .... gr. iij. 

01. Terebinth, gj. 

M. Ft. pil. no. xij. Sig. — One thrice 
daily in obstinate gleet. If strangury 
occur, stop for a day or two. 



R. Ac. Tannici, gr. x. 

Bismuthi Subnit., . . . . 3 ij. 
Aq. Rosse, ^ vj. 

M. Sig. — Shake and use as an injection 
thrice daily. [Maury.) 



GLOSSITIS GONORRHOEA. 579 

Glossitis. 

Bismuth, gr. xx of subnit., with ^j of glycerin and 5vij of water, as lotion, 
for erythematous inflammation of tongue (A ). Purgatives, with gargles, 
leeches, antiphlogistic regimen generally (D.). Quinine and Iron, should be 
given internally, with dilute acid washes, and free purgation (CL). Alum, dry, 
powdered, may be dusted on tongue (CL). Leeches, applied beneath the jaw, 
if symptoms are urgent (CL). Abscess, should be opened, if any form. In- 
cisions, along superior surface, followed by vapor of hot water, may instantly 
relieve congestion (A.). Tracheotomy, or Laryngotomy, if suffocation is immi- 
ment (A.). 

Glottis, CEdema of. 

Emetics, non-depressing when oedema slight (A.). Inhalations, of steam 
with benzoin, or conium, of great service (A.); or of tannin, gr. viij or x to 
5j of water; or alum, gr. x to the £, or a saturated solution of potassium 
chlorate, all as spray (Walker). Ethyl Iodide, by inhalation, proved curative 
in one case in which it was repeated twelve times (See). Scarification, by 
laryngeal lancet, of paramount value (A.). Tracheotomy, if the above fail 
(A.). O'Dwyer's laryngeal tubation promises well. [Compare Croup, Laryn- 
gitis.] 

Goitre. 

Iodine, is curative in simple hypertrophy (ordinary goitre), used both inter- 
nally and externally. Deep injection of the tincture is very successful in cystic 
degeneration of the gland (B.) ; also in the fibrous and fibro-cystic varieties, 
if injection be made into the tumor; dangerous, if into a vein or into the 
surrounding areolar tissue (Wa.). Mercuric Iodide, as oint. assisted by the sun's 
rays, a piece the size of a large pea rubbed in daily, very successfully used in 
India for simple hypertrophy (R.) ; the official unguent, hydrarg. iodidi rubri, 
i in 10 daily (B.) ; is too strong (Gross) ; gr. xv to the J strong enough for the 
worst cases (Wa.). Potassium Iodide, internally, also externally as ointment, 
in simple hypertrophy of the gland (R.). Strychnine, gr. T x g thrice daily, has 
been successful in several cases (Holmes). Chloride of Iron, injections of the 
solution used in thirty-eight cases with curative results (Mackenzie). Ergotin, 
injected with benefit into the parenchyma of the goitre (P.); also used hypo- 
dermically with good results (Wa.). Ammonium Chloride, as an internal 
remedy, has proved curative (Stevens). Electrolysis, has sometimes cured in 
cases of simple hypertrophy and cystic gland (B). Spongia Usta, was formerly 
considered a sovereign remedy (Wa.). Seton, has cured. Fluoric Acid, in 
doses of tt\,xv to 5j thrice daily, largely diluted, cured seventeen cases out of 
twenty (Woakes). Excision, is a very difficult operation, only to be considered 
in extreme cases ; it has been performed successfully by Desault, Harris, 
Hedenus, Billroth and Greene. [Compare Exophthalmos.] 



R. Ammonii Chloridi, . . . £vss. 
Syrupi Simplicis, . . . . ^ ss, 
Aq. Cinnamomi, . . . . giv, 
M. Sig. — Teasp. thrice daily. 



Prescriptions. 

R. Ung. Hydrarg. Iodidi Ru- 
bri, z'y.. 

Vaselini, 2> vr j- 

M. Sig. — Use as directed. (Gross.) 



Gonorrhoea. 

Aconite, a drop of tinct. each hour in the acute stage (R.) ; when inflam- 
mation (PL, St.). Gelsemium, serviceable, acute stage (PL). Cannabis Sativa, 
after acute symptoms subside, a few drops 3 or 4 times a day, is fully as effect- 
ual as copaiba or sandal, and infinitely more pleasant to take (PL)- Canna- 
bis Indica, relieves pain, diminishes discharge (P.) ; occasionally useful (R.). 
Mercury, excellent results from corrosive sublimate (PL) ; gr. X~/^ t0 ^ VU J ac l use 
destill. in subacute and chronic stages, as injection thrice daily; may have 



58O GONORRHOEA. 

gr. ss-j of zinc chloride added with benefit. Often effectual (Wa.). See page 
470 for formula. Hydrastis, the infusion best for injection, 3j of root to ^viij 
aquae (Pf.) ; the fluid extract is one of the best injections, properly diluted; or 
the muriate of berberine (hydrastin) 3j to %\v of mucil. acacias (B.). Col- 
chicum, the wine of the seed has frequently cured gonorrhoea, and was used 
in thirty-minim doses nightly for the relief of chordee by Brodie (B.). Chlo- 
ride of Iron, when acute stage has passed and the discharge is degenerating 
into gleet, few remedies are more useful than this tincture, in doses of n\,xv- 
xx thrice daily (Wa.). See Erysipelas for formula. Alkalies, citrates or 
bicarbonates to render the urine alkaline (R.) ; Litnium Carbonate in five-grain 
doses thrice daily for the same purpose. Alkalies are the chief factor in 
Otis's treatment ; Potassium Bicarb., gr. x in a tumbler of water, or in flaxseed 
tea, or infusion of triticum, with gr. xv of Potass. Bromide, if great pain 
present. Vichy Water (Celestin's) freely (Otis.) Turpentine, in chronic 
stage, when parts are relaxed, moderate doses are of great benefit (B.). Can- 
tharides, drop-doses may be used (R.) ; in the chronic stage (B.). Pulsatilla, 
in subacute and gonorrhoeal ophthalmia (P.). Copaiba, especially adapted to 
gonorrhoea (B.); pour it upon a half a wineglassful of water to which add some 
bitter tincture (Chapman) ; if given too early in the disease it will aggravate 
the symptoms (P.) ; should not be used until pain in urinating is nearly gone, 
chordee ceased, and the discharge is diminishing and of yellow color (Wa.) ; 
is no good, but rather injurious, and prolongs the disease (Otis). See page 
467 for formula. Sandalwood Oil, valuable in subacute (P.) ; a good quality 
difficult to obtain (Pf.). Best internal remedy ; Copaiba next (St.). Silver 
Nitrate, a weak solution (gr. j-v-^j) as injection. In vaginal gonorrhoea a 
strong solution (o\j-^j) through speculum to every part of canal (B.). As 
abortive injection is useless and dangerous (St.). Cubeba, unlike copaiba, given 
with good effect in acute stage ; best results from mixture of both as in electu- 
ary. See formula below. Is not irritating to the stomach, and agrees with some 
patients better than copaiba (Wa.). Zinc Salts, a weak injection of the chlo- 
ride, gr. j to ^vj or viij of rose-water; or the sulphate gr. j to the %, frequently 
repeated, is probably the best treatment (B.). The best injections are those of 
the sulphate or acetate, gr. vj-xij to ^iv aquae, after the acute inflammation 
subsides (St.). Bismuth, the oleate, smeared on a sound, and inserted for 5 
minutes (Shoemaker) ; with mucilage as an injection, excellent in chronic gon- 
orrhoea (Hill). Lead Acetate, the dilute solution of the subacetate, as injection, 
may be employed at any stage (B.). Chloral, a weak solution, gr. j-iv to the 
3, a very good injection (Hill). Resorcin, a 1 per cent, solution makes a use- 
ful injection (Wa.). Injections, of tannin, copper sulphate, iron, cadmium, port- 
wine, brandy-and-water, and 1000 other agents (R.)- Injections are very bad, 
especially in the acute stage ; should never be used until the 5th week and 
then only if the case is not progressing (Otis). True gonorrhoea is never cured 
in less than four weeks (Van Buren and Keyes) ; urethritis is a different 
disease entirely (Otis). Balsams of Peru and Tolu, also Buchu, Uva Ursi, Chi- 
maphila, Pareira, etc., are among the numerous remedies used for gonorrhoea 
(R.). Alcohol, as a beverage, or any other stimulant, must be avoided entirely 
(R.). Soluble Bougies made of iodoform, eucalyptus and cacao-butter, are 
highly recommended to cut the disease short (Wa.) ; a series of similar prepa- 
rations, having a basis of gelatin and glycerin, medicated with the usual astrin- 
gent and sedative drugs, is manufactured, by C. L. Mitchell, of Philadelphia, 
and may be obtained of the drug trade. Wrappings of several folds of cotton 
are heating and uncomfortable, also dirty and productive of balanitis, etc. Pin 
a false front to shirt for covering (St.). Rest in bed is an absolute desideratum, 
especially during the inflammatory stage. Hot water, ioo° F., to the penis 
during urination, extreme cleanliness, milk diet ; water freely as a beverage ; 
flavored with a few drops of oil of gaultheria, or flaxseed tea, or infusion of triti- 
cum with potassium bicarbonate. Sexual thoughts to be entirely avoided (Otis). 
[Compare Chordee, Gleet, Orchitis, Rheumatism Gonorrhceal, Ureth- 
ritis, Urethral Stricture, Vaginitis.] 



GOUT. 



581 



Prescriptions. 



For Internal Use. 



R. Potassii Citratis, ^ ss_ j- 

Spt. Limonis, gss. 

Syr. Simplicis, ,^ij. 

Aquas, %). 

M. Sig. — Dessertsp. largely diluted, 3 
or 4 times daily. As alkali for the increas- 
ing stage. [Otis.) 



The Black Paste. 



a 



. Pulv. Cubebas, ;fiij. 

Copaibas, Jj ss - 

Aluminis, gij. 

Sacchari Albi, ^j. 

Magnesias, 3J SS - 

Olei Cubebae, 55 j. 

Olei Gauliherias, .... 3;]. 

M. fiat elactuarium. Sig. — A piece 



th« 



size of a walnut after each meal. ( Otis 



R 



Oleoresinas Cubebas, . . . 55 iv. 
Potassii Bromidi, . . . . %']■ 

Olei Sassafras, rr^x. 

Syr. Acacias, ^ lj. 

Aquas, q. s. ad 1$ vj. 

M. Sig. — Dessertsp. 3 or 4 times daily. 
(/. Win. White.) 



[For Alkaline Emulsion of Copaiba see 
ante, page 467 ] 



R. 



M 



T^r Local Use. 

Resorcini, gj. 

Ac. Borici, gr. xx. 

Zinci Acetatis, g r -X~K- 

Aquas Destil., j|iv. 

Sig.— Dessertsp. as injection. 



R . Pulv. Iodoformi, 3 ss. 

Ac. Carbolici, . . . . . gij. 

Glycerini, ^ij. 

Aquas Destil., . . . . ad ]§viij. 

M. Sig. — Teasp. as injection. 



R 



Zinci vSulphatis, gr. vj. 

Plumbi Acetatis, . . . . gr. viij. 

Ammonii Chloridi, . . . gr. iv. 

Aluminis, gr. v. 

Aquas Rosas, §j. 

M. Sig. — Injection, to be used • after 
acute symptoms subside. 



R . Zinci Sulphatis gr. viij. 

Liq. Plumbi Subacet. Dil., 3 iv. 
M. Sig. — Use as an injection. 



R. Zinci Chloridi, gr. j. 

Aquas Rosas, 1| vj— viij. 

M. Sig. — Use as injection. 



[For Injection Brou and others, see ante, 
page 470.] 



Gout. 

Piperazine, the best solvent for uric acid; promptly reduces the redness and 
swelling of the joints in acute gout, given in 15-grain doses; remarkably 
relieves the paroxysm, and promotes elimination of uric acid and urates. 
Morphine, hypodermically, as close to the affected joint as possible outside of 
the red areola, is miraculous in giving immediate relief. Antipyrine, remark- 
ably efficient for relieving the pain as well as prophylactic against future 
attacks (Marshall). Aconite, may certainly relieve pain (P.). Belladonna, 
the best remedy to effectually and speedily soothe pain ; also in gout of the 
stomach, 5-nx doses efficacious (P.). Potassium Iodide, especially when pain 
is worse at night (R.). Colchicum is merely palliative ; a large dose (£j) of the 
wine often removes the severest pain in an hour or two, and soon after the swell- 
ing and heat subside (R.) ; it is especially useful in acute and rheumatic gout (B.) ; 
is not specific, nor a lasting or final remedy for gout, but acts very directly on 
the pain and inflammation of acute attacks. Laville's tincture is a colchicum 
preparation, though colocynth is also a constituent (P.) ; is useful in the bron- 
chitis, asthma, dyspepsia, urticaria, etc., of gouty subjects (R.). Veratrine, as 
ointment to painful joints (R.). Sulphides, as baths in chronic gout, or fumi- 
gation with sulphurous acid, and bed-clothes exposed to strong fumes (R.) ; sul- 
phur waters certainly benefit (B.). Iodine, painted round joints in chronic (R.). 
Strychnine, hypodermically for later stage of gout paralysis (R.). Arsenic, very 
serviceable in a form of chronic arthritis allied to neuralgia (B.). Lithium, the 
bromide internally and a strong solution of lithia to the joints (B.) ; the bro- 



5^2 



GUMS. 



mirie is the most efficient agent in combating the disease (Aulde) ; the carbo- 
nate (gr. v to the 3) on lint around gouty enlargements, joints, etc. (R.). 
Sodium Salicylate, gr. x internally every 2 hours, also 3'\j to Sjvij water warmed, 
as lotion on lint covered with oiled silk. Guaiacum has long had high repute, 
and may be given for a long time without injury (Wa.). Rhubarb with an 
alkali, regularly during intervals, very serviceable (Halford). Manganese, 
syrup, ferri et mang. iodidi (n\, x-gss) for the cachectic state (B.). Alkalies, to 
relieve indigestion, especially lithium salts. Alkaline mineral waters have long 
had a deserved reputation (B.) ; Magnesia and its carbonates often of great 
service ; the latter dissolved in excess of C0 2 an elegant form of administra- 
tion (Wa.). Alkaline Poultice, 9 of linseed meal to one of sodium bicarb, is a 
useful application (R.). Turkish Baths, are useful in chronic gout (B., R.). 
Aliment. Farinaceous vegetables and acid fruits. Avoid animal or saccha- 
rine food. Milk-cure has improved cases, and apparently removed the diathe- 
sis (B.). Cod-liver oil in chronic gout (B., R.). Entire abstinence from alcoholic 
beverages is best ; the worst wines are port, sherry and maderia. Local 
Measures. The affected limb should be raised, and surrounded with hot, moist 
flannels. Wrap the hands in flannel dripping with water, and cover with 
water-proof bag, to dissolve gouty deposits. [Compare Rheumatic Arthritis, 
Lith^emia.] 

Prescriptions. 



Scudamore 1 s Mixture (Modified). 
R. Vini Colchici Radicis, . . ^j. 
Magnesii Sulphatis, . . . ,^j. 
Magnesiae Optimae, . . . . 5J ij. 
Aquae Menth. Pip., . . . . J x. 
M. Sig. — Tablesp. every hour until it 
operates. 

R- . Colchicinae, gr. j. 

Ext. Coloeynthidis Co., . . gss. 

Quininae Sulphat., .... ghj. 
Ft. pil. no. lx. Sig. — One every four 
hours. (B.) 



R- . Vini Colchici Sem., . . . ^ss. 

Tinct. Digitalis, gij. 

Liq. Potassii Citratis, . . . ^ijss. 



M. 
hours 



Sig. — A teasp. in water every six 



Lallemand' 's Specific. 
R-. Ext. Colchici Acet. (B. P.), 

Ext. Opii Aquosi, . . aa gr. xv. 

Potass. Iodidi, giv. 

Potass. Acetatis, jfij. 

Aquae Destill., ^ iijss. 

Vini Albi, . sj ss. 

M. Sig. — 20 drops thrice daily. 

R- . Lithii Citratis, 

Magnesii Carbonat., . 

M. et div. in pulv. no. 1. 

Sig. — One in water thrice 
chronic gout. 

R . Lithii Bromidi, .... 

Liq. Potas. Citrat., . . . 

Syr. Tolutan., 

M. Sig. — A teasp. in plenty of water 
after each meal. [Atdde^) 




In 



Gums. 

Myrrh, the tincture for spongy and ulcerated gums (P.) ; o'ij-iv i n %' lv °f 
water or infusion of cinchonia,, is highly serviceable as a gargle or mouth-wash 
(Wa.). Alum, for spongy and ill-conditioned gums, tending to recede from the 
teeth, whether of mercurial or scorbutic origin (Wa.). Catechu, a piece dis- 
solved slowly in the mouth is often of service in similar conditions (Wa.). 
Rhatany, the powder as a dentifrice, keeps gums in good order (P.). Potassium 
Chlorate, gr. ij every four hours for a child of one year, for inflammation of 
gums in teething (Wa.). Carbolic Acid, gr. iij ad ^j aquse, as lotion in diseases 
of the gums (Hilditch). Pomegranate, the bark an excellent basis for gargles 
in relaxed gums (P.). Potassium Iodide, gr. x thrice daily, for periostitis of 
alveolar processes, marked by looseness of teeth, pain and swelling of gums 
(Graves). Iodine, gr. j ad ^j aquse, applied by a camel's-hair brush, after each 
meal, for retraction of gums with loosening of the teeth (Stille). Tannin, the 
glycerite, for spongy and bleeding gums (B.). Carbolate of Iodine, when fetor, 
(B.). Benzoin, the tincture a good application (B.). [Compare Scurvy, 
Teeth.] 



HAIR HAY-FEVER. 



583 



Prescriptions. 



R. Aluminis, 3 ss. 

Tinct. Myrrhse, gj. 

Tinct. Cinchonae, . . . . % iv. 

Mel. Rosae, Jfj 

Vini Albi, ^ viij. 

M. Sig. — Mouth- wash. 



R . Tinct. Orris, 
Spt. Rosse, 

Alcoholis, aa ^ iv. 

01. Amygd. Amar., . . . gtt. ij. 
M. Sig. — Violet Mouth wash. 

{Piesse.) 



Hair. 

Rosemary, encourages the growth of hair, mitigates baldness, and is supposed 
to prevent uncurling in a damp atmosphere (P.). Hydrogen Peroxide, and 
other preparations of oxygen, are used to "blonde" the hair, for purposes of 
fashion (Wilson). Hair-dyes, comprise potassium permanganate, pyrogallic 
acid, black oxide of lead, which are temporary, and the black oxide of silver, 
which is permanent in its action (Wilson). Depilatories usually consist of 
powders containing quicklime 3 parts, sodium sulphide 1, and starch 4. A 
powerful depilatory is barium sulphide made into a thin paste with starch 
(Wilson). Another contains yellow sulphide of arsenic, gr. xx, quicklime, ^ss, 
starch, gij. A very effective one is barium sulphide and oxide of zinc (B.). 
Sarsaparilla is stated by Teste to possess the curious property of changing red 
hair to a light flaxen color when taken internally for three months. [Compare 
Alopecia, Syphilis, Tinea Tonsurans, etc.] 



Prescr 

R . Sodii Boratis, ^ iv. 

Aq. Ammoniae, # ^j. 

Spt. Myrcise, ^ij. 

Aq. Rosae, ^ xiij. 

M. Sig. — Shampoo Hair Wash. 

R. Ac. Salicylici, gr . xl. 

Tinct. Benzoini, # ^ss. 

Alcoholis, Glycerini. . aa ^viij. 
M. Sig.— Hair Wash. 



Ricini, ?]ss. 

Bergamn, 3J SS - 



iptions. 

R. 01 
01 

01. Cinnamomi, 
01. Caryophylli, . . . aa TT\vij 

Ol. Lavandulae, ^xl. 

Tinct. Cantharidis, . . . . %]. 

Aq. Ammoniae, 5jij. 

Alcoholis, . . . q. s. ad Oj. 
M. Sig. — Hair Tonic. 



Hay-Fever. 

Arsenic, especially valuable when disease is more of catarrhal than of asth- 
matic type, 3-minim doses of liquor arsenicalis (Makenzie) ; as cigarettes, 2 
or 3 daily (see Asthma for formula) (B.). Belladonna, when nasal secretion is 
very profuse (B.). Euphrasia, of decided benefit for the catarrhal symptoms 
(Pf.). Quinine, very useful after the more acute symptoms have subsided (R.) ; 
injected into the nares checks catarrhal discharge and spasmodic symptoms 
(P.) ; a solution of the hydrochlorate, gr. iv-viij ad ^j aquae, applied locally to 
nasal mucous membrane by a spray-producer or a brush, will arrest the disease 
if confined to the nares and fauces (B.). Ipecacuanha, in hay-asthma (R.); 
is of great value, though the smallest closes cause similar effects (P.). Aconite 
is better than arsenic in true hay-fever (R.) ; has been used with the best results 
(P.). Grindelia benefits cases of asthmatic type (B.). Iodides are very ser- 
viceable, locally and internally ; large doses until some iodism observed, may 
be combined with arsenic (B.). Opium, especially as morphine, of great value 
in any stage, but great danger of the opium-habit (B.) ; the tincture in doses of 
rr\jj-iij every 2 hours for three doses, then try every 2 hours until the discharge 
abates, his given excellent result's (Wa.). Black Coffee is highly recommended 
(P.). Cocaine, a 5 to 20 per cent, solution of the hydrochlorate, brushed over 
the nasal mucous membrane after drying it as far as possible, is the most effi- 
cient palliative yet obtained (R.) ; a 4 per cent, solution dropped from a medi- 
cine-dropper well into anterior nares, the head being thrown well backward, or 



5?4 



HEADACHE, BILIOUS-SICK. 



sprayed up the nostrils from a small atomizer ; gives immediate relief, and 
though not curative it prevents so much suffering and distress that in no case 
should it be left untried (Da Costa). Ignatia, the tincture has seemed to benefit 
some cases, and to favorably influence the course of the disorder (Da C). 
Lobelia, has been found an efficient remedy (Wa.). Tobacco, smoking helps 
some and aggravates the symptoms in other instances. Internally ad nauseam 
it helps, but there are better and safer remedies (Wa.). Removal to the sea- 
coast, or a barren, mountainous district, gives the only relief to some sub- 
jects ; though many of the worst cases, hitherto unaffected by medicine, are 
now relieved by the local application of Cocaine. [Compare Asthma, 
Catarrh, Conjunctivitis, Influenza.] 



For Internal Use. 



Prescriptions. 



R 



. Potassii Iodidi, %]. 

Liq. Potass. Arsenit., . . . gj. 

Aquae Cinnam., Ji y - 

M. Sig. — Teasp. every 4 hours. 



R. Ext. Hyoscyami, gr. xij. 

Potassii Iodidi, ..... ^j. 

Potassii Bicarb., ^ij. 

Ext. Glycyrrhizae Pur., . . %iv. 

Aq. Anisi ^ivss. 

M. Sig. — Dessertsp. every 4 hours until 
relieved. ( Weber.) 



R. 



Liq. Potassii Arsenit., . . £]. 

Tinct. Belladonna, . . . . gij. 
M. Sig. — 5 to 10 drops after meals, as 
prophylactic. 



R. Tinct. Euphrasiae, .... £jss. 
Aq. Camphorae, . . . . ad Jij. 
M. Sig. — Teasp. four times daily, for 
the catarrh. 



For Local Use. 



R. 



Tinct. Iodi, gj. 

Ac. Carbol., gtt. x. 

Aq. Destill., Sjiv. 

M. Sig. — For local use with atomizer 
or post-nasal syringe. 



R. Menthol, %]. 

Ac. Carbol., gss. 

Zinci Oxidi, %). 

01. Amygd. Dulcis, . . . ,^jss. 

Cerati Simplicis, Jij. 

M. Sig. — Apply thoroughly to the nos- 
trils every few hours. 



R. Quininae Bisulph., .... ^iij. 

Aquae, . . ^iv. 

M., Sig. — Irrigate the nares, after 
cleansing with a weak alkaline solution. 



R. Cocainse Hydrochlor., . . gr. vj. 
Aquae Destill., . . . . . . gij. 

M. Sig. — 5 per cent, solution. A few 
drops to be instilled into nares while head 
is lowered. (Da Costa.) 



Headache, Bilious-sick. 

Antipyrine, the most valuable single remedy for headaches ; an 8-grain dose 
in dyspeptic headache, in a little water, at commencement of attack, the 
patient lying down in a dark room. A second dose one hour after is generally 
enough, but a third or fourth may be required. Sleep generally follows, and 
there are no unpleasant after-effects. Acetanilide, in 4-gr. dose, equally effec- 
tive. Nux Vomica, gtt. j of tinct. frequently, when acute gastric catarrh, with 
headache and nausea (R.) ; gtt. j every 10 minutes, soon after meals, often 
gives marked relief in sick-headache not of neurotic origin (A. A. Smith). 
Strychnine, with aloin and belladonna, in minute granules, for bilious head- 
ache from obstinate constipation, effective if given several times a day for a 
week or ten days (Roy). Belladonna, the extract in doses of gr. ^V-rV» in 
similar form. Iris, blinding headache in right supraorbital region, nausea, 
vomiting, usually the result of hepatic derangement. rr\j every half-hour for 
three doses. Usually relieves promptly (Pf.)- Bryonia, ordinary bilious with 
vomiting (P.). Picrotoxin, gr. ^ by stomach, in periodical form (B.). Cha- 
momile, a popular remedy (R.). Podophyllum, in sick headache, with dark, 



HEADACHE, CONGESTIVE. 



585 



bilious diarrhoea, or constipation with dark motions (R.). Sanguinaria, when 
due to stomach derangement, a few doses relieve (P.). Hydrastis, from con- 
stipated bowels (P.). Mercury, as "blue pill," to prevent or mitigate; or, 
gr. y^o of bichloride when with light-colored diarrhoea (R.). Ammonium 
Chloride is an efficient remedy in most forms of headache (Wa.). Sodium 
Phosphate, a useful laxative in so-called "bilious-sick headache" (B.). Po- 
tassium Bromide, a large dose in ordinary or sick-headaches (R.). Ginger, 
in paste, as counter-irritant (P.). Water, as cold or hot affusion, or ice-bag 
to head ; hot sometimes best. The purgative waters (as Friedrichshall) before 
breakfast in a cup of hot water (R.) ; a brisk saline purgative, or small doses 
of Epsom salts thrice daily, very effectual for frontal headache with constipa- 
tion (Br.). Nitro-muriatic Acid, 10 drops of the dilute acid in a winegl. of 
water, before each meal, often an effectual remedy (Br.). Charcoal, two tea- 
spoonfuls stirred in half-glass of water, as a draught, is an efficient remedy 
for sick- headache with sour stomach and flatulence, etc. [Compare Hemi- 

CRANIA.J 

Prescriptions. 



li. Ammonii Chloridi, .... giij. 

Morphinae Acetatis, . . . gr. j. 

Caffeinae Citratis, 3 ss. 

Spt. Ammonii Aromat., . . gj. 

Elix. Guaranae, ,l^ v * 

Aquae Rosae, t ^iv. 

M. Sig. — Dessertsp. every quarter-hour 
until relieved. {Carpenter.) 



R- . Podophvlli Resinae, . . . gr. ij. 
Tinct. Zingiberis, . . . . £ij. 

Alcoholis q. s. ad %]. 

M. Sig. — Teasp. in a winegl. of water 
every night at bed-time, or every second, 
third or fourth night as required. 

(Dobell.) 



Headache, Congestive. 

Aconite, to reduce the circulation (R.). Veratrum Viride, at menstrual 
periods (R.). Belladonna, relieves cerebral congestion, and distress from light 
and sound (P ) : pain over brows and in eyeballs — often due to stomach or 
uterine derangements — especially in young women ; rr\jij of tinct. every three 
hours (R.)- Potassium Bromide, a large dose (gr. xv-xx) in ordinary or sick- 
headaches (R.) ; Bromides are useful when nervous system has been irritated, 
but when exhausted they do harm (Hammond). Calomel, gr. -^, every hour 
for ten or twelve doses, will relieve the headache of syphilis occurring at night 
(Tr.). Cannabis Indica is given with uniformly good results in the headache 
of the climacteric. Potassium Iodide, throbbing, intolerance of light, pain 
passing from back of neck over vertex to brow, nocturnal, tender scalp, almost 
unbearable ; ten-grain doses ter die will cure (R.). Hydrastis, when consti- 
pated bowels (P.). Amyl Nitrite, for headaches with severe flushing heats at 
menstruation or climacteric, "HVjo a sufficient dose (R.). Mustard, in hot foot- 
bath, or as poultice to nape of neck in various forms of headache (R.). Water, 
cold water poured gently over forehead, sometimes warm water better (R.). A 
very hot foot-bath often effectually relieves (Wa.). Purgatives are often bene- 
ficial, especially when congestive headache arises from suppression of hemor- 
rhoidal discharge, or in persons of phlegmatic habit; aloes best (Wa.) ; or 
colocynth, as derivative, when cerebral hyperaemia (Da Costa). 



Prescriptions. 



R- . Ext. Colocynthidis Co., . . gr. xij. 

Pulv. Capsici, gr. iv. 

Ext. Gentianae, gr. xxiv. 

Ft. pil. no. xij. Sig. — One pill thrice 
daily. Also a 25-grain dose of Sodium 
Bromide every night at bedtime. 

{Da Costa.) 



R- . Spt. Ammoniae, t fj. 

Spt. Camphorae, % ss. 

M. Sig. — For a quart of water in which 
a handful of common salt has been dis- 
solved. Cork tightly and use locally on 
lint as an evaporating lotion. 



586 



HEADACHE, NERVOUS. 



Headache, Nervous. 

Cannabis Indica, ten-minim doses of the tincture thrice daily in the intervals, 
often curative in bad cases of neuralgic headache; or ^ to ^-grain doses of 
the extract (P.). See under Hemicrania. Belladonna, n\jij of tinct. every 
3 hours, when pain over brows and in eyeballs, especially when at men- 
strual periods ; also when from over-study or fatigue (R.). Nux Vomica, if with 
gastric symptoms (R.) ; is better than strychnine, and should be given in quarter- 
grain doses of the extract after meals, combined with iron and quinine if patient 
is chlorotic (Hammond). Bromides, when the nervous system has been irritated 
are useful, but harmful when it is exhausted (Hammond). Silver Nitrate, half- 
grain doses with minute doses of pil. coloc. comp., invaluable in headaches of 
hysterical women and especially stomach headaches of delicate and literary 
men (Wa.). Ignatia, removes clavus hystericus (Pf.). Ammonia, the aromatic 
spirits (3ss-^ij ) or the carbonate (gr. v-x) in nervous headache (B.) ; the hydro- 
chlorate (gr. x-xx) in bilious and hysterical headaches, especially in hard-worked 
and delicate young women (Wa.). Amyl Nitrite, inhaled when extreme pallor 
of face (B.). Arsenic, throbbing supra-orbital (R.) ; as a nerve tonic stands 
next in value to Zinc (Hammond). Cimicifuga, in nervous or hysterical women, 
especially at menstrual periods (R.); in rheumatic headaches and menstrual 
(P.). Coffee and Tea, when from nervousness or exhaustion (R.) ; coffee espe- 
cially useful (P.). Guarana, a very effective palliative, gr. xx every half-hour 
for three doses (P.) ; rr\,xv of the fluid extract every quarter-hour increased to 
rr\,xl will often relieve periodical headaches not of malarial origin (A. A. Smith). 
Sodium Salicylate, in small doses, gr. ij-iij every quarter-hour, is very efficient 
in neuralgic headache (Br.). Caffeine Citrate, two-grain doses, in capsule, every 
half-hour, a very effectual remedy for nervous and sick-headache, but causes 
insomnia if used in the evening. Phosphorus, as dilute phosphoric acid, in 
doses of rtvxxx well diluted, thrice daily ; or zinc phosphide, gr. -^ in pill, ter 
die. very useful in most forms of nervous headache (Hammond). Cajuput Oil, 
well rubbed in twice daily (P.). Menthol, locally to forehead in frontal head- 
ache (Wa.). Potassium Cyanide, locally in reflex headaches, as gastric, cardiac, 
pulmonary, menstrual (B.). Valerian is of great value in excitable persons 
(P.). Camphor, a saturated solution in eau-de-cologne rubbed on head, when of 
uterine origin (R.) ; in hysterical females, internally, with magnesium carbonate 
(P.). Podophyllum, purgative doses often give relief when near menstrual 
periods, with constipation and dark stools (R.). Zinc Oxide, two- to five-gr. 
doses useful (R.) ; a remedy of great value (Hammond). Bismuth, the sub- 
carbonate, in two-grain doses after each meal, often better than zinc, especially 
where gastric disturbance (Hammond). Ether Spray, for frontal headache, 
after acute illness or fatigue (R.). Chloroform, rr^xv-xxx of the spirit internally, 
often effective (Wa.). Galvanism, sometimes valuable ; the constant current 
always, avoiding too great intensity lest amaurosis ensue (Hammond). [Com- 
pare Hemicrania, Neuralgia.] 



Prescriptions. 



R. Potassii Cyanidi, gr. x— xx. 

Aquae Laurocerasi, . . . . ^ iv. 
M. Sig. — Apply locally on a compress 
for ^ to l / 2 an hour. (B.) 



• gr- nj. 
. gr. x. 



R. Zinci Pho-phidi, . . 
Ext. Nucis Vom., . , 
Confect. Rosoe, q. s. 
M. et div. in pil. no xxx. 
Sig. — One pill after each meal. 

{Fordyce Barker.) 



R . Extracti Nucis Vom., . . . gr. iij. 

Ferri Reducti, gr. xij. 

Quininae Sulphatis, .... gr. vj. 
Ft. pil no. xij. Sig. — One after each 
meal. {Hammond.) 



R 



Ext. Cann. Ind. Fl., . . . Sjss. 

Pulv. Acaciae, £v. 

Syr. Aurantii Cort., . . . 5|ij. 

Aquae, q. s. ad Jyj. 

M. Sig. — Teasp. every 3 hours. 



HEART DISEASES. 587 

Heart Diseases. 

Aconite, in the highest degree serviceable to diminish excitement or irrita- 
bility. It is more a remedy for functional derangement than for organic disease 
(Wa.). In pericarditis (R.). Nervous palpitations and hypertrophy (P., B.). 
The heart seldom affected in rheumatic fever if aconite be used from the start 
(P.). Veratrum Viride, as cardiac depressant (B.); in chronic cardiac diseases 
where excessive hypertrophy, i. e., when digitalis is contraindicated (W.). Cimi- 
cifuga, safer than digitalis in fatty heart (B.). Its action is strongly stimulating 
and tonic; it relieves excessive dyspnoea when weak heart (P.). Caffeine, an 
excellent cardiac stimulant, and diuretic, gr. ij-v of the citrate every three hours 
(Da C). Arsenic, for dyspnoea from weak heart (R.) ; in all cardiac neuroses 
it is especially valuable when combined with iron and strychnine, and is 
regarded as indispensable in all forms of weak heart accompanied by pain 
(Wa.). Digitalis, acts as a stimulant tonic (P.) ; small doses of sedative action ; 
tonic or physiological doses to create hypertrophy in dilatation (Tr.) ; irregularity 
of pulse is best indication (R.). Irritable heart (Da Costa). The tincture, given 
without water, is the best preparation ; especially indicated in weak heart acting 
rapidly because of its weakness, and in valvular disease (Wa.). Convallaria 
Majalis, will usually succeed in all cases in which digitalis is useful, acting 
similarly to that drug, but with less reliability ; is useful in aortic disease and in 
others where digitalis cannot be used(Wa.); valuable in all forms of heart 
disease where there is oedema of tissues (See). Potassium Iodide, the true 
remedy for the heart ; especially applicable in non-compensatory mitral or 
myocardial diseases, and where there is cardiac debility ; restoring energy and 
vascular tension at first, then by dilating, later on, all the arterioles, it frees the 
heart from resistance, and enables it to recover its contractile power, also dilat- 
ing the coronary arteries furnishes nutrition to the heart itself (See). Strych- 
nine, in medicinal doses, said to strengthen heart-beats (R.). Blisters, flying, 
over precordial region, to stimulate action in extreme weakness (R.). Alcohol, 
brandy when heart suddenly enfeebled by fright, loss of blood, etc. (R.). Ether, 
ttlxx hypodermically, repeated soon, is a very promptly-acting stimulant in 
sudden heart-failure. The compound spirit in Z] doses for less urgent cases. 
Morphine, next to Digitalis, is in general the most indispensable remedy in the 
treatment of severe heart disease, being by far the most efficient agent for the 
dyspnoea (Striimpell), hypodermically, is employed in many cardiac disorders 
with marked advantage, especially in dyspnoea and angina with diseased 
coronary arteries ; mitral regurgitation, with its dyspnoea and insomnia ; aortic 
disease, etc. ' Iron, useful in various forms, especially anaemic disorders and 
palpitation. Also in dilatation and fatty heart, and mitral regurgitation (B.). 
Hyoscyamus, in functional derangement from emotion, is specially indicated ; 
requires large doses (ir^xl-lx), or gr. ^ of hyoscyaminse sulph. hypodermically 
(Wa.). Amyl Nitrite relieves heart-pains resisting all other treatment (W.). 
[Compare Angina Pectoris, Dropsy, Endocarditis, and the. five following 
articles.] 

Prescriptions.. 



Be. Ext.Ergotas Fl., f, iijss. 

Tinct. Digitalis, ^ ss. 

M. Sig. — Teasp. thrice daily in enlarged 
heart without valvular lesion. 



R- . Spt. Athens Comp., 
Liq. Morphinse Sulph. 

(U. S. P., 1870), . aa gj. 
M. Sig. — Teasp. as required for the 
dyspnoea. 



Heart, Dilated. 

Digitalis, where much dilatation, and hypertrophy of left ventricle without 
valvular disease. Is not contraindicated when aortic disease (R.) ; physiologi- 
cal doses (Tr.). In simple dilatation gives most favorable results (W.). Very 
useful in mitral disease, with dilatation of the left ventricle (P.) ; gives miracu- 
lous relief, is not sufficiently appreciated, but requires skilful administration. 



588 HEART, FATTY — PALPITATION. 

Use the infusion in preference to other preparations, a tablespoonful thrice daily, 
watching its effects (Da Costa). Scoparius, the infusion (broom-tea), to main- 
tain the kidney action if digitalis is not sufficient (Da C). Purgation, brisk, 
free, watery stools next to digitalis are the best treatment (Da C). Morphine, 
hypoderm. gr. %-% two or three times a week in dilated heart with dyspnoea 
(B.). Amyl Nitrite, dyspnoea from dilatation (R.) ; is useful when great dysp- 
noea (cardiac asthma) (P.). Ether, the compound spirit an excellent remedy for 
the dyspnoea (Da Costa). Mercury, a classical pill and'a very efficient one as 
a diuretic in dropsy from cardiac disease is the combination of gr. j each of 
Pulv. Digitalis, Pulv. Scillae and Hydrarg. cum Creta (B. Foster). 



Heart, Fatty. 

Iron, the tinct. ferri perchlor. in small doses for a long time, has been of 
remarkable T benefit(Wa.). Cimicifuga, safer than digitalis (B.) ; the latter should 
not be used ( Wa.). Digitalis of no value except for very temporary use and for 
some special indication (Da Costa). Strychnine, often the first remedy to do 
good. Unduly pushed will produce nervous worry and be injurious (P.) ; is the 
remedy with iron, nourishing but not fat-making diet, and wine to keep up the 
tone of the blood (Da C). Ergot, occasional doses have been given with appa- 
rent benefit (Wa.). Ether, the compound spirit for sudden attacks of pain or 
dyspnoea (Da C). Amyl Nitrite, for the same, but chloral must be entirely 
debarred (Da C). Stimulants, freely, in an acute attack of any kind, give the 
only chance (Da C). 

Heart, Hypertrophied. 

Aconite, often better than digitalis (R.) ; dangerous in hypertrophy of left side, 
with diseased valves, but useful in simple hypertrophy (P.); for over-action, with 
hypertrophy (B.) : the one remedy which can be depended on. Small doses for 
months, say gtt. j of a good tincture ter die, to lower the heart gradually and 
keep it low (Da Costa). Digitalis, very useful in pure hypertrophy due to val- 
vular disease or excessive muscular exertion (R.). The primary action (small 
doses) required, as it creates hypertrophy when given in physiological or tonic 
doses (Tr.). Veratrum Viride, as a cardiac depressant (gtt. v ter die) will 
relieve in simple hypertrophy, and irritable heart from abuse of tobacco, inad- 
missible when valvular lesions exist (B.) ; gives the best resuks, next after 
aconite (Da C). Lead Acetate, for violent palpitations, in some instances 
(Wa.). Amyl Nitrite, in dyspnoea, syncope (R.). Ergot, in enlarged heart 
without valvular lesion ; may be combined with digitalis (B.). Potassium 
Iodide, small doses long continued, benefit some cases (Wa.). Camphor, in 
doses of gr. iij-xij daily for tumultuous palpitations, and dyspnoea of hyper- 
trophy with dilatation (Wa.). Iron is necessary where anaemia exists (DaC). 
Quiet Life of great importance, no stair-climbing, no long walks ; rest in bed 
often of service for days at a time, moderate diet, avoiding fattening foods, 
meat, and stimulants (Da C). 



Heart, Palpitation. 

Aconite, for " fluttering" of nervous persons, and nervous palpitations (R.) ; 
for over-action, with hypertrophy (B.) ; for palpitation with simple hypertrophy 
(P.). Hydrocyanic Acid, when from dyspepsia (P.). Iron, when due to anae- 
mia, a very frequent cause. Other causes are tobacco, coffee, tea, etc., to excess, 
dyspepsia, venery, excessive exercise (Da C). Spigelia Anthelmia, when due 
to mitral and aortic disease, with much dyspnoea (P.). Digitalis, in small doses 
as sedative (Tr.) ; combined with iron in palpitations with valvular disease, or 
alone in very severe cases (Wa.) ; suits a large number of cases, especially for 
temporary purposes (Da C.) ; the only remedy for positive service for the actual 



HEART, VALVULAR DISEASE — HECTIC FEVER. 



589 



palpitation (Richardson). Camphor, recommended in nervous palpitations 
(R.). Veratrine, as ointment to chest, when rapid, irregular pulse, hurried 
breathing, dropsy and lividity, palpiiation, inability to lie down (R.). Nux 
Vomica, of great value in nervous palpitation. Bromides, in "fluttering" 
heart (B.) ; are useful when tolerated by the stomach (Da C). Hyoscyamus, 
in nervous, and violent palpitations from excited state of the brain (P.) ; in 
large doses, for functional disturbance arising from emotion (Wa.). Belladonna, 
in small doses, may also be applied externally, when irregularity of rhythm 
(Da C). Valerian, nervous, with dyspnoea (P.). Eucalyptus, palpitation and 
weak heart (B.). Galvanization, of cervical sympathetic and pneumogastric, 
for palpitation (B.). Hot Foot-Bath relieves palpitations (R.). Milk-cure, 
has been beneficial in irregular action (B.). Ice, to the cardiac region, has 
benefited many cases; is of chief value when patient can be kept in bed, 
which sometimes becomes necessary (Da C). 



Prescriptions. 



B 



Pulv. Digitalis, gr. xx. 

Pulv. Colchici Sem., . . . gr. xl. 

Sodii Bicarb., gr. lx. 

M. et div. in chart, no. xl. Sig. — One 
powder at first 3 or 4 times daily, gradually 
reduced to one at bedtime. For irregular 
cardiac action. {Boivditck.) 



&. Tinct. Digitalis, ^ij. 

Spt. Etheris Nitrosi, . . . %]. 
Liq. Ammonii Acet., . ad 3 iv. 
M. Sig. — A dessertsp. every 4 hours. 
If prolonged insomnia with palpitation add 
of Morph. Sulph. gr. T X g to each dose. 

{Richardson.} 



Heart, Valvular Disease. 

Digitalis, in aortic regurgitation (R.) ; most effective in mitral insufficiency 
(P.) ; in rapid action with low arterial tension ; and in mitral disease. Infusion 
best ; tablesp. doses twice daily (B.) ; rt\j of tinct. every yi hour or hour, often 
gives more relief than larger doses (A. A. Smith) ; when heart is weak and 
struggling (Da Costa). Morphine, hypodermically for dyspnoea, better in mitral 
than in aortic disease (R.) ; the agent above all others in aortic insufficiency, 
combating the two great symptoms therein, the cerebral anaemia and the dysp- 
noea ; is to aortic regurgitation what digitalis is to mitral (Dujardin-Beau- 
metz). Aconite, useful for the palpitation, but dangerous in hypertrophy of left 
side with diseased valves (P) ; for cases presenting excessive growth and strong 
action, diminishes the blood-pressure in the arterial system, and gives great 
relief (Da C). Veratrum Viride, has similar applicability, but is more apt to nau- 
seate. An admirable sedative, and one which does not sicken is a mixture of 
Tinct. Aconiti,rr\j, Tinct. Verat. Vir., "rr^iij, Tinct. Zingib., rr\,vij (DaC). Stro- 
phanthus, is a cardiac tonic like Digitalis, but does not contract the vessels 
nearly as much (Br.). Nitroglycerin, is the best of all remedies when actual 
cardiac pain ; it lessens blood-pressure and diminishes the resistance the heart 
has to overcome (Da C). Caffeine, as a tonic and diuretic, of especial value 
in cases where urine is scanty, with cardiac pains, headache and dyspnoea, and 
weak heart; gr. ij of the citrate every three hours (Da C). Adonidine, in doses 
of gr. T X o to i thrice daily, acts excellently as a cardiac regulator (Da C). 
Barium Chloride, gr ^ in pill three or four times daily, is diuretic, lessens 
cardiac pain, increases tone in the vessels, and is a good general and cardiac 
tonic (Da C). Purging, with Jalap, etc., in engorgement of right side' of 
heart (R.) ; occasionally purging (Da C). Treatment is directed chiefly to the 
dilatation or hypertrophy resulting from 'the valvular disease. The simplest 
rule is to use judgment as to when the heart needs strengthening by Digitalis 
or reducing by Aconite or by Veratrum Viride (Da C). [Compare Endocar- 
ditis.] 

Hectic Fever. 

Quinine, large doses, gr. xv-xx daily, if stomach and intestines don't rebel 
(P.) ; given before the paroxysm, to limit it (Roberts). Antipyrine, is better 
than quinine, but must be used in much smaller dosage than ordinarily employed, 
say gr. iv or v about ^ hour before fever rises, then doses of gr. ij hourly as 
long as temp, remains above 100. 5 . This daily, will give excellent results in 



59Q 



HEMATEMESIS HEMATOCELE. 



hectic of phthisis (Pribram). Aconite in small doses, a remedy of much value 
in the irritative fever of phthisis (Da C). Morphine and other anodynes, are of 
especial value, given in full doses toward bed-time (Gross). Prunus Virginiana, 
the bark has been found useful, especially when irritable cough (P.). Calcium 
Phosphate, is especially useful (R.). Calumba, excellent for tonic effects (P.). 
Digitalis, the tincture, combined with tinct. ferri chloridi, abates the tempera- 
ture and diminishes the sweats (B.). Iron, the mistura ferri composita has 
obtained great celebrity, especially when much debility and anaemia (Wa.) ; the 
sulphate and tincture of the chloride of especial value in the treatment of hectic 
(Gross). Ipecacuanha. A few grains of Dover's powder at bed-time, will stop 
the profuse perspirations (Wa.). Salicin, for profuse perspirations (Wa.) ; as 
antipyretic. [Compare Perspiration, Phthisis.] 



Prescriptions. 



R. Tinct. Digitalis, 3 iij . 

Tinct. Ferri Chlor., . . . . 3 v. 
M. Sig. — 15 drops 3 or 4 times a day. 



R. Quininse Sulph., 3J SS - 

Elix. Taraxaci, ^iv. 

M. Sig. — Teaspoonful every hour for 
six hours. 



Hematemesis. 

Ipecacuanha, is decidedly effective in small doses, also when hematemesis 
is vicarious of menstruation (P., Wa.). Hamamelis, tt\J— ij of tinct. every 2 or 
3 hours (R.) ; effective from its tannin (B.). Alum, serviceable in passive hem- 
orrhage ; iron better (B.). Turpentine, especially in passive hemorrhage 
with debility (R.) ; and in hemorrnagic transudations on the free mucous sur- 
faces — hematemesis, etc. (B.). Ergot, has often cured when other means failed 
(P.) ; most valuable. In urgent cases ergotine in 2- to 5-gr. doses hypodermi- 
cally (R.). Iron, the subsulphate (Monsel's solution) or pernitrate, the best 
remedies ; gtt. j-ij frequently, diluted with ice-water (B.). Lead Acetate, espe- 
cially in gastric ulcer, gr. ss-gr. v (B.). Tannic Acid, gr. x-^j, when from 
gastric ulcer or obstructive disease of liver (B.). Gallic Acid, an extremely useful 
agent ; is best used in combination with dilute sulphuric acid (Wa.). Ice, small 
pieces swallowed, a most useful agent, with perfect rest for stomach; when 
hematemesis from that organ, nutrient enemata must be employed. Iced cham- 
pagne to arrest faintness, if persistent ; when moderate need not give cause for 
alarm. 



R- . Olei Terebinth., 3 iij. 

Ext. Digitalis Fluid., . . . gj. 

Mucil. Acacise, J ss. 

Aq. Menth. Pip., ^j. 

M. Sig. — Teasp. every 3 hours. 



Prescriptions. 



Ac. Gallici, . . . . 

Ext. Ergotse Aquosi, 

Digitalis, .... 

M. et div. in pil. no. 

every 4 hours. 



z\> 



aa gr. xx. 
Sig. — One 



Hematocele, Pelvic. 

Opium, or morphine, if needed for pain, with absolute rest in bed, and a 
moderately tight abdominal bandage (E.). Hemostatics, as gallic acid, lead, 
turpentine, etc., to arrest the hemorrhage, if it still be going on, combined with 
opiates, and the use of ice-bags or cold lotions to the abdomen or per vaginam. 
Tonics, as iron and quinine, while resolution of the extravasation is going on. 
Bromides and Iodides, to quiet the action of the ovaries, if the hemorrhage 
recurs at different periods. Potassium Iodide, as an absorbent, may be given 
with quinine (Braxton Hicks). Iodized Cotton, an excellent application to the 
cervix uteri in cases of hematocele ( Wa.). Leeches, should be applied early 
in cases of peri-uterine hematocele ; later, except to check inflammation, they 
are inadmissible (Wa.). Mercury, gr. fa of the bichloride thrice daily, with 
iron and ergot, conjoined with vaginal injections of hot water morning and 



HEMATURIA HEMERALOPIA. 



591 



evening ; later in lieu of the mercurial the syrup of the iodide of iron in 20- 
drop doses thrice daily,, was thoroughly efficient treatment in one very bad case of 
retro-uterine hematocele (Hengst). Surgical interference has many advocates, 
but is criminal in a large majority of the cases (E.). If the case does not end 
in resolution it will terminate in pelvic abscess. 



Prescription. 



R. Iodi., gj. 

Poiassii Iodidi, 51J. 

Glycerini, 5 viij. 



Mix and saturate 8 oz. of cotton with the 
mixture; then carefully dry, and label 
" Iodized Cotton." 



Hematuria. 

Turpentine, when with constitutional debility (B.) ; in very small doses (R.) ; 
often is very efficacious (P.). [See ante, Hematemesis, for formula.] Hama- 
melis, has arrested severe cases (R.). Chimaphila, controls hematuria (P.). 
Gallic Acid, the most uniformly successful remedy (B.) ; gr. x-xx every 
hour or two (Da Costa). Sulphuric Acid, alone or with gallic acid, is an 
efficient remedy (Da C). Acetic Acid, in a case of alarming hemorrhage 
from the bladder, which occurred after an operation for vesico-vaginal fistula, 
and resisted all other means, an injection of apple-vinegar and ice-water, 
equal parts, succeeded in arresting it (Ghent). Quinine, large doses necessary; 
cures when intermittent or from malarial infection (B.) ; useful in some cases 
of intermittent hematuria (R.). Iron. Tinctura ferri perchlor., tt^x-xx several 
times daily ; in this affection the best form of iron for intern al use (Wa. ) . Ipeca- 
cuanha, exercises a powerful influence (Wa.). [See a?ite, Hematemesis.] Ergot, 
by stomach or subcutaneously ; may be combined with ipecac, krameria, or 
other astringents (B.). Ergotine, hypodermically, is far superior for efficacy 
and rapidity of operation (Wa.). Matico, the infusion, in doses of §ij every 2 
or 3 hours, is fully equal to gallic acid, lead, etc. (Thompson). Ammonium 
Benzoate, in 5-grain doses, for the albuminuria and hematuria of scarlatina 
(Hillier). Cannabis Indica, is especially indicated in dysuria and strangury 
when there is bloody urine (R.). Camphor, in 2 to 5-grain doses is said to 
promptly remove the renal hyperaemia with bloody, coagulable urine, caused 
by cantharis, turpentine, oil of mustard, copaiba, etc. (R.). Ice in rectum or to 
perineum, for vesical hemorrhage (Thompson). 



Prescriptions. 



R • Acidi Gallici, ^ss. 

Ac. Sulphurici Dil., . . . 3J. 

Tr. Opii Deodor., . . . . ^j. 

Infusi Digitalis, §i v - 

M. Sig. — Tablesp. every 4 hours or 
oftener. In hematuria, menorrhagia, pur- 
pura hemorrhagica, and the hemorrhagic 
diathesis. (D.) 



B 



. Ext. Ergotae Fluidi, 

Tine. Krameriae, . . 
M. Sig. — A teasp. every hour or two. 



I* 



R. Ext. Ergotse (Squibb), . . £j. 

Aquae, Jj. 

M. Sig. — For hypodermic use; Y([\ 
contain gr. j. 



Hemeralopia and Nyctalopia. 

Strychnine, night-blindness ; small doses, gradually increased, of service 
(Wa.). Mercury, Hydrarg. chlor. corr. gr. ij ad aquae %), dropped into the eye 
twice daily, with blister on each temple, and mild aperients, cured hemeralopia 
(Smith). Quinine, in as large doses as can be borne, after cathartic and emetic, 
for night and day-blindness (Howard). Blisters, small, \yi inches in diameter, 
close to external canthus of the eye (Bampfield). Electricity, occasionally 
useful (Wa.). Rest, protection of eyes trom bright light, constitutional reme- 
dies, as indicated by state of general health, change of climate, speedily cures 
hemeralopia. It is sometimes merely a symptom of pigmentary degeneration 
of the retina, or a feature of scurvy. 



592 HEMICRANIA. 

Hemicrania. 

Belladonna, when due to vaso-motor spasm, the face feeing pallid (B.) ; the 
tincture in small and repeated doses if the disease be of reflex character (H.). 
Iris, in blinding form, from hepatic trouble, right supra-orbital region ; Try 
every half-hour for 3 doses, usually relieves promptly (Pf.). Cannabis Indica, 
one of the most valuable remedies for megrim or sick headache, apparently 
acting on the nervous centre whence the disorder springs ; is most useful in 
the intervals to prevent the attacks, and especially when the paroxysms are 
becoming more frequent ; it may be combined in pill with either iron or aloes 
(K.) ; in the congestive form of especial value, the tincture in repeated doses 
until physiological action is induced (H.) ; gr. % of the extract before each 
meal, increased gradually to yi or % grain, in the intervals, kept up for 3 
months (Seguin) ; gr. x /% of the solid extract night and morning, very efficient 
in migraine, if used continuously for some time (Hare). Camphor, gr. iij-v, 
with xx or xxx-grain dose of magnesic carbonate, is very useful, especially in 
hysterical females (P.). Croton-chloral, in milder forms without severe vomit- 
ing, headache being predominant ; the bromides are useful after it (R.) ; rarely 
of any use, but if given it should be in 20-grain doses twice daily (H.) ; Gua- 
rana, is useful (B.), a very effective palliative ; gr. xx every ^ hour, for three 
hours (P.) ; efficacy diminishes by degrees, attacks usually become longer (Tr.) ; 
gij of fluid extract in course of an hour or two, to anticipate the attack when 
expected (Seguin). Caffeine, in typical migraine ; gr. j ad rri^xxv-xxx aquse 
hypodermically (P.) ; is especially adapted when chronic gastric catarrh, gr. j 
every yi hour (B.). The citrate in grain doses every hour for some time before 
a paroxysm (Wa.) ; gr. j every yi hour often gives marked relief (A. A. Smith). 
Valerian, of especial value when in excitable temperaments; after profuse or 
painful menstruation (P.). Ammonium Chloride, is exceptionally serviceable ; 
seldom fails to cut short an attack (Austin), x-xv gr. doses (B., R.) ; as a diffu- 
sible stimulant is very efficient, gr. xx up to Z) every hour during the attack 
(H.). Sodium Chloride, in small doses, proved very efficient in six positive 
cases attended by gastric distress (Rabon). Antipyrine, the most valuable 
single remedy for headache, especially in migraine and those cases of it for 
which Ergot and Amyl Nitrite are indicated. 5 grains at beginning of the attack 
often sufficient (Birdsall) ; of great value in true migraine, employed in twenty 
cases with unfailing benefit; less useful in the malarial or dyspeptic forms, and 
useless in ursemic (Thompson) ; one dose of gr. xx, or 2 doses of gr. x each, 
x / 2 hour apart, given in the prodromal period, or at the very beginning of a 
paroxysm, will invariably cut it short within an hour (Sprimon, Ungar, etc.). 
Phenacetine, has been given with great benefit, in doses of 2 grains with 12 
grains of Caffeine citrate, for migraine. Podophyllin or Mercury, bilious origin 
(R.). Bromides, for true migraine. Raspail's eau sedative locally, gives great 
relief (B.). When due to uterine disorder (R.). Potassium Bromide, very ser- 
viceable in the paroxysm, also in continuous form (R.). Eucalyptus, in cere- 
bral anaemia (B.). Digitalin, granules (g 1 ^ bis die), for congestive hemicrania 
(B.). Ergot, if due to miliary aneurisms of intercranial arterioles ; also in con- 
gestive migraine, and in nearly all kinds (B.). Menthol, locally in frontal 
headache due to migraine, is said to be very efficient (Wa.). [See formula 
below.] Piscidia, is highly recommended (Wa.) ; efficient in doses of 3 ij of 
the fluid extract (Ford). Arsenic, for cerebral congestion and hemicrania (B.) ; 
for throbbing pain in one brow (R.) ; often has the best effect. Watson believed 
that gtt. iv-vj of liq. arsenic, 3 or 4 times a day, with due attention to the bowels, 
would cure 9 out of every 10 cases (Wa.). Aconitine or Veratrine, ointment, 
over brow(R.); Aconitine is of great service internally (Seguin). Phosphorus, 
is strongly recommended (R.). Amyl Nitrite, by inhalation, in migraine, with 
pallor of face (B., R.). Sanguinaria, a few doses very successful, when m. due 
to stomach derangement (P.). Ignatia, removes clavus hystericus (Pf.). Nux 
Vomica, when of gastric origin (R.). Cimicifuga, is strongly recommended 
(P.). Rubber Bandage, applied tightly from eyes up, protecting the temporal 
arteries by pads, or a dry muslin bandage wetted after being put on (Weir 



HEMIOPIA HEMIPLEGIA HEMOPTYSIS. 



593 



Mitchell). Acupuncture, the needle run down to the cranium, will give relief 
to clavus hystericus, when nothing else will do so (Pancoast). 



Prescriptions. 



R 



Quininae Sulph., 3 SS - 

Pulv. Belladon., gr. x. 

Ext. Digitalis, gr. xv. 

Ext. Valerianae, ^ss. 

Mellis, q. s. 

Ft. pil. no. xl. Sig. — 2 to 10 pills daily, 
gradually increased, during 3 or 4 days be- 
fore the expected attack. 



R. Mentholi, . . . . . . . £j. 

Alcoholis, ^j. 

01. Caryophylli, 

Ol. Cinnam., . . . . aa tt\xx. 
M. Sig. — Apply with finger over seat 
of pain. 



R. 



3 V J- 



Ammonii Chloridi, 

Ammonii Bromidi, 

Spt. Etheris Nitrosi, . , . ,^j. 

Syr. Pruni Virgin., . . . . 3 rij. 

Aquae, q. s. ad ^vj. 

Sig. — Dessertsp. 3 or 4 times daily, 
conjoined with the use of Raspail' s Eau 
Sedative (see page 95), ideally. 



M. 



B 



. Aconitinae (Duquesnel), . gr. -fa. 

Alcoholis, 

Glycerini, aa zj. 

Aq. Menth. Pip., . q. s. ad 31J. 
M. Sig. — Teasp. thrice daily. 

{Seguin.) 



Hemiopia. 

When established, hemiopia offers little hope of cure, though it has no ten- 
dency to progress. In hemiopia scintillans, Potassium Bromide, gr. xl-lx 
daily, or band of such metal as idiosyncrasy of the patient may decide, with 
stimulants to ward off the aura ; Quinine, Iron, Hydropathy, when Potassium 
Bromide fails (De Wecker). 

Hemiplegia. 

Strychnine, is most useful when members are relaxed; hypodermically, 
when paralysis incomplete, and the muscles flaccid but not wasted (B.). [See 
Paralysis for formula.] Potassium Iodide, gr. x-xviij daily, occasionally 
proves effectual (Wa.). Galvanism, constant current to the brain or cord, 
faradic to the muscles opposite those contracted (Hammond). Physostigma, 
prevents muscle wasting, and hence is given with benefit to hemiplegics ; gr. 
^q— Jjj of the extract repeated frequently (R.). Massage, in hemiplegia and 
other forms of paralysis due to intercranial lesions, when cold and blue skin, 
wasting and contracted muscles, ulcerations, etc. (B.). Cocculus, in hysterical, 
epileptic and choreic hemiplegia, acts well ; also in hemiplegia from cold (P.). 
[Compare Paralysis, Facial.] 



Hemoptysis. 

Gallic Acid, exceedingly effective (P.) ; may be combined with ergotin and 
digitalis. [See Hematemesis and Hematuria for formulae.] Acetate of 
Lead, with opium (B.) ; proves signally useful (Wa.). Ergot, the fluid extract 
in 30 to 40-minim doses, every 3 or 4 hours, or hourly in severe cases ; or 
Ergotin hypodermically for urgent cases, in 2 to 3-grain doses (R.). Opium, 
should be freely used for the attendant excitement (W.). Turpentine, drachm- 
doses every 3 hours, may cause unpleasant symptoms which soon disappear on 
its discontinuance (R.) ; has proved very efficient (P.) ; after other hemostatics 
fail it is worthy of trial (Wa.). Alum is serviceable in purely atonic hemor- 
rhages (Wa.) ; in 10-grain doses every 2 hours (B.). Oil of Erigeron, is very 
efficient when no fever or other signs of constitutional irritation (Wa.). Hama- 
melis, rr\j-ij of tincture, every 2 or 3 hours (R.) ; rruj-x of fresh tincture sev- 
eral times a day (Pf.). Ipecacuanha, has been highly praised (R.) ; in emetic 
doses (Tr.) ; arrests as emetic (B.) ; arrests, though in poisonous doses pro- 
ducing hemoptysis (P.). Ferric Acetate, a little added to water so as to taste, 

38 



594 



HEMORRHAGE. 



this constantly sipped (R.). Iron spray will often arrest (B.). Digitalis, has 
undoubted power over hemoptysis (B.). Small doses daily (P.). Infusion in 
large doses (R.). Arnica, of great service, if from violence (P.). Aconite, 
employed with best results (P.). Sodium Chloride, half a teaspoonful of com- 
mon salt, taken dry, repeated till nausea (R.). Sulphuric Acid, the dilute acid 
a useful adjunct to other treatment (Wa.). Spinal Hot- Water Bag, to cervical 
or upper dorsal vertebrae (R.). Auxiliaries, — Cold externally, acidulated 
drinks, perfect rest, and antiphlogistic diet (Wa.). 



Prescriptions. 



R 



. Ext. ErgotasFl., gjss. 

Ext. Ipecac. Fl., 

Tr. Opii Deod., .. . . aa gij. 
M. Sisr. — Teasp. every *4 hour. 



J& . Plumbi Acetat., . . . . gr. xx. 

Pulv. Digitalis, .... gr. x. 

Pulv. Opii, gr. v. 

M. ft. pil. no. x. Sig. — One every 4 
hours. (B.) 



R. Aluminis, 5jj. 

Sacch. Alb., gss. 

Pulv. Ipecac. Comp., . . . gr. xx. 
M. ft. pulv. no. vj. Sig. — One every 2 
hours. [Skoda.) 



R . Liq. Ferri Subsulph., . . . TTLxx. 

A q u8e > lij- 

M. Sig. — Use as spray by inhalation for 
5 minutes every hour. 



Hemorrhage, Hemorrhagic Diathesis. 

Acids. Sulphuric sometimes very effective in uterine hemorrhage (B.). 
Dilute Vinegar to leech-bites, piles, cuts, etc. (R.). Apple-Vinegar as injec- 
tion for vesical hemorrhage. [See under Hematuria.] Iron, when hemor- 
rhagic diathesis due to anaemia ; the tincture of the chloride preferred (B.). 
The tincture of ferric perchloride as styptic (Wa.) ; 1 or 2 teaspoonfuls of the 
concentrated solution in a glass of water, an excellent hemostatic (Tr.). The 
acetate, just enough to make water taste, in hemorrhage of lungs and kidneys 
(R.). Ergot, in uterine hemorrhage of any kind, and many forms of hemor- 
rhage, ergot or ergotine of great value (P.) ; not to be relied on alone (B.). 
Alum, is sanctioned by high authority (B.) ; dusted on in slight cases (R.) ; in 
uterine and traumatic hemorrhage, when small vessels open (Tr.). Hamamelis, 
rr\j-ij of tincture every 2 or 3 hours, effective in many forms (R.). Ipecac- 
uanha, produces hemorrhage in poisonous doses, yet has great energy in 
arresting it (P.) ; exercises a powerful influence on internal hemorrhage gener- 
ally, and in exhaustion therefrom ; gr. j-ij every X hour (Wa.). In emetic 
doses serviceable (Tr.). Turpentine, few agents more useful in the passive 
forms (B.) ; small doses in hematuria (R.) ; for serious hemoptysis, and hemor- 
rhage of typhoid (P.). Belladonna, hemorrhage from rectal ulcers (P.). Digi- 
talis, in uterine, and many other forms, of great value (P.) ; with restoratives 
has undoubted power in the hemorrhagic diathesis (B.). [See Hemoptysis.] 
Chimaphila, controls hematuria (P.). Gallic and Tannic Acid, in all passive 
hemorrhages, especially in that of the bladder (P.). Tannic acid for local 
use, Gallic for systemic effects upon remote parts. When hemorrhage occurs 
in relaxed and debilitated constitutions, Gallic Acid may be combined with 
Ergot and Digitalis (B.). Matico, proves useful in many cases, especially 
menorrhagia, hematuria and hemoptysis (Wa.). Nux Vomica, in hemorrhagic 
diathesis, especially when occurring in anaemic subjects. Also the syrup of 
iron, quinine, and strychnine; no prescription more generally useful (B.). 
Aconite, to reduce the circulation, in epistaxis, hemoptysis, etc. (P.). Cinchona, 
internally very efficient in some forms of hemorrhage (Tr.). Copper Sulphate, 
in stick, solution, or ointment, to arrest hemorrhage from small vessels (R.). 
Arnica, in hemorrhages (ecchymoses), from mechanical violence (P.). Rhatany, 
the extract, one of the most powerful hemostatics (Tr.). Grape cure, as tonic 
for convalescents (P.). Alcohol, in hemorrhagic diathesis, to elevate the arte- 
rial tension (B.) ; brandy, wine, when heart suddenly enfeebled by hemorrhage 



HEMORRHAGE, INTESTINAL, POST-PARTUM. 



595 



(R.). Venesection, will promptly arrest pulmonary hemorrhage (B.). Styptics, 
are either needless or inefficient, hence practically useless in general surgery ; 
hemorrhage should be controlled by either pressure or ligation (Roberts). Hot 
Water, sponged over a bleeding surface, the best agent to stop hemorrhage 
(Gross). Transfusion, when death imminent (B.). Ice, internally in wounds 
or hemorrhage of lungs, or from stomach ; small pieces frequently (R.). Rest. 
Perfect rest often indispensable, especially in hematemesis, in which nutrient 
enemata may be required. [Compare Dysentery, Epistaxis, Hematemesis, 
Hemoptysis, Hemorrhoids, Hematuria, Hemorrhage, Post-Partum — 
Intestinal, Menorrhagia, Metrorrhagia, Purpura, Wounds, etc.] 



Prescriptions. 



R 



PagliarVs Styptic. 

Tinct. Benzoini, .... ^viij. 

Aluminis, lb. j. 

Aquae ft), x. 

Boil 6 hours in a glazed earthenware 
vessel, adding hot water in lieu of that 
vaporized, and keeping well stirred; filter, 
and put up in stoppered bottles. 



R. Infusi Digitalis, ^ij. 

Ext. Ergotae Fluidi, 
Tinct. Krameriae, . . . aa^j. 
M. Sig. — A tablesp. as required in 
hemorrhagic conditions generally. (B.) 



Pancoast' 's Styptic. 

& . Potassii Carbonat., . . . . gij. 

Saponis, 3.HJ- 

Alcoholis, ^iij. 

Mix and use as a styptic especially for 
operations about the face. {Jos. Pancoast.) 



R. Ext. Ipecac. Fl., . . . . ^ij. 
Ext. Ergotae FL, . . . . giv. 
Ext. Digitalis FL, . . . . 5 ij. 
M. Sig. — Half teasp. to a teasp. at a 
dose, repeated as required. An excellent 
anti-hemorrhagic combination. 

(B.) 



Hemorrhage, Intestinal. 

Turpentine, should be used (B.) ; especially in typhoid (P.). [See Hema- 
temesis, for formula.] Belladonna, for irritable and bleeding rectal ulcers 
(P.). Iodine, in passive, gtt. j-ij of tinct. frequently repeated, of great service 
(B.). Sulphuric Acid, is serviceable (B.). Acetate of Lead, often of great 
service, especially when used as an enema (Jenner). Tannin, one of the most 
serviceable remedies for the intestinal hemorrhage of typhoid fever (B.). 
Hamamelis, very effective in intestinal hemorrhage, owing to its large propor- 
tion of tannin (B.). Ergot is most valuable ; may be given hypodermically in 
urgent cases (R.). Gallic Acid, gr. xv with gtt. iij-v of laudanum, in a winegl. 
of iced water, every 2 or 3 hours in the hemorrhage of typhoid (Jenner). 
Opium, a valuable adjunct to astringents, allaying the nervous excitement 
(Wa.) ; is most useful (Da Costa). [Compare Hemorrhoids, Dysentery, 
Typhoid Fever.] 

Hemorrhage, Post-Partum. 

Hamamelis, for persistent oozing (R.). Ipecacuanha, in flooding after de- 
livery (R.). Iron, Monsel's solution, j-iij of water, strong enough and safe 
as injection (B.) ; the perchloride diluted (R.). Amyl Nitrite, rr^v by inhala- 
tion, has stopped a hemorrhage promptly and permanently (Kerr). Ergot, 
a full dose of the fluid extract as soon as birth is completed as a prophylactic 
(Playfair) ; hypodermically in urgent cases, gr. ij of Bonjean's Ergotine deeply 
into the tissues of the arm (Wa.) ; gss doses of the fluid extract every 4 hours 
in secondary hemorrhage. Cimicifuga, will check post-partum hemorrhage, 
especially when tediously prolonged (P.). Digitalis, the infusion best ; a 
tablesp. bis die, or in urgent cases every half hour for 4 doses (B.). Nux 
Vomica, gtt. xx ; ext. ergot, fl. gtt. xxx ; each hour for 2 or 3 doses (B.). 
Opium, the tincture 3j> with brandy, in profuse flooding (R.). Vinegar, a 
handkerchief soaked in vinegar and carried into the uterus, will often check 
a severe hemorrhage (Landis) ; is antiseptic, astringent and sufficiently irri- 



596 HEMORRHOIDS. 

tating to produce contraction, yet not so irritating as to cause subsequent mis- 
chief, and always acts promptly (Penrose). ' Tamponade by absorbent cotton, 
plugs of linen, etc., is indicated in hemorrhage from abortion or placenta 
prasvia (Parvin) ; never tampon after delivery ! you might as well hang the 
woman by the neck (Wallace). Auxiliary Measures of importance are firm 
pressure on the uterus, compression of the abdominal aorta, the plug, and if 
necessary intra-uterine injections (Wa.). Hot Water, no° to 122 F., injected 
into uterus, extremely successful in checking post-partum hemorrhage (Att- 
hill) ; the most prompt and certain method, and the least unpleasant to the 
patient (Parrish). See also Dr. Cameron in Canada Med. and Surg. Jour., 
March, 1878, with record of 16 cases so treated. Ice, to abdomen or within 
the womb (B.) ; into womb or rectum (R.). As a prophylactic against hem- 
orrhage and to secure firm contraction of the uterus, a good method is to 
grasp the womb through the abdominal parietes with a hand kept cold by 
frequent immersion in a pan of broken ice, while waiting for the expulsion of 
the placenta. While one hand is kept on the uterus the other may be im- 
mersed in the ice. Transfusion of milk into veins may be necessary in cases 
of collapse (Thomas). 

Hemorrhoids. 

Galls, as ointment, very useful ; the official unguentum galls, or combined 
with lead and opium. See formula below (R.). Iron, a solution of the sub- 
sulphate as wash to bleeding piles, which should then be well oiled (B.); or 
an ointment of the subsulphate, gr. xv to the Hj, locally night and morning, 
with gr. j of the salt thrice daily by mouth ; gives excellent results. Hama- 
melis, by mouth, also lotion or injection in bleeding piles (R.) ; is employed 
with satisfaction ; Tr^ij— x of tincture several times a day ; also enema or 
suppository (Pf.). Nux Vomica, emphatically beneficial (P.). Sulphur, gr. 
v-x, with 3] confec. sennse, as laxative (R.). Exercises a most soothing in- 
fluence (Wa.). Sulphides, especially Blue Lick waters (B.). Podophyllum, 
as cathartic for hemorrhoids of recent formation, bleeding from stasis in portal 
circulation (B.). Aloes, causes congestion of pelvic viscera, yet Fordyce 
Barker shows it to be curative in piles, especially in recent ones, as after de- 
livery (B.) ; to greatly relieve bowels (R.); cures by removing constipation 
(P.). Hydrastis, as lotion or ointment to external piles, of great value ; n\v 
of tincture ter die internally at same time (P.). Ergot, with or without nux 
vomica, in dilated hemorrhoidal veins without new tissue, given by the stomach 
and used locally will often cure (B.). [See Diarrhcea for formula.] Stil- 
lingia, will remove permanently when due to constipation, and temporarily 
when from hepatic obstruction (B.). Senna, to procure soft and easy evacu- 
ations, use the confectio sennae at bedtime, gr. cxx in a bolus (B.). Iodoform, 
the ointment, and in suppository (B.). Nitric Acid, as caustic, followed by 
free use of olive oil (B., R.) ; ^ss-^j ad Oss of water as lotion for bleeding 
piles (R.). Hyoscyamus or Stramonium, leaves bruised, or ointment, locally, 
for pain (P.). Oleum Lini. Linseed Oil, boiled, in doses of ^ij twice daily, 
has quite a reputation as a remedy for piles (W.). Alum, to painful bleeding 
piles, a crystal trimmed and passed into rectum, or as an ointment (B.). Ice, 
to painful, bleeding piles, or cold water injected daily (B.) ; locally, for pain 
after operation (R.). Leeches, directly to swollen, irreducible, and painful piles 
(B.). Alkaline Mineral Waters, excellent (B.). Carbolic Acid, 3 parts to I 
of olive oil, a few drops injected into the tumor. A favorite and successful 
treatment by itinerants (Andrews) ; uncertain in all cases and in many fraught 
with danger (Gross). A good procedure, use 4 drops each of pure carbolic 
acid and glycerin, and inject one tumor at a time (Hunt). Grape-cure, is used 
with success (B.). Saline Purgatives, notably Epsom salts, in bleeding piles, 
combined with sulphuric acid, will often stop the hemorrhage (B.). [See Dys- 
entery for formula.] Diet, etc. Avoid stimulants, indigestible food and over- 
eating ; during an attack use little animal food. Petroleum soap when piles 
protrude, with cold or tepid water ablutions. Injections, Oj cold or tepid 



HEPATALGIA HEPATIC CIRRHOSIS. 



597 



water, are very useful. Stool should be at night. Surgical Methods are — the 
ligature for internal hemorrhoids, excision for external ones. Ligation is the 
proper treatment for the former, all other methods of operating radically being 
now discarded as unsurgical, and dangerous to life (Gross). The thermo-cau- 
tery is used by Smith of London and many other surgeons, but is apt to leave 
behind fissures and ulcers, which are with difficulty healed. Prevention. Soft 
seats favor the production of piles, as also of uterine disorders, by pressure on 
the arteries as they emerge from the pelvis, and so tend to drive the blood into 
the interior of that cavity (Holden). 



Prescriptions. 



R. Pulv. Gallae, gr. xxx. 

Pulv. Opii, gr. x. 

Ung. Plumbi Subacet., . . gr. xl. 

Ung. Simplicis, £j. 

M. et ft. unguentum. Sig. — Ointment 
or piles. [CEsterlen.) 



R 



gr. xx. 



. Ext. Colocynth. Co. , . 

Ext. Nucis Vom., . . 

Hydr. Chlor. Mitis, 

Ext. Hyoscyami, . . . aa gr. xij. 
M. et div. in pil. no. xij. 
Sig. — One as required for sluggish bowels. 
[Barker.) 



R 



. Ac. Carbolici, £ij. 

Ac. Tannici, 3 j. 

Alcoholis, 7,'w. 

Glycerini, £]. 

M. Sig. — Hypodermic injection for piles. 
[Girard.) 



R. Iodoformi, ....... ,"j. 

Balsam. Peruv., ^ij. 

Magnes. Calcin., ^j. 

Cetacei, ^ss. 

01. Theobromje, q. s. 
M. et fiant suppositoria xij. Sig.- 



One 



twice daily. 



R 



[Potter.) 



g r - 



Pulv. Gallae, 

Pulv. Opii, 

Plumbi Acetat., . . . 

Ung. Picis Liquidae, 

Cerati Simplicis, . . . aa % ss. 
M. et ft. unguentum. Sig. — Apply night 
and morning after bathing parts with cold 
water. 



R . Ext. Opii, gr. x. 

Pulv. Stramonii, £j. 

Pulv. Tabaci, % ss. 

Ung. Simplicis, 3; ss. 

M. Sig. — Ointment for piles. 

[Shoemaker.) 



Hepatalgia. 

Ammonium Chloride, grains xx-xxx, every 4 hours, is highly efficacious 
( Anstie). Bryonia, worthy of commendation in many liver affections (P.). Nux 
Vomica, has been found of much benefit. Dose should be small, gr. T ^ to -£% 
twice or three times a day (P.). Quinine, would naturally be thought of in 
malarial subjects, but does not afford any relief (Anstie). 



Hepatic Cirrhosis. 

Diuretin, for the dropsy. (See under Dropsy.) Nitric Acid, in long-stand- 
ing diseases, as this, will augment flow of bile after liver has struck work from 
mercury (R.). The mineral acids do not benefit (B.). Arsenic, small doses 
perseveringly, give good results in improving the nutrition of the organ (B.). 
Bryonia, of great value in many liver complaints (P.). Iodides, are the best 
remedies for the first stage (B.) ; the potassium iodide is highly recommended 
by some authorities (Da Costa) ; the great measures in the treatment of this 
affection are potassium iodide, hydrotherapy, and a milk diet (Lanceraux). 
Stillingia and Alkaline Mineral Waters, are important in the first stage (B.) ; 
alkalies early, especially Carlsbad water, with total abstinence from alcoholic 
beverages (Legg). Mercury. Corrosive sublimate in small doses, gr. ^ thrice 
daily, for a long time, does benefit the condition, and has possibly cured a few 
cases (Da C). Sodium Phosphate is said to produce good results (Da C.) ; 
has power to retard the sclerosis, and may possibly arrest the changes and 



59 8 



HEPATIC CONGESTION. 



restore a state of comparatively normal function (B.). Chloride of Gold and 
Sodium, in doses of gr. -£$, as an hepatic alterative, may be used conjointly 
with phosphate of sodium (B.). Tapping becomes necessary for the dropsy, 
though purgation and diuresis may help to lessen it (Da C). Diet, should be 
easilv digested, especially milk, avoiding starches and fats, and quitting alcohol 
(DaC). 

Hepatic Congestion. 

Nitric Acid, in chronic congestion, will augment flow of bile after liver has 
struck work from excessive use of mercury (R.). Nitro-Muriatic Acid, is found 
useful in India, with the acid bath (^iij ad gall, j) to hypochondrium (B.) ; 
formerly held high rank but is now superseded by ammonium chloride ; the 
acid baths being now rarely employed (Fayrer). See page 470 for formula. 
Sulphur. Sulphates in purgative natural waters, small doses often repeated ; 
potassium sulphate is occasionally poisonous (R.). Chelidonium, as deobstruent 
(P.) ; energetically affects the liver (Pf.). Iodine, tincture and unguent, locally 
for hepatic engorgement after malarial attack. The iodide of ammonium in 
moderate frequent doses in functional derangement, from malarial disease (B.). 
Sodium Phosphate, 3j-ij, 3 or 4 times daily, in plenty of water, as a purgative 
(B.). Ammonium Chloride, in passive congestion, and chronic torpidity, is 
well worthy of attention ; gr. xx every 4 hours (Wa.) ; an excellent remedy 
(Da Costa). Turpentine, epithems, hot, often found very beneficial (Wa.). 
Quinine, gr. xv-xx with morphine, gr. %-yi, in the acute congestion due to 
climatic or malarial causes, no remedy so efficient (B.). Bryonia, is worthy of 
commendation in liver affections of various kinds (P.). Iris, really serviceable 
when stools clay-colored and skin jaundiced (B.) ; is one of the best aperients 
in hepatic derangement (P.). Mercury, valuable only as a purgative ; its use 
restricted to cases where there is deficiency or excess of bile (B.) ; a full calo- 
mel purgative is of utility in cases of congestion (Wa. ). Podophyllum, the resin 
in congestion of the portal circulation, is especially useful (B.) ; Y^-]i gr. doses 
every six hours will speedily relieve symptoms (P.). Sanguinaria, is useful in 
hepatic engorgement without organic disease (P.). Colchicum, in hepatic con- 
gestion and dropsy ; an active remedy in congestion of the liver (B.). Resin- 
bearing Purgatives, as Rhubarb, Podophyllum, Iris, Euonymus, etc., are all 
actively cholagogue. (See list on page 39.) Ipecacuanha, decidedly stimulant 
to the flow of bile (B.) ; is the Indian treatment now for the local liver, given 
in large doses for a week or two (Da C). Taraxacum, has had a reputation, 
but I cannot recommend it (Da C). Aliment. No starches or fats. Milk, 
e ©g s > oysters, beef broth, whitefish, etc. (B.). Cold Water Belt around the 
abdomen, covered with oiled silk, gives great comfort in chronic cases (Da C). 
[Compare Biliousness, Jaundice, etc.] 



a. 



Elaterii, 

Spt. Athens Nitrosi, 
Tinct. Scillae, 
Tinct. Colchici, . . 
Syrupi Simplicis, 



gr.]- 



Prescriptions. 

R. 



M. Sig. — Teaspoonful thrice daily. (B.) 



R . Hydrarg. Chlor. Mitis, . . gr. vj. 

Pulv. Ipecac, gr. j. 

Sodii Bicarb., gr. x. 

Div. in pulv. no. ij. Sig. — One at bed- 
time, followed by the following : — 
R. Ac. Nitro-hydrochlor. Dil., 3 iij. 
Elix. Taraxaci Co., . . ad ,^vj. 
M. Sig. — Dessertspoonful before meals, 
and a milk diet. 



Ext. Taraxaci, gr. lxxij. 

Ext. Aloes, gr. xxiv. 

Ext. Colchici Rad., 

Pulv. Ipecac, . . . . aa gr. xij. 
M. et div. in pil. no. xxiv. 
Sig.— 2 nightly in chronic enlargement 
and torpidity. {Martin.) 



R. Sanguinarise, gr. viij. 

Podophyllini, gr. iij . 

Ext. Hyoscyami, gr. iij. 

Saponis, gr. viij. 

M. et div. in pil. no. xx. 
Sig. — 2 to 4 pills daily. In hepatic tor- 
por without organic disease. {Phillips.) 



HEPATIC DISEASES. 



599 



R 



R 



. Pil. Hydrargyri, 

Pulv. Aloes Socot., . . aa gr. iv, 

Pulv. Rhei, 

Ext. Hyoscyami, . . . aa gr. vj. 
M. et div. in pil. no vj. 
Sig — 2 pills every other night. 



Cinchonidinae Sulph., 

Euonymini, 

Leptandrini, 

Juglandini, 

Irisini, 

Podophyllini, 

Ext. Belladonna, 

Ext. Hyoscyami, . . . 
M. et div. in pil. no. lx. 
Sig. — One pill thrice daily, 
hepatic torpor. 



aa 3j. 



aa gr. x. 

In obstinate 
{Blackwood.") 



R. Euonymini, gr. xij. 

Ext. Hyoscyami, . . . . gr. vj. 
M. et. div. in pil. no. vj. 

Sig. — One at bedtime, followed next 
morning by a full dose of an aperient min- 
eral water. 



Potass. Bicarb., 
Potass. Citratis, 
Syrupi Simplicis, 



aa gj. 



M. Sig. — A teaspoonful to a tablesp. 
with a similar quantity of lemonjuice, in ^ 
glass of wa'.er ; the whole to be drunk 
while effervescing. ( Wood.) 



Hepatic Diseases. 

Ammonium Chloride is highly serviceable in all cases of liver disease, 
whether due to organic changes or to functional derangement ; especially 
indicated after the more acute symptoms have abated (Wa.). Nitro-hydro- 
chloric Acid formerly held high rank, but is now superseded by ammonium 
chloride (Wa.) ; even the acid baths, so long considered of great importance, 
are now but little, if ever, used in India (Fayrer). Nitric Acid acts in some 
way beneficially on long-standing liver-diseases, as in chronic congestion and 
cirrhosis (R.) ; with vegetable bitters, long continued, useful in waxy liver 
(Wa.). Podophyllum has a high reputation in a variety of liver diseases (P.) ; 
is actively cholagogue (R.). Mercury, mercurial purgatives are used for both 
deficiency and excess of bile ; harmful in many acute forms of hepatic disease, 
and generally are of doubtful propriety in liver affections (B.) ; in hepatic con- 
gestion a full calomel purge is of great benefit (Wa.). Red Iodide of Mercury, 
as ointment, gr. j to gv, gives best results in malarial enlargement of the liver 
(W\). Calomel is used in inflammatory disorders of the liver, but is less suited 
to parenchymatous than to serous inflammations (Da Costa). Ipecacuanha 
prom'otes the flow of bile (B.) ; may be used in small doses with great advan- 
tage in functional derangement of the organ (Wa.). Resinous Purgatives, as 
Leptandra, Iris, Euonymus, Rheum, etc., are decidedly cholagogue (B.). 
Euonymin is of great value in torpid liver and its accompanying headache 
(W.). Bryonia is worthy of commendation in liver affections of various kinds 
(P.). Chelidonium powerfully affects the liver (Pf). Taraxacum is highly 
recommended in all chronic affections of the liver, especially in indolent 
enlargement and incipient scirrhus (Watson). Sodium Phosphate is cholagogue, 
and extremely useful in liver affections, especially the jaundice of children and 
hepatic calculi (Thudicum). Phosphorus specifically affects the liver, and used 
early in acute yellow atrophy may have an 'action of antagonism upon the 
disease (B.). Potassium Salts, as depuratives, are of decided value, especially 
the citrate, in hepatic torpor and other affections (W.). See preceding article 
for formula. Sulphur, the sulphurous mineral waters, prolonged, give excel- 
lent results in liver disorders (B.). Alkaline Waters are very serviceable (B.) ; 
especially the sulphur waters. Glauber's salt in their place (Da Costa). Chlo- 
rine Water has been employed with benefit in chronic hepatic affections; in 
doses of 3ss-ij in ^iij or iv of water (W.). Iron preparations, long continued, 
in amyloid degeneration (Da C). Gentian, and other bitter tonics, in func- 
tional disorder ; also Nux Vomica occasionally, but use mercurials and podo- 
phyllum sparingly (Da C). Iodine and Iodides in waxy enlargement, simple 
hypertrophy and chronic congestion, of great value (Wa.) ; the iodide of 
potassium alternately with the iodide of iron in waxy liver (Frerichs) ; a few 



600 HEPATITIS HERNIA HERPES. 

drops injected into hydatids (B.). Sanguinaria is of great value in hysteria 
from chronic hepatitis, and in hepatic engorgement without organic disease 
(P.). See preceding article for formula. Stillingia, for torpid liver and jaun- 
dice following ague, in the first stage of cirrhosis, and in ascites from hepatic 
changes (B.). Malt Liquors are harmful in all chronic affections, especially in 
fatty liver (B.). Galvano-puncture for hydatids, the negative needle into the 
hydatid (B.). [Compare Lists of Agents acting on the Liver, page 39, ante ; 
also, the articles in this section entitled Biliousness, Calculi, Cancer, 
Hepatalgia, Hepatic Congestion, Hepatic Cirrhosis, Hepatitis, Jaun- 
dice.] 

Hepatitis and Hepatic Abscess. 

Ammonium Chloride, is almost a specific in hepatitis and abscess of the liver 
(Stewart) ; often preventing the latter disorder, and in many instances curing 
it (Wa.). Quinine, in large doses for the acute parenchymatous inflammation 
(Da Costa). Tartar Emetic, gr. X~/^ every two or three hours, with opium or 
calomel as indicated by symptoms ; of especial value early in the acute attack 
(Wa.). Leeches to margin of the anus in the acute type (B.) ; to unload the 
portal system (Wa.). Mercury is used, but is better suited to serous inflamma- 
tions than to parenchymatous ones (W.). Chelidonium has been used with 
benefit in both acute and chronic hepatitis (P.). Alkalies and Colchicum, , 
when the affection is of a gouty nature (Wa.). Sulphites are recommended in 
chronic forms (Da Costa). Sinapisms and linseed poultices over the hepatic 
region in acute hepatitis (Wa.). Saline Purgatives, as the sulphates of sodium 
or magnesium, to increase the watery exudation from the mucous membrane 
of the intestines, in acute hepatitis (Wa,). Nitro-Hydrochloric Acid, for some 
time in chronic form tending to abscess (Da C). Aspiration, when, pus forms ; 
early operation the rule of practice ; has induced many recoveries (Da C). 
[Compare Jaundice.] 

Hernia. 

Opium, or morphine hypoder. to narcotism, often obviates the necessity of 
an operation in strangulated hernia (Wa.). Chloroform, of evident benefit 
(Wa.) ; inhaled to assist reduction (R.) ; has superseded the use of tobacco and 
lobelia in strangulated hernia (P.). Coffee, large doses, has certainly a remark- 
able influence in aiding or causing reduction of strangulated hernia (Wa.). 
Oak Bark extract, as injection into the tissues, for a radical cure by stimulating 
the occlusion of the rings (Heaton's radical cure). A similar operation was 
patented by a Dr. Gage in 1840, the oil of cloves being the injection used. 
Professor Pancoast injected tincture iodine for the same purpose. Operations 
for radical cure all satisfactory. A properly adjusted truss (Ag.) : is the best 
remedy for a reducible hernia, answering the purpose of a retentive apparatus, 
and often permanently curing the disease by the steady, gentle and uniform 
pressure of its block (Gross). Ice Poultice is of use if no strangulation of gut 
or omentum (Wa.). Sternutatory, as snuff or ipecac, to cause sneezing while 
patient lies on his shoulders with elevated hips and legs over the back of a 
chair, frequently successful after taxis has failed to effect reduction. 

Herpes. 

Ferrum Arseniate, in doses of gr. \ daily, will effect the cure of a herpetic 
affection in the adult, however extensive or long established (Duparc). Mer- 
cury, calomel ointment, 3j to the ^, is one of the best mercurial preparations 
(Pereira). Potassium Carbonate, as lotion, gr. xxx to Oj, to allay irritation 
(Wa.) ; or as ointment, gr. xx to gj, smeared over eruption at night, and 
washed off in the morning with a solution, gr. xxx to Oj (Neligan). Glycerin, 
diluted, is a serviceable application in herpes labialis (Wa.), Ergot, the oil 
prepared by the action of benzin upon ergot, which, upon evaporation of the 
solvent, makes a valuable application in herpes genitalium and other skin 



HERPES ZOSTER — HICCOUGH. 6oi 

affections (Shoemaker). Alum, in herpes prseputialis, a solution of Z] to ^j 
aquae, applied on lint to the glans penis, is generally effectual (Wa.), Collo- 
dion, the flexible form, is applicable to various kinds of herpes (Wa.). Mag- 
nesium Citrate, as a cooling laxative, with soothing and protective lotions and 
ointments, and the Liquor Picis Alkalinus, diluted 10 to 20 times for the itch- 
ing (Bulkley). Astringent Lotions, of tannin or zinc sulphate, in herpes prae- 
putialis, to render the parts less sensitive (Da Costa). [For Herpes Circinatus 
see Tinea Circinata.] 

Prescriptions , 
R . Tragacanthae, 'Z\)-\v. 

Liq. Calcis, J iv. 

Glycerini, 3jj. 

Aquae Rcsae, ^ iij. 

M. Sig. — A soft jelly for local use as 
ointment. 



R. Ac. Carbolici, gtt.v-xv. 

Pulv. Calaminae Praep., 

Zinci Oxidi, aa^ss-j. 

Ung. Aq. Rosae, . . . . gj. 
M. et ft. unguentum. 
A soothing and protective application. 



Herpes Zoster. 

Rhus Toxicodendron, very readily subdues, especially when burning or itch- 
ing (P.). Aconite and Opium, locally for pain (Wa.). Morphine, oleate ext., 
without friction (R.) ; hypoder. to mitigate the pain (Anstie). Celandine has 
been recommended (P.). Dulcamara has an old reputation (P.). Silver Ni- 
trate, painted on the warning patch of erythema, before or as soon as vesicles 
begin' to form (R.). As a local application, reported on favorably (Wa.). Vera- 
trine, as ointment, 9j-ij-^j, in neuralgia following shingles (R.). Zinc Phos- 
phide, gr. y^ every 3 hours, is said to control the pain and abort the eruption 
(Hughes). Grindelia is reputed to relieve the pain (Stille). Mercury, the Ung. 
Hvdrarg. Ammoniat. is said to relieve trie pain and irritation remarkably (Wa.). 
Blisters, for subsequent neuralgia (R.). Hot Fomentations will often disperse 
(R.). Baths daily, exercise out of doors, abundant nutritious food. Flexible 
Collodion, constantly reapplied to exclude air (Anstie). Galvanization of the 
affected intercostal nerves, the positive pole over their points of emergence, the 
negative brushed over the terminal filaments in the skin (B.). Starch, dusted 
over the eruption, and on a muslin band sewed tightly around the body to pro- 
tect it from the friction of the clothes, gives the greatest relief (Bulkley). Rest, 
absolute, when eruption is extensive (Fournier). 

Prescriptions. 



R . Zinci Phosphidi, 

Ext. Nucis Vomicae, . . aa gr. x. 

M. et div. in pil. no. xxx. 

Sig. — One every 2 to 4 hours, as a nerve 
tonic. {Bulkley.) 



R . Bismuthi Subnit., . . . . 3 iv. 
Hydr. Chi or. Mitis, 

Zinci Ocidi, a^3J- 

M. ft. pulvis. Sig. — To be dusted on 
cotton-wool, and applied to the ulcerated 
vesicles, after washing with the solution of 
R. Liq. Sodii Hypochlorit., . ^iv. | Sodium Hypochlorite. {Fournier.) 

Aquae, g ij. 

M. Sig. — Wash for ulcerated vesicles. 
{Fournier. 

Hiccough. 

Nux Vomica, in 5- or io-n\, doses of tincture, with rr^xv of dilute nitric acid ; 
a short course frequently curative (P.). Chloroform, combined with opium (R.). 
Pepper gr. ij-x, to stop hiccough (P.). Laurel-water, a useful remedy, r^v (P.). 
Morphine, hypoderm. often arrests (R.). Camphor has been recommended 
(R.). Mustard, Z] infused in %iv aq. fervid, has cured most obstinate cases 
(R.). Pilocarpine, gr. -^ of the muriate, has cured bad cases which resisted 
all other means (Ortille). Ether, as spray to the epigastrium for ten minutes, 
then the site of the phrenic in the neck (Regoni) ; or the spirit, ttlxx-xxx in 
some aromatic water, given internally, will often arrest the spasm immediately 



602 HYDROCELE HYDROCEPHALUS HYDROPHOBIA. 

(Wa.). Zinc Valerianate, gr. ^ with a small portion of extr. belladonnas, cured 
a severe case of fifteen days' duration (Danet). Nitro-glycerin, sometimes 
arrests (R.). In mild cases deep inspirations, holding breath as long as pos- 
sible, or a firm belt around epigastrium (T.). 

Hydrocele. 

Iodine, injection of tincture I, water 2, into the sac to excite obliterative 
inflammation, the usual procedure for radical cure after tapping the sac (Wa.) ; 
may be used full strength, or with equal part of water ; the latter the safest 
method in ordinary cases, but relapses are not infrequent (Gross). Carbolic 
Acid, 3ss, with a minute quantity of water or glycerin to render it fluid, injected 
into sac and manipulated to bring all portions under its action, after which 
rest in bed and support to scrotum (Levis) ; a very efficient method for radical 
cure, but may cause erosion of vessels and hemorrhage into sac (Gross). Am- 
monium Chloride, as discutient lotion to the scrotum in- hydrocele of children 
(Wa.). Galvano-puncture, a current of 20 to 40 elements, by two needle elec- 
trodes, will invariably cure (B.). Operations ior radical cure include that by 
iron-wire sutures to excite adhesive inflammation (Simpson) ; and the incision 
of the hydrocele under antiseptic precaution (Volkmann) ; the same end may 
be obtained by the simpler methods of injection noted above (Gross). [Com- 
pare Dropsy, Orchitis.] 

Hydrocephalus, Acute. 

Iodine, lotions to scalp, or inunction of iodine ointment together with ferric 
iodide and cod-liver oil internally, offer* the best chance of success, although 
most remedies often fail (Wa.). Tartar Emetic, oint. as counter-irritant to 
scalp in tubercular meningitis (R.) ; in large doses internally was formerly 
employed (Wa.). Croton Oil, is said to have removed the excess of fluid from 
the ventricles (R.). Mercury, hydrarg. chlor. corr., in doses of gr. -£$ to -^, has 
proved successful (Wa.). Magnesium Carbonate, o'j-ij saturated twith lemon- 
juice, every 2 or 3 hours, a useful purgative in hydrocephalus (Wa.). Turpen- 
tine, in doses of tt^v-x with rr^xx-xl of castor-oil, or terebinthinate enemas, in 
incipient hydrocephalus (Wa.). Purgatives, in small doses, every 4 or 6 hours 
after having overcome the constipation, to maintain action for some days. A 
single dose of calomel, followed up by magnesium sulphate at short intervals. 
Their value can hardly be overrated (Wa.). Leeches, on crown of head rather 
than on temples, when much febrile action ; inadmissible if patient is much 
debilitated ; sometimes serviceable (Wa.). 

Hydrocephalus, Chronic. 

Mercury, holds a high place in the opinion of many. Calomel gr. %-yi 
twice daily, with mercurial inunction to the shaved head, or the latter alone ; 
child to wear a woollen cap. This treatment for 30 or 40 days (Wa.). Ferric 
Iodide, with cod-liver oil, always gives good results among the poor (Wa.). 
Iodine, lotions. [See Hydrocephalus, Acute.] Potassium Iodide, may 
arrest progress (Wa.) ; is of value certainly ; appears to have power of promot- 
ing absorption (Wa.). Cod-liver Oil, sometimes improves the condition, 
especially in scrofulous children (Wa.). [Compare Dropsy.] 

Hydrophobia. 

Belladonna, in all hypersemic states of the brain and spinal cord, is one of 
the very best remedies (P.). Stramonium, is used by Brahmins in India with 
apparent success. Glonoin, may be of benefit (Wa.). Nicotine, rightly used, 
will probably prove to be our best remedy (B.). Amyl Nitrite, should be fairly 
tried (B.). Curare, is encouraging, grm. 0.02 injected, 7 doses in 5^ hours, 



HYDROTHORAX HYPOCHONDRIASIS HYSTERIA. 603 

dispelled the symptoms, but replaced them by paralysis of limbs continuing 
over 2 months (Ros.) ; has seemed to antagonize the convulsive phenomena 
(B.). Chloride of Lime, a filtered solution injected into wound, very effective 
in snake bites (Binz.). Morphine, chiefly palliative. For deep injection into 
the tetanized muscles (B.). [See Tetanus.] Coniine, is indicated ; has not 
succeeded (B.). Cauterization, with hot iron or caustic potash after cleansing 
wound, which should be kept open by unguentum basilicon for 5-6 weeks (Ros., 
A.) ; with Silver Nitrate sharpened to a point, and applied freely to every 
sinuosity of the wound as preventive (Wa.). Excision, the safer practice (Wa.). 
Baths, warm and hot, produce calm (Ros.). Pasteur's Inoculation, with a 
" modified virus," is claimed to protect the person bitten from the disease. 

Hydrothorax. 

Diuretin, has been employed with benefit. [See under Dropsy.] Digitalis 
in purely dropsical form, also in passive pleuritic effusions ; used as a diuretic 
(5 j-ij of infusion bis die, or oftener) of great value (R.). Elaterium, unques- 
tionably of value as a derivative, though many fear it (P.). Jaborandi, pro- 
duces good results (B.). Iodine, Z] of tincture injected in returning hydro- 
thorax (B.). Sanguinaria, has been used with the best effects (Wa.). Blisters, 
when effusion has taken place, certainly seem to stimulate the absorbents to 
action (Wa.). Dry Cupping, over the chest, gives relief (Da Costa). Thora- 
centesis, if much distress. [Compare Dropsy.] 

Hypochondriasis. 

Arsenic, in the aged, gives great comfort, especially when combined with 
opium (B.). Ignatia, is useful. Tincture, best (P.). Cimicifuga, of singular 
value in puerperal hypochondria, and in that accompanying spermatorrhoea, 
etc. (P.). Aurum, Chloride, gr. ^ to -^ ter die gives excellent results, when 
depression, vertigo, cerebral anaemia (B.). Valerian, quickly relieves flatulence 
(B.). Asafcetida, especially indicated in cases marked by flatulence and gloom 
(B.). Potassium Bromide, especially among female town-dwellers, but also in 
male (R.) ; effects are variable, relieves some, not others (Wa.). Hyoscyamus, 
when syphiliphobia (P.). Opium, stimulant doses of the tincture are of great 
importance (B.). Caffeine, the citrate (gr. j-v) has been used as a cerebral 
stimulant with advantage (B.). Alcohol, in hypochondriasis gives temporary 
relief; should never be given for its narcotic stimulant effects in these cases 
(W.). Cocaine, especially useful in cases marked by debility and nervousness, 
and in mental affections accompanied by depression ; the fluid extract of Coca 
may be used, either alone or in wine (Br.). Turkish Baths, are useful for town- 
dwellers, with soft, flabby tissues, and mental depression (R.). [Compare 
Melancholia.] 

Hysteria. 

Ignatia, useful in many forms of hysteria, with feeling of suffocation, sensa- 
tion as of a ball rising to the throat, convulsive crying, flatulence, etc. (P.). 
Camphor, in hysterical excitement (P.). Musk, for many anomalous and dis- 
tressing symptoms (R.). Chamomile Oil, in the spasmodic and pseudo-neuralgic 
affections of hysterical women, a very excellent remedy (P.). Cimicifuga, in 
hysterical chorea, is rapidly curative (P.) ; for the headache (R.). Asafcetida, 
in hysterical convulsive affections, with flatulence and cough (P.) ; arrests 
paroxysm, valuable for flatulence (B.) ; removes headache, peculiar sensations 
in head, and flatulence (R.). Valerian, has great value, gss doses of fluid ex- 
tract (B.) ; useful in most cases, especially those of hysterical dyspepsia (P.). 
Zinc Valerianate, especially at the climacteric age, for hysterical symptoms 
which can be traced to no particular cause (R.). Ergot, with iron and other 
tonics (see formula below), in cases depending on sub-involution of the uterus, 
with indigestion and anaemia (B.). Nux Vomica, of great use in middle-aged 
subjects, with flatulence, weight on head, flushings and perspirations (R.)« 



604 ICHTHYOSIS IMPETIGO. 

Atropine, for hysterical aphonia, gr. jfo to ^ morning and evening (B.). Ether, 
for the flatulence, and for the hysterical paroxysm in sudden seizures (B.). 
Ammonia, the aromatic spirits for the acidity and eructations (B.) ; the fetid spirit 
for flatulent colic, etc., may be given with great advantage in doses of 3ss-j 
(Wa.). Potassium Bromide, gives control, and prevents paroxysms. When 
verging on nymphomania large doses required (R.). Iron, a course often use- 
ful, especially when anaemia or uterine obstructions (R.). Phosphorus, in 
hysterical paralysis (R.). Arsenic, lessens mobility of nervous system, and 
improves nutrition (B.). Opium, gtt. j of laudanum with gtt. ij of tinctura nucis 
vomicae 3 or 4 times a day, for flushings, weight on head, depression (R.). 
Ovarian Compression, has in many cases relieved recent hysterical contractions, 
and many other similar phenomena (Bourneville). Electricity, for aphonia, 
paralysis and anaesthesia, and to educate the nervous control. Electricity is 
the sworn enemy of hysteria. Accessory Measures. Occupation of mind and 
body. Removal from influence of friends. Complete abandonment of use of 
alcohol. The shower-bath, or cold-bath, as an educator of the will, as well as 
to invigorate the body. Excitement to be avoided. The word " Hysteria" 
should never be applied to the case in the patient's hearing. Disorders of 
vision are often found at the bottom of hysteria ; look for hypermetropia and 
astigmatism. 

Prescriptions. 



R. Ext. Ergotae, ^j 

Ferri Sulphatis, ^ss. 

Ext. Nucis Vomicae, . . . gr. viij. 
Hydr. Chlor. Corros., . . . gr. ss. 
M. Fiant pil. no. xxx. Sig. — One pill 
thrice daily. To improve digestion and 
anaemia. (B.) 



&. Tinct. Asafcetidas, 

Tinct. Valerianae Ammon., 
Tinct. Castorei, . . aa . . £ij. 

Aquae Camph., J> vr j- 

M. Sig. — A tablespoonful or two every 

hour. 



Ichthyosis. 

Zinc, the ointment or glycerite of the oxide, especially the latter with a little 
camphor added to it, is a most useful application (Wa.) ; an ointment of the 
sulphate, Z] to %), found very efficient (Wilson). Sodium Bicarbonate, as oint- 
ment, gr. xv-xxx to ^j, or lotion, 3^ ij — i i j to Oj (Devergie). Copper Sulphate, 
gr. x ad ^j Unguentum Sambuci, a useful application (Wilson).' Ulmus, in 
decoction, used internally, has cured the disease (Wa.). Cod-liver Oil, applied 
locally with friction, has proved promptly curative. Warm Baths, may gener- 
ally be employed with benefit (R.) ; alkaline and vapor baths, with sapo mollis ; 
and inunctions of oil or simple ointment, to prevent Assuring of the new skin 
(Duhring) ; frequent alkaline baths, with internal and external use of oily 
preparations, as linseed and cod-liver oils, yield the best results (Bulkley). 

Impetigo. 

Arsenic, is very useful. [See Eczema.] The iodide in doses of gr. -^ has 
been employed with great success. Or Donovan's Solution, Tr^v-x (Wa.). 
Nitric Acid, internally, frequently benefits (Wa.). Glycerite of Tannin, an 
excellent application (B.) ; during day, with poultice at night to remove scabs 
(R.). Quinine, Mineral Acids, when from imperfect digestion (R., B.). Zinc, 
the ointment of the oxide, after subsidence from inflammation (R.). Sulphur, 
internally, serviceable (R.). Calcium Chloride, gr. xv-xxx, daily, in some 
vegetable infusion, well spoken of (Wa.). Mercury. Citrine ointment dilute, 
locally, is an excellent application (Wa.) ; a very weak white precipitate oint- 
ment answers best in impetigo contagiosa, with a little carbolic acid lotion (1 to 
20) if it does not yield (Bulkley). Calomel to cover the floor of the pustules, 
after opening, evacuating and washing them out (Da Costa). Laurel-water, 
relieves itching (P.). Grape-cure, has proved excellent (P.). Flexible Collo- 
dium, or liquor guttae-perchae, to cover the pustules, if located where they are 
liable to irritation (Da Costa). [Compare Eczema. J 



IMPOTENCE INFLAMMATION. 



605 



Impotence. 

Phosphorus, no remedy more efficient. The pill of zinc phosphide the most 
convenient form (B.) ; gr. -fa thrice daily. Phosphoric Acid, full doses, with 
gr. ss of pulvis cantharidis, an effective combination, especially in impotence of 
old age (B.). Chloride of Gold, prevents decline of sexual power (B.). Can- 
tharis, with iron, is beneficial (B.). In large doses (gtt. xx-xxx), with iron and 
phosphoric acid or nux vomica (R.). Of doubtful efficacy (Wa.). Cubebs, 
removes functional trouble (B.). Nux Vomica. Drop doses of tincture in 
atonic impotence (B.). In large doses when spermatorrhoea (R.). Sanguina- 
ria, has decided aphrodisiac properties, but useful only in functional form (B.). 
Serpentaria, in relaxation and feeble erections, will often restore power. 3ss 
doses of tincture bis in die (B.). Ergotin, hypodermically about the dorsal vein 
of penis, when its enlargement and too rapid emptying is the cause of impo- 
tence (B.). Cannabis Indica, is a useful remedy ; the best combination for 
functional impotence would be one of Cannabis, Nux Vomica and Ergot (B.). 
Polygonum Hydropiperoides, is a useful remedy in the functional form, erections 
feeble, semen watery and testes soft (B.). Arseniate of Iron, acts as a tonic to 
the organs, and in full doses often benefits cases of functional form (B.). 
Damiana, has been brought forward as a genital stimulant, and a remedy for 
impotence, but there is probably no ground for any confidence in such claims 
(Stille). [Compare Emissions, Spermatorrhcea, also List of Aphrodisiacs, 
ante, page 47.] 

Prescriptions. 



R- . Ferri Arseniatis, . 
Ext. Ergots, . . 
Ft. pil. no. xxx. Sig. 



. . . gr. v. 
. . . gr. xxx. 
-One twice daily. 



R . Ext. Cann. Indicae, . 


. . . gr. x. 


Ext. Ergotse, . . . 


. . . gr. xl. 


Ext. Nucis Vom., . 


. . . gr. x. 


Ft. pil. no. xx. Sig.- 


—One pill night 


and morning. 





R-. Quininae Sulph., . 

Strych. Sulph., . 

Ext. Ergotae, . . 

Mas. Ferri Carb., 
M. Ft. pil. no. xxx. 
or 3 times daily. 



. . . gr. xxx. 
. . . gr. ss. 
. . . gr. xv. 
. . . gr. xlv. 

S ; g. — One pill 2 



R- . Sanguinarinae, . 
Ext. Ergotse, 
M. Ft. pil. no. 
thrice daily. 



. . gr. ij. 

. . . gr. xx. 
Sig. — One pill 



&. Tinct. Sanguinariae, . . . giij. 

Ext. Stillingiae Fl., . . . . 3 v. 

M. Sig. — 15 to 20 drops in water, 
thrice daily. 



R- . Phcsphori, gr. ss. 

Ext. Nucis Vom., . . . . gr. vj. 

Mas. Ferri Carbonat., . . gr. xl. 

Ext. Gentianae, gr. xxx. 

M. Ft. pil. no. xxv. Sig. — One 2 or 3 
times daily. 



Inflammation. 

Aconite, especially in inflammation of respiratory organs, eruptive fevers, and 
ajl inflammatory states of high temperature and sthenic reaction. Not in ady- 
namic states, or continued fevers, except for hyperpyrexia. May be advantage- 
ously combined with opium (B.) ; gives most brilliant results in many forms (R.). 
Always indicated in early stages of simple inflammatory fevers, in all inflam- 
mation of serous membranes, pneumonia, tonsillitis, acute rheumatism, ery- 
sipelas, etc. Is especially adapted to the uses for which bleeding was formerly 
employed (P.). Arnica is antipyretic, large doses (5ss of tinct.) in sthenic, 
small doses (n\,x) in asthenic inflammation (B.) ; in inflammation of serous 
membranes it has given good results (P.). Belladpnna, in many forms no 
remedy more useful, notably scarlet fever, erysipelas, low fevers. Inflamma- 
tion of eyes, boils, carbuncles, etc., by atropine externally, belladonna inter- 
nally. When much fever, may be combined with aconite (B.) ; both locally 
and internally in inflammation of the eye ; is effectual in inflammation which 
threatens to end in abscess (R.). In 'erysipelas, inflammatory sore throat, 
encephalitis, gouty and rheumatic inflammation, cystitis, pneumonia, etc. (P.). 



606 INFLAMMATION. 

Gelsemium, especially inflammation of lungs and pleurae, and in pneumonia 
(rr\,v-x of fl. extr. every two hours) (B.). In acute stage of acute gonorrhoea is 
valuable (P.). Bryonia, exceedingly valuable in pleurisy and other serous 
inflammations, especially pericarditis. After the aconite stage (P.). Veratrum 
Viride, when much delirium and arterial excitement, useful at beginning only 
(B.). In pneumonia, Veratrine is most valuable, also in acute rheumatism and 
generally as an antipyretic (P.). Tartar Emetic, in frequent minute doses, 
gr. ^ renders incontestable service (B.). In pneumonia, tonsillitis, pleurisy, 
bronchitis, and other inflammatory affections (R.) ; gr. l /e, frequently repeated, 
has the power of completely dissipating early local inflammations (Spender) ; 
quite as useful in arresting local inflammation as quinine is in malarial fever 
(Surgeon-Major Lawrie). Pulsatilla, in acute and subacute inflammations with 
muco-purulent discharges, especially of eyes, ears, and nasal passages (P.) ; 
also with aconite in epididymitis (Pf.). Mercury, in acute glandular inflamma- 
tion of throat and neck, in ileo-colitis, iritis, syphilitic inflammations of serous 
membranes, laryngitis (B., R.). Silver Nitrate, locally in strong solution, gr. 
clx. to 3J of distilled water, painted over surface and beyond, after thorough 
cleansing and drying ; no agent so safe, powerful or efficacious in subduing 
external inflammation (Higginbotham). A strong solution in nitrous ether is 
a most efficient application to check inflammation in superficial parts, as boils, 
felons, orchitis, synovitis, erysipelas, erythema, eczema, etc. (B.). Iodine, as 
liniment in vicinity of local inflammation to produce vesication (R.). Sulphides, 
especially that of calcium (doses -^ gr.) appear often to arrest suppuration. 
After formation of pus they hasten maturation and circumscribe inflammation. 
In boils, abscesses, and deep-seated suppuration, they improve the condition 
and promote healing (R.). Antipyrine, Kairine, and other antipyretics. See 
under the title Fever. Alkalies, especially ammonium and potassium salts, 
are very valuable in the stage of exudation (B.). Astringents, locally in inflam- 
mations of mucous membranes (R.). Lead, the liquor plumbi subacetatis 
dilutus as a soothing and astringent application to inflamed and erysipelatous 
surfaces (Wa.) ; to eczema and other inflammatory diseases of the skin (Pf.). 
For Leadwater and Opium formulas see page* 468. Digitalis, the German 
antipyretic, is especially useful in pneumonia, bronchitis, rheumatic fever and 
scarlet fever (B.). Aconite safer and better (R.) ; locally and internally is use- 
ful in inflammations, especially those of joints, of breast, erysipelatous and 
varicose : a fomentation of a teasp. of the dried leaves in half a pint of boil- 
ing water, or Z) of tincture to the same quantity of water, applied by flannels 
to the part, will quickly subdue (Fairbank). Quinine, in peritonitis (Tr.). It 
is indicated in most acute forms, unless objections occur (P.). Has power to 
arrest inflammation in formative stage. With morphine and in full doses 
(gr. xv-xx) may suppress many forms (B.). Chloral, excellent when tempera- 
ture is high, much delirium ; gr. v every 3 hours (B.). Opium, is important 
in most inflammations, but especially those of serous membranes ; a full dose 
(gr. % of morphine) at first, smaller doses after. Is especially curative in 
inflammation of intestines and peritoneum, and of cerebro-spinal meningitis, 
arachnitis, etc. (B., R.). Saline Purgatives, valuable as part of the denutrition 
treatment, and to diminish arterial tension (B.). Salicylic Acid is antipyretic, 
especially in septicaemic inflammation, and acute rheumatism, erysipelas, pneu- 
monia (B.). Salicylate of sodium more soluble (R.). Colchicum often exer- 
cises a happy influence over certain acute inflammations, as bronchitis, 
conjunctivitis, etc., especially if occurring in gouty subjects (P.). Cocaine, 
locally in commencing inflammations of mucous surfaces, to constrict the 
blood-vessels of the part (R.). Pilocarpus gives good results in the exudative 
stage of pleuritis, iritis, keratitis, etc. (B.). Cold, by ice in bags, or cold water, 
a very useful agent. Heat, by hot water, fomentations, etc., often much better. 
Ice, in small pieces in a bladder applied to inflamed part (R.). Water, cold 
and hot baths and packing very useful in all inflammations (B.). Alcohol is con- 
stantly prescribed, and is of value in low states, if symptoms after its adminis- 
tration are ameliorated (B.). [See Fever. J Poultices, useful in many inflam- 
matory states, but often abused (B.). To check formation of pus and assist in 



INFLUENZA. 



607 



maturation (R.). Venesection, when pulse hard, strong, full and frequent, a 
plethoric state of the system and great intensity of morbid action ; if required 
the earlier it is done the better (Gross). Leeches very useful in many forms 
where sthenic reaction and plethora. Value of bloodletting probably due to 
derivative and counter-irritant effect (B.) ; a remedy of great power for good or 
evil, now much neglected (Wa,). Local bleeding by leeches, cups, scarifica- 
tion, etc., should generally be preceded by some form of general depletion 
(Gross). Aliment : when no inflammation of digestive tract, use milk and beef- 
tea alternately every 3 hours. No starches or fats. In intestinal inflammation, 
milk, eggs, animal broths, oysters, fish, but must be used with great caution. 
Skim-milk treatment (B.). Cod-liver oil in many chronic inflammations, as of 
heart, lungs, kidneys, etc. (R.). [Compare the various titles, as Bronchitis, 
Pleuritis, etc., also the list of Antiphlogistics, on page 43.] 



Prescriptions. 



R. 



Tinct. Aconiti, ^j. 

Tinct. Belladon., . . . . 31J. 
M. Sig. — Three or four drops in water 
every hour. (B.) 



R. Ammonii Chloridi, . . . . 3 v. 
Acidi Acetici, 
Alcoholis, aa ^ x. 



Aquae, 
M. et fiat lotio. 
cutient lotion. 



s. ad 



Evaporating and dis- 



R- . Antim. et Pot. Tart., . . . gr. ijss. 

Magnesii Sulph., . . . . t ^ij. 

Morphinae Sulph., . . . . gr. ji/£. 

Ac. Sulph. Aromat., . . . 3 ss. 

Tinct. Verat. Virid., . . . gjss. 

Syr. Zingiberis, t ^ij. 

Aquae Destill., .... J x. 
M. Sig — Tablesp. every 2,4, or 6 
hours. Antimonial and Saline Mixture. 

(Gross.) 



[See pages 468 and 469 for Lotion and Liniment formuke.] 



Influenza. 

Salipyrin, highly extolled during the epidemic of 1891. Phenacetine, used 
with great benefit, both as a prophylactic and a remedy. Strychnine. For the 
underlying weakness and depression, the real enemy to fight against in the 
grippe, strychnine is the best remedy we have (Huchard). Digitalin, crystal- 
lized, in dose of gr. ^, in grippal pneumonia, in which, though the disease is 
in the lungs, the danger is in the heart (Idem). Sodium Benzoate, with quinine 
and caffeine [see formula below] in the simple form of the grippe (Idem). 
Quinine Hydrobromate in 8 to 16-grain doses, if the fever is high (Idem). Qui- 
nine has been used beneficially throughout the disease, especially after the 
acute stage, for neuralgic pains (Wa.). Ammonium, the liquor ammonii ace- 
tatis, combined with nitric or chloric ether, is often of great service (Wa.). San- 
guinaria, used with much benefit (Wa.). Cimicifuga has been given with much 
success (R.). Camphor, in solution, hypodermically [see formula below], 2 to 
4 injections daily, with 3 to 6 of Caffeine and 2 to 3 of Ether, for grippal pneu- 
monia (Huchard). Bismuth Salicylate, or naphthol, betol, salol, or benzo- 
naphthol, as intestinal antiseptics, when required (Idem). Sulphurous Acid, 
by fumigation or inhalation, a few drops on boiling water or as a spray, often 
controls (R.). Tartar Emetic has been recommended strongly, but is too de- 
pressant (W T a.) ; has extraordinary power of aborting local inflammations, espe- 
cially those of respiratory apparatus. [See under Inflammation.] Spiritus 
Etheris Nitrosi, in doses of 3j-jss, in any convenient vehicle, is a popular and 
efficacious remedy (Wa.). Cocaine, a 4 per cent, solution snuffed up nostrils 
or applied by spray-producer, very efficacious in the early stage (R.). Cubebs, 
3ss or Z) doses of the tincture in >£-glass of linseed tea thrice daily, for the 
subsequent cough, often curing like a charm (R.). Opium, best avoided in 
early stage, but later for the cough, with ipecac, gives great ease. Dover's 
powder, with nitre and lobelia is a good form (Wa.). Potassium Nitrate, nitre 
largely diluted, as lemonade, 3j-ij in the course of the day, proves highly 
useful (Wa.). Turkish Baths have been employed with marked advantage 



6o8 



INSOMNIA. 



(Wa.). Hot Fomentations, for headache (R.). Benzoin, the compound tinc- 
ture, 3ss-j, inhaled from a pint of hot water frequently (Da Costa). [Compare 
Bronchitis, Catarrh, Hay-Fever.] 



B 



Prescriptions. 



Ext. Ipecac. Fl., . . . . gij. 
Tinct. Opii Deod., . . . g'iv. 

Tinct. Aconiti, ^j. 

M. Sig. — Five to ten drops every two 
hours. For the bronchitis. 



R . Ext. Cimicifugse Fl., . . . ^ss. 
Tinct. Opii Deod., . . . . 3 j. 

Syr. Tolutani, ^xj. 

M. Sig. — Teasp. every four hours. 



B . Ammonii Chloridi, . . . gjss. 
Morphinse Sulph., . . . . gr. ij. 
Tinct. Sanguinarise, 

Syr. Ipecac, aa^iv. 

Mist. Glycyrrh. Co., 

Aquse, aa^jss. 

M. Sig. — Teasp. as required for the 
cough. Each dose has of Morph. Sulph. 



B« Quin. Hydrobromat., 
Sodii Benzoat., 
Caffeinge, 

M. et ft. pil. no. xxx. 

Sig. — One pill thrice daily 



aa gr. xxx. 

(Huchard.) 



gr. ss. 



B . Strych. Sulphat., .... 
Alcoholis, . . q. s. ad solv. 
Aquse Destillat, . . . . £ iv. 
Solv, Sig. — 3 iij to 3 vj daily. 



R . Camphorse, 3 ijss. 

01. Olivse (steriliz.), . . . Jj iij. 
M. Sig. — 3 ss hypodermically twice or 
thrice daily. {Huchard.) 



Insomnia. 

Chloral, the best hypnotic (gr. xv-xx), quite unrivaled. Cautiously in deli- 
rium tremens, which see (B.). In many forms of sleeplessness (R.) ; acts best 
in cases which are of purely nervous type (Wa.) ; in combination with alcoholic 
preparations, especially if potassium or sodium bromides are present, it is apt 
to separate to the top as an alcoholate. (See ante, page 169.) [Chloralamid, gr. 
xxx in 5j of whisky or brandy, in simple or idiopathic insomnia, or that from 
nervousness, hysteria, chronic alcoholism, but not when due to excitement or 
severe pain. (See ante, page 169.) Sulphonal, gr. xxx, in milk, 2 hours before 
effect is desired ; an admirable hypnotic in many cases, but its efficacy de- 
creases with use. Croton Chloral, 3j may be given (R.). Potassium Bromide, 
when from cerebral over-action, gr. xv before each meal, and gr. xxx on retir- 
ing. Cumulative effect (B.). It increases hypnotic effect of hyoscyamus, 
belladonna, cannabis indica, ether and chloroform (R.). Hyoscyamus, an 
effective substitute for opium in children, Sij-^j of tinct. necessary, and with- 
out danger (B.) ; when opium disagrees (R.). Belladonna, hypnotic in some 
morbid states, especially those marked by prostration, low arterial tension, con- 
tracted pupils. Atropine, gr. T |o to -fa (B.). Paraldehyde, in doses of rr^xxx- 
£>ij, is an efficient hypnotic with little or no depressing action on the heart 
(C). Hypnal, gr. xv-xxx, is credited with simultaneous action as a hypnotic 
and an analgesic. Ignatia, for sleeplessness from nervous erethism, better 
than morphine (Pf.). Gelsemium, in simple wakefulness (B.) ; and in that of 
drunkards, mania and over excitement (R.). Coffee, insomnia from lowering 
of nervous power, and chronic alcoholism (P.). Opium, Morphine the best 
form, gr. J^-gr. ss, when pain (B.). Codeine and Narceine, also hypnotic, 
should be given to act at natural time for sleeping (R.). Sumbul, n\,xxx-xl of 
tinct., with a little chloric ether, very efficient in the insomnia of chronic alco- 
holism (P.). Tartar Emetic, and opium, very effective when due to cerebral 
congestion, and when opium stimulates (B.). Ether or Chloroform in a full 
dose (R.). Phosphorus, nutrition inactive. Insomnia of the aged (B.). Humu- 
lus, a hop-pillow effective (B., P.) ; tinct. lupulinae, gss-^ss, as cerebral seda- 
tive (B.). Cocaine has been used with some success (Wa.). Chamomilla, Try 



INTERMITTENT FEVER. 



609 



of the tinct. every quarter-hour, an excellent sedative for children (A. A. 
Smith). Cannabin Tannate, in 8-grain doses, a good hypnotic (Fronmuller) ; 
very inefficient (W.). Cannabis is very uncertain in its action (R.). Alcohol, 
if from cerebral anaemia, a full dose of whisky or brandy ; or in some a glass 
of ale or beer answers better (B.). Water, a tepid bath just before retiring 
often effective. When head is hot, cold to it, and tepid bath to the body (B.). 
[Compare Nervousness ; also the list of Hypnotics on page 27 ; also the 
Analogues of Chloral, page 169.] 

Prescriptions. 



R. Paraldehyde, 3i) ss - 

Alcoholis (90 per cent.), . Jjss. 

Tinct. Vanilke, g ss. 

Aquae, ^j. 

Syr. Simplicis, . . . . ad ^ iv. 
M. Sig. — A teasp. or two every hour 
until sleep is obtained. 

( Yvon's Hypnotic Elixir.) 



B. Chloralis Hyd. 31}. 

Potassii Brom., ^iij. 

Tinct. Opii, £j. 

Syr. Aurantii Cort , . . . giij. 

Aquae, ad £ ij. 

M. Sig. — Teasp. dose. May be 
peated if necessary. 



R . Potassii Bromidi, . . . . 3 iv. 

Chloralis Hydrat., .... ^iij. 

Tinct. Asafcetidse, . . . . 3 iv. 

Syrupi, gvj. 

Aquae, q. s. ad J| vj. 

M. Sig. — Tablesp. every 2 hours until 
sleep is induced. In the insomnia of hys- 
teria. 



R . Potassii Bromidi, 

Chloralis Hydrat., . . . aa % ss. 
Syr. Pruni Virgin., . . . . %]• 

Aquae, q. s. ad %'\]. 

M. Sig. — Teasp. in a winegl. of water. 

Repeat in one hour if necessary. 



Intermittent Fever. 

Cinchona. Quinine as prophylactic, gr. v-x each morning in black coffee ; 
begin with gr. v, add gr. j each week (R.). In ordinary intermittents give 6 or 
10 grain doses up to 20 or 30 grains, so as to have it all in 4 or 5 hours before 
the expected paroxysm ; give the sulphate and in solution to get its full action 
(Da Costa). For acute ague, gr. x in sweating stage, and same 5 hours before 
next paroxysm; and gr. x-xv at the septenary periods, until the third has 
passed. In pernicious form, gr. xx-xl are required, by stomach, rectum or 
skin, to secure safety of patient. Best in combination with morphine, and with 
continuous administration of arsenic during intermissions. May be given in 
solution by rectum, or hypodermically (B., R.). Is almost specific in inter- 
mittents when uncomplicated, and of recent origin (Wa.). Chinoidine may 
be used as a substitute for quinine in doses twice as large (B.). Cinchonine, 
Cinchonidine, Quinidine, the sulphates of these alkaloids are scarcely, if at all, 
inferior to quinine as therapeutical agents. (Report of the Madras Commis- 
sion, 1866.) Average dose of each, gr. x (Wa.). Salicylate of Cinchonidine, 
promises well as an antiperiodic (B.). Opium, as morphine, gr. */(>-% hypo- 
dermically, not only lessens the chill but aids the action of the antiperiodic ; is 
to be strongly urged (Da Costa) ; is useful in the pernicious variety, in combi- 
nation with quinine (B.). Arsenic, the best remedy next to quinine, especially 
useful in long-standing agues, of quartan type (R.). Useful as adjunct to qui- 
nine daily, to prevent relapse. Most important in chronic ague, with iron ; 
also as prophylactic small doses of Fowler's solution (B.). Capsicum, the 
resins of black and red pepper, as adjuvants chiefly (B.); promotes action of 
quinine (Pf.). Nux Vomica, has been used with success, but now used as 
adjunct to quinine (B.) ; good in convalescence (P.) ; has antiperiodic value 
not inferior to quinine. Strychninse gr. ^, equals gr. j of quinine sulphas 
(Wa.). Hydrastine, stands next after arsenic ; same indications as quinine 
(B.) ; in doses of gr. ij-ix is strongly recommended (P.). Pilocarpine, gr. % 
of the muriate, in the cold stage, is strongly recommended by high authority, 

39 



6lO INTERMITTENT FEVER. 

to excite profuse perspiration and thus lessen the attack (Da Costa). Apiol, 
when prejudice exists against quinine. Gtt. xv during an hour, in divided 
doses, 4 hours before paroxysm (B.) ; is one of the minor remedies which often 
prove successful in mild cases (VVa.). Salicin, as substitute for quinine, but 
inferior (B.) ; grs. x-xl, in mild cases (P.). Chloroform, to prevent an impending 
paroxysm ; 3j-3\j (of spt.) before the chill, or by inhalation (B.). Narcotine, 
gr. ij-v ter die, is eminently antiperiodic. No drug (except quinine) cures 
intertnittents so rapidly and surely, or with more freedom from disagreeable 
effects (Wa.) ; said to be superior to quinine (R.). Nitric Acid, full doses, 
every 4-6 hours (B.). Sodium Chloride, in large doses during the apyrexia, 
3viij-xij, may occasionally prove efficacious (Wa.). Eucalyptus, during con- 
valescence (B.); has been successfully used in treatment of ague, 3j-ij of a 
tincture (Wa.). Carbolic Acid, in 4-grain doses with infusion ol ginger, cured 
a series of 8 cases which had resisted quinine (Wa.) ; its value established ; 
rr\,ss-ij in mint-water ; or gr. ^ in tt\,xx of water, hypodermically (Tessier) ; 
combined with iodine is of great value in chronic malaria, and in acute cases 
after quinine has stopped the paroxysm (B.). Mercury, uncalled for in ordi- 
nary cases ; buthydrarg. cum creta, quinine and rhubarb of service in obstinate 
intermittents of children in tropical regions (Wa.). Sodium Hyposulphite, 
gr. xv-xx every two hours is said to cure (R.). Cascarilla, Chamomile, Quassia, 
used (R.). Gentian, is valued chiefly as vehicle (P.). Ammonium Picrate, 
proved wonderfully effective in India, where 10,000 cases were treated there- 
with (Clark). Lemon, in decoction, exceedingly efficient in preventing recur- 
rence of the paroxysms after thery have been broken up by the use of Quinine 
(Crudeli). Emetics, may cure many cases; one each morning will assist the 
action of quinine. Ipecacuanha preferred to antimony (R.) ; only at com- 
mencement, inadmissible if gastric irritation (Wa.). Antimony, at the onset 
and continuously in mild, uncomplicated cases. Tartar Emetic, gr. ]4,- l /e 
every 2 hours, has been followed by complete cures (Moore). Antipyrine, is 
useless (Falkenheim). Resorcin, and similar agents, have no specific action, 
merely controlling the pyrexia (Wa.). Warburg's Tincture is a remedy of 
great power, but produces such severe diaphoresis as to be dangerous to adyna- 
mic subjects (Prof. Maclean). Purgatives, in the intermission, before using the 
antiperiodic, is good practice; podophyllum, colocynth or jalap (Da Costa). 
Iron is valuable in chronic cases ; the system should be thoroughly saturated 
with it (Da C). Ergot, for the enlarged spleen (Da C). [Compare the title 
Malaria ; also the List of Antiperiodics on page 43.] 

Prescriptions. 



R. Quininae Sulph., gr. xxxij. 

Mucil. Acacise, sjij. 

Syr. Eriodyctii Aromat. 
(Parke, Davis & Co.), vel 

Mist. Glycyrrhizae Co., vel 

Velatine, . . . . q. s. ad £ ij. 
M. Fiat emulsio. Sig. — A teasp. con- 
tains gr. ij of Quin. Sulph. Suspension of 
the quinine without dissolving it makes the 
bitter taste less perceptible (Squire), and 
the Syrup of Yerba Santa covers the taste 



R. Quininae Sulphat., . . . . gr. lxxx. 

Ac. Sulph. Diluti q. s. 

Spt. Etheris Nitrosi, . . . 3 iv. 

Syr. Tolu, Aquae, . . • . ad ^ij. 
M. Sig. — A teasp. contains gr. v of 
Quin. Sulph. {Da Costa.) 



R. Quininse Sulphat., .... £j. 
Ac. Hydrobrom. Dil., . .31]. 

Aquae, . 3 xiv. 

well/ '{Potter') M - Sig.— A teasp. contains gr. iij^ of 



R. Ac. Carbolici, 7 ) ). 

Tinct. Iodi Corap., . . . . £iij. 
M. Sig. — 4 drops every 4 hours in suf- 
ficient water. (B.) 

R. Massae Ferri Carb., . . . 3J. 

Ac. Arseniosi, gr. j. 

M. Ft. pil. no. xx. Sig. — One thrice 
daily in chronic ague. (B.) 



Quin. Sulph. The acid directed prevents 
the unpleasant cerebral action. (B.) 



R. Quininse Sulph., £ss. 

Pulv. Acaciae, 3 ss. 

Syr. Zingibens, % iv. 

M. Sig. — A teasp. contains one grain of 
Quin . Sulph . A good formula for children, 
the quinine being suspended, not dissolved. 



INTERTRIGO IRITIS. 



611 



R. Quininae Sulph., gr. xl. 

Ferri Sulph. Exsic, . . . . gr. xx. 

Ac. Arsenic-si, gr. j. 

M. Ft. pil. no. xx. Sig. — One thrice 
daily. (B.) 



R. Quininae Sulph., . . . . gr. xxx. 

Capsici, gr. xv. 

Opii Pulveris, gr. iij. 

M. Ft. pil. no. xxx. Sig. — One to five 
pills as required. [Piffard.') 



Intertrigo. 

Bismuth, nitrate or .carbonate, as dusting powder (R., B ). Tannin, the 
glycerite, excellent (R., P.). Camphor, added to dusting powders, to allay 
heat and itching (R.). Lime-water, to obviate irritating urine (R.). Soap, free 
ablution with, when caused by acid secretions ; use greasy applications after- 
wards (R.). Boracic Acid, as ointment, 5jss to |jj of vaseline, a very useful 
application (Wa.). Glycerin, with tragacanth, etc. [See under Herpes for 
formula.] Calomel, as ointment, 3] to ^j, is especially useful (Wa.). Zinc 
Carbonate. Calamine is a good dusting powder ; so also is the oxide, or 
fullers's earth. 

Intestinal Obstruction. 

Opium, even )4 -grain doses every 4 hours, for 2-4 days, arrests dangerous 
symptoms, and brings a painless purgation (Brinton, P.). Morphine, endermi- 
cally (Wa.). Belladonna, often successfully employed (P.) ; gr. X~K every 
few hours, when from want of tone and partial spasm (Tr.). Strychnine, occa- 
sionally beneficial ; cautiously in acute cases (Wa.). Mercury. A full dose of 
calomel, followed in a few hours by castor oil, and a turpentine enema, affords 
relief (Wa.). Caffeine acts upon the muscular tissue and often proves of the 
utmost value (Wa.). Senna, the infusion, in doses of ^j-iij, forms an efficient 
purgative (Wa.). Purgation to be refrained from (Brinton). Enemata, insuf- 
flation and surgical measures are often necessary. [Compare Constipation, 
Intussusception, Hernia.] 

Intussusception. 

Belladonna, gr. iv of extract in an enema, has been successfully used (Wa.). 
Opium, in full doses carried to narcotism, has been successful in many cases 
(Wa.) ; must be used freely to prevent inflammation (Alacleod). Effervescent 
Enemata, have been employed with success (B.). Tobacco Enema, may over- 
come, and has proved exceedingly effective, but is dangerous. Produces most 
depressing nausea. Not safe to use more than ^iv of the infusion ; 3j-Oj (B.). 
Inflation, of intestines with air {Hipftocrates), seems a most reasonable mechan- 
ical remedy. Irrigation, by hydrostatic pressure is resorted to with success. 
Requires care and gentleness (B.). Hot water (Wa.) ; ox-gall, gr. x-xxx in the 
solution used, is especially efficient in cases arising from partial paresis of the 
bowels (Hawkins). The knee-chest position is the best during irrigation or 
inflation. [Compare Hernia, Typhlitis.] 



Irritability. 

Ignatia, in small doses diminishes, in large doses excites irritability of cere- 
brospinal axis. The remedy par excellence (Pf.). Chloral gr. v, 2 or 3 times a 
day, in irritability with nervousness and restlessness (R.). Chamomilla, is an 
excellent sedative for children, in doses of rr\J of the tincture every ^ hour (A. 
A. Smith). Opium, gives calm to the nervous system if used in medium doses. 
Strychnine, in functional irritability of the nervous system. [Compare Insom- 
nia, Nervousness.] 

Iritis. 

Belladonna, locally and internally (R.) ; rr^v every 3 hours, also lotion (Jj of 
extract to ^iv aquae), is of great value (P.). Atropine (solution gr. iv ad ^j) 
has a wide field of utility, as mydriatic (B.) ; should never be omitted (C.) ; is 



612 



JAUNDICE. 



essential in the treatment of every form, should be applied early in the case 
and persevered in throughout its continuance (Lawson). Mercury, when of 
syphilitic origin, as it usually is (B.) ; the bichloride is of great service (R.). In 
plastic iritis of original severity, or in cases aggravated by improper treatment, 
mercury is imperative, gr. ij of blue pill twice a day, until blue line on gums 
(C). Duboisine, as substitute for atropine, is more rapid for effecting dilatation, 
less irritating to the conjunctiva, and has less permanent after-effects (B.). 
Turpentine, in so-called "rheumatic iritis" is very successfully used; small 
repeated doses (P.). Opium, when much pain, an indispensable adjuvant. 
Morphine, hypodermically (C). Copaiba, 5'j i n mucilage, thrice daily, gives 
excellent results in iritis and sclerotitis, diminishing pain in 24 to 48 hours, and 
restoring sight (Hall). Quinine and Iron, when the patient is feeble or anaemic. 
Irritants, or astringents should never be employed (C). Surgical. Paracen- 
tesis when increased tension. Corelysis when only one or two adjacent adhe- 
sions. Iridectomy. Complete functional rest to the eyes, by atropine and a 
bandage with compression-pad, an absolute necessity during the whole period 
of treatment (C). [Compare Syphilis.] 

Prescriptions. 



R . Hydr. Chlor. Corr., . . . gr. j. 

Potassii Iodidi, £j. 

Tinct. Calumbae, % ij. 

Aquae Destil., .... ad ^vj. 
M. Sig. — A dessertspoonful, in a wine- 
glass of water, 2 or 3 times daily. 

{Lawson.) 



R. 01. Terebinth., yiij. 

Syr. Acacise, 3J SS « 

Aquae Cinnamomi, . . . . ^ss. 
M. Sig. — A teaspoon ful 4 or 5 times 

daily. 



R. Extracti Belladon., .... ^j. 
Ung. Hydrargyri, ; . . . % vj. 
M. Sig. — For inunction to brow. 



Jaundice. 

Mercury, in attacks with depression, sickness and coated tongue, gr. Ye-y^ 
of gray powder taken at onset, and repeated three or four times a day, very 
valuable (R.). As purgative in jaundice from both deficiency and excess of 
bile, singularly enough (B.). Gray powder with ipecac, followed next morning 
by castor oil, is well adapted in the jaundice of infancy and childhood (Wa.). 
Mercurials and podophyllum are better avoided, especially in obstructive jaun- 
dice, unless very marked indications for them exist (Da Costa). Celandine, was 
formerly employed as deobstruent (P.) ; energetically affects the liver (Pf.)- 
Hydrastis, useful if continued for some time, in jaundice from catarrh of ducts 
(B.). Arsenic, has been used with success in jaundice from catarrh of bile ducts 
after catarrh of duodenum. Better for jaundice of malarial origin (B.). Nitro- 
Hydrochloric Acid, internally, and acid bath to right hypochondrium ; tempera- 
ture of bath 96 , ^iij-gall. j (B.) ; when jaundice depends on torpor of the liver, 
or is catarrhal in origin (W.) ; during convalescence, tt\,v-x of the dilute acid 
in Z] of a compound elixir of taraxacum before each meal (Da Costa). Quinine, 
when due to malarial miasm, or when periodic (B.). Euonymin, an hepatic 
stimulant of especial power (B.). Podophyllum, in catarrhal and malarial 
jaundice (B.) ; when stools exhibit no trace of bile, one dose has cured (Wa.). 
Best avoided, unless markedly indicated (Da C). Sodium Phosphate, no 
remedy superior in jaundice from catarrh of gall-ducts; Z) doses every four 
hours for adults : gr. x-^j for children (B.). Manganese, in jaundice from 
malarial origin, or catarrh of biliary passages (B.). Aloes, for simple jaundice 
of an atonic kind (B.) ; when hypochondriasis (P.). Rhubarb, for above mala- 
dies in children; white or clay-colored pasty stools; skin jaundiced (B.). 
Saline Purgatives to depurate the upper bowel, as Rochelle salt ; with alkaline 
baths, diaphoretics and diuretics (Da C). Ammonium Iodide, gr. j-iij in water 
every 2 or 3 hours in catarrh of bile ducts and jaundice. Also Ammonium 
Chloride, with fluid extract of taraxacum (B.). The Chloride, in 20-grain doses 



JOINT AFFECTIONS KERATITIS. 613 

every 4 hours, produces a decided change (Wa.). Stillingia, relieves jaundice 
and torpid liver following intermittent fever (B.). Dulcamara, employed with 
advantage (P.). Iris, in malarial jaundice and that from duodenal catarrh (B.). 
Alkaline Mineral Waters, especially in catarrh of duodenum or bile-ducts (B.). 
Potassium Salts. The Chlorate in chronic or asthenic jaundice. The Sulphate 
the most useful saline purgative in jaundice (Wa.). Aliment. No starches or 
fats. Milk, eggs, oysters, beef broth, broiled or raw beefsteak, or whitefish (B.). 
Plenty of green vegetables at each meal, use cold water freely, avoid all high 
seasoning in food, and all liquors. [Compare Hepatic Cirrhosis, Hepatic 
Diseases, Calculi.] 

Joint Affections. 

Phenacetine, for the pyrexia of polyarthritis ; is efficiently antipyretic and 
safe. Aconite, for pains in inflamed joints (R.) ; the liniment locally in chronic 
arthritic swellings (Wa.). Mercury, the oleate in chronic inflammation of the 
knee (R.). Diluted Ung. Hydrarg. Ammoniat. 3j to giv at first, then 3] to ^j, 
by gentle friction 2 or 3 times daily, in chronic articular inflammations by far 
the best application (P.). Rhus Toxicodendron, internally and as lotion, is 
invaluable for subacute stiffness and aching of joints after acute rheumatic 
fever (P.). Iodine, with 3iij— yj ad glycerini giij, aq. destil. ^iv, in numerous ob- 
stinate cases of jo,int affections consequent on rheumatism (Wa.). Ferric 
Iodide, with Iodine locally, in scrofulous affections of the bones and joints 
(Wa.). Iodoform has been used with satisfactory results in scrofulous affections 
of the joints and bones by many continental authorities (Wa.). Salicylic Acid, 
5j with 5iv of Lanolin, and 01. Olivse, q. s. to make a paste, applied locally and 
covered with cotton, or rubbed in once daily for 3 or 4 days, then omitted for a 
week, and again renewed, is of proven value in many obstinate cases of stiff 
knees, pains from so-called rheumatism, painful ankle and wrist-joints, etc., 
(Aulde). Arsenic, often serviceable in rheumatoid arthritis and nodosity of 
joints. Large doses continued necessary (R.). Alcohol, and water, equal parts, 
an excellent evaporating lotion (B.). Silver Nitrate, a strong solution in nitrous 
ether is the most efficient application to check inflammation in small joints if 
applied early to adjacent vascular parts (B.). Cod-liver Oil, in strumous subjects 
(R.) : the remedy on which most reliance may be placed in scrofulous joint 
affections (Wa.). Cold Douche, Galvanism, Turkish Baths, for stiff joints 
(R.). Digitalis, as fomentation, gj of tincture to 0)4 boiling water, applied on 
flannel, has proved very efficient in acute inflammations of joints (Fairbank). 
Turpentine, the liniment a serviceable application in chronic enlargement of 
the joints (Wa.). Sulphuric Acid, as irritant ointment, £j of acid to %] of lard, 
very beneficial in chronic diseases of joints (Wa.). [Compare Bursitis, Cox- 
algia, Gout, Rheumatic Arthritis, Rheumatism, Synovitis.] 

Keratitis. 

Atropine, renders great service by contracting vessels (B.). Atropine by 
instillation, with enforced disuse, and a protective bandage, should be regarded 
as measures of course (C). Mercuric and ferric perchlorides, with cod-liver 
oil, will accomplish all that medicine can do for interstitial keratitis in syphilitic 
subjects (C). Calcium Sulphide, proves most useful in doses of gr. -^ to }{ , 
thrice daily, in sugar-of-milk trituration (Snell). Arsenic, Potassium Iodide or 
Bromide, Iron or Quinine, for constitutional effects in vascular keratitis. Also 
counter-irritation by iodine painted on the temples till soreness (C). Ferric 
Perchloride, successfully employed in panniform keratitis. A large drop of the 
solution dropped from a quill every second or third day (Wa.). Eserine, lowers 
intra-ocular tension (B.). Astringents or Irritants (as alcohol in any form, zinc 
sulphate, silver nitrate, etc.), are entirely inadmissible (C). Iridectomy, is often 
beneficial in severe vascular keratitis (C.). Pressure Bandage, in severe sup- 
purative forms, limits extent. Water, cold when inflammatory symptoms 
marked: hot (90-100 F.) in non-inflammatory form, to excite inflammatory 



614 LABOR — LACTATION. 

reaction ; should be discontinued when marked injection. [Compare Corneal 
Opacities.] 

Prescription. 

Sig. — A teasp. in a winegl. of tepid 



R . Hydrarg. Chlor. Corr., . . gr. j. 

Ammonii Chloridi, . . . . gr. vj. 

Tinct. Belladonnae, . . . . Sjij. 

Aquae Destillatre, . . . . ^ viij. 
M. et fiat, collyrium. 



water, to be applied frequently with a 
pledget of lint on the closed lids. In 
phlyctenular keratitis of children. 

( Turnbull.) 



Labor. 

Ergot, when uterine inertia, after the first stage passed. Is dangerous if any 
obstacle in front. Danger to child in paralysis of fcetal heart (B.). Is best 
given when head has passed the brim of pelvis (Wa.). Anaesthetics, in pro- 
tracted and painful labor ; cautiously with primiparse (B.) ; increase the risk of 
post-partum hemorrhage (W.). Chloroform, not to complete anaesthesia, lest 
uterine action be interrupted. Usually begin when os is dilated (Simpson). 
Chloral, of great value to relieve pain ; does not interfere with the exhibition 
of chloroform ; should be given in 15-grain doses every J^-hour till effect pro- 
duced (Wa.) ; the best of all remedies for rigid, undilatable cervix, gr. xv every 
20 minutes for 3 doses, perhaps a 4th after an hour's interval (Playfair). 
Ethyl Bromide, a rapid, sure and safe anaesthetic, particularly suited to labor 
cases (Levis). Opium, facilitates dilatation, promotes expulsive power of uterus, 
lessens hemorrhage, stimulates longitudinal and oblique fibres of the os (Wa.). 
Cimicifuga, exercises special action, similar to that of ergot ; is less dangerous 
to life of child and soft parts of mother (Wa.) ; for mental disturbance and 
suppressed lochia (R.) ; as partus accelerator in lieu of ergot, also to allay ner- 
vous excitement after labor, and to check post partum hemorrhage (P.). Opium, 
a full dose of Morphine, gr. X» i n tedious labors, with severe pains, will aid 
patient greatly and promote progress of the child. No bad results ensue. 
Morphine, for relief of pains and after-pains, or painful complications (Wa.). 
Hypodermically in rigid os and cervix (R.). Belladonna, topically to uterus, of 
great service in long-protracted labors from rigidity of os and cervix (H.). 
Gelsemium, quiets the " nagging" pains of the first stage ; requires physiologi- 
cal doses (B.) ; relaxes spasm in rigidity of the os (Wa.). Quinine, to strengthen 
uterine contractions ; used by many in place of ergot (R.). Cannabis Indica, 
the tincture gtt. xxx, as stimulant to uterine contractions, more prompt, less 
lasting, than ergot (Wa.). Ipecacuanha, after delivery ; to promote natural 
functions (R.). Cotton-root, as excitant of uterine contractions may be more 
energetic than ergot (P.). Althaea, the decoction, as vaginal injection in diffi- 
cult labor (P.). Sodium Borate, excites activity of the uterus, and is well em- 
ployed in tedious labor, where there is deficiency of uterine contraction (Rigby). 
Amyl Nitrite, has acted admirably in a case of hour-glass contraction of the 
uterus; seems to antagonize the action of ergot (Barnes). Oil of Eucalyptus 
is very valuable in effecting antiseptic midwifery (Wa.). Mercury. The 
bichloride, gr. vijss to a quart of hot water gives a 20W solution, probably the 
worst of all antiseptics for this purpose : is too dangerous for obstetrical use 
(Fleischman). [Compare Abortion, After-pains, False Pains, Hemor- 
rhage Post-partum, Lactation, Puerpera.l Convulsions, — Mania, — 
Fever, — Disorders.] 

Lactation. 

Pilocarpine, as a galactagogue, gr. y& of the muriate in brandy on retiring, 
the patient to be covered well in bed. Is efficient in direct proportion to its 
diaphoretic and sialagogue effects, these being evanescent, but its galactagogue 
power remaining for weeks, an occasional dose only being required to spur up 
the secretion when flagging (Minges). Antipyrine, as an anti-galactagogue, 
4-grain doses every 2 hours have proven highly efficient. Belladonna, inter- 
nally or externally or both, in excessive lactation (R.). Atropine gr. iv-^j aquas 



LARYNGISMUS STRIDULUS LARYNGITIS. 



615 



rosse on lint around the breast to arrest secretion of milk. Remove when fauces 
become dry and pupils dilated (B.). Camphor, locally to arrest the secretion ; 
a saturated solution in olive oil or glycerin, is more efficient than belladonna 
(Wa.). Potassium Iodide, in 25 to 30-grain doses internally, for the same pur- 
pose, is very effectual (Rousset). Calcium Phosphate and Hypophosphite, in 
debility from over-lactation (R., Wa.). Ammonium Chloride, for the intercostal 
neuralgia of suckling women ; gr. x-xx, every 3 or 4 hours (Wa.). Quinine, 
Tannin, are used to arrest the secretion (R.). Alcohol, as beer or porter, 
often useful in excessive lactation — not always (R.). [Compare Abscess, 
Agalactia, Mastitis, Nipples, also the List of Galactagogues on page 49, 
ante.'] 

Excreted in the milk, when taken by the nursing woman, are the oils of 
anise, cumin, dill, wormwood and garlic, — turpentine, copaiba,-— the active 
principles of rhubarb, senna, scammony, and castor-oil, — opium, iodine, indigo, 
antimony, arsenic, bismuth, iron, lead, mercury, and zinc. Acids given to the 
mother cause griping in the child. Natural salts, as a rule, and the purgative 
agents above-named, act as purgatives to the child, and potassium salts as 
diuretics. Turpentine, copaiba and potassium iodide given to the mother, can 
be detected in the urine of the child. Opium given to the mother may narcot- 
ize the child, and mercurials in the same manner may salivate it (Br.). Atro- 
pine, hyoscyamine, the salicylates, and potassium sulphide, have also been 
found in the milk after their ingestion by the woman. 



Prescription for Milk- Fever. 



R . Tinct. Aconiti, TC\xx. 

Antim. et Potass. Tart., . gr. ij. 
Spt. Etheris Nitrosi, 

Syr. Simplicis, . . . . aa Jf j. 

Aquae Aurantii Flor., . . . 5 ij 
M. 



Sig. — A teaspoonful in a wineglassful of 
sweetened water, every two hours. 

{Fordyce Barker.} 



Laryngismus Stridulus. 

Aconite, checks the spasm and relieves the croupous breathing (R.). Bella- 
donna, promises to be of value (Wa.). Atropine, gr. ^^ in a goblet of water 
(60 doses), of which give a teasp. every hour or ^-hour, will give prompt 
relief (A. A. Smith). Bromides, when uncomplicated except with convulsions 
(R.). Full doses will suspend an attack, and moderate doses steadily contin- 
ued will prevent recurrence (B.). Ipecacuanha, an emetic dose to cut short 
an attack (B.). Lobelia, has been employed (R.)- Chloroform, quickly cures 
the paroxysm, a few drops on a handkerchief sufficient (B.) ; may often be 
used with advantage (W.). Nitroglycerin, will speedily allay the spasm (B.). 
Chloral, gr. v-xv to prevent or arrest (B.). Quinine, given between attacks to 
prevent (B.) ; a most valuable remedy, but in small, repeated doses (P.). 
Emetics. Tartar emetic; mercuric sulphate (gr. iij-v) safer and better (B.). 
Conium, is valuable, carried to a point of physiological effect (B.). Water, 
wet pack to neck (B.) ; cold sponging twice or thrice daily more successful than 
anything else, with out-of-door exercise. Cautiously if hoarse voice indicates 
laryngitis (R.). [Compare Croup, Laryngitis.] 



Laryngitis, Acute Catarrhal. 

Aconite, very valuable (R.) ; especially indicated in inflammatory states of 
respiratory parts ; gtt. ss-j every half-hour till an impression is made on the 
fever, then every hour or two (B.). Antimony, Tartar emetic, gr. 3 ^, a very 
excellent remedy internally ; larger doses in cedematous laryngitis, gr. y 1 ^ with 
gr. iij of Dover's powder every 2 or 3 hours (Da Costa). Iodine, inhaled ; 
also as counter-irritant painted over neck (B.). Morphine, small doses to allay 
cough (A.). Sulphurous Acid Spray, is vaunted (Wa.). Leeches to throat are 
valuable auxiliaries to general treatment in sthenic cases ; or cupping at the 



6l6 LARYNGITIS. 

nape of the neck (Wa.). Rumex, has selective action on the laryngeal mucous 
membrane. See page 352. Zinc or Copper Sulphates, as emetics, in large 
quantities of warm water, where oedema slight (A.) ; a solution of zinc sulphate, 
gr. xx to £j on sponge to larynx with aid of the laryngoscope if possible to use 
it (Da C). Scarification, by Mackenzie's laryngeal lancet, of great service in 
the cedematous form (Da C.). A Purgative and Diaphoretic, with mucilagi- 
nous drinks, if given at the start may be sufficient (Da C). Iron, Monsel's 
solution, 1 part to 2 or 3 of water and glycerin, an excellent local application 
(Da C). Heat, by poultices or fomentations (A.). Hot-water stupes may 
succeed (Wa.). Inhalations of hot steam, with benzoin, the comp. tinct. gtt. 
x-xv to 3J, with gtt. x tinct. opii, or hops, or conium, of great service (Da C.). 
Tracheotomy ought not to be delayed, if inhalations, leeches, and fomenta- 
tions fail (A., Wa.) ; is especially indicated in sudden attacks of cedematous 
laryngitis, as those occurring in Bright's disease (Da C). Ice, steadily applied 
in bags over the larynx, if tracheotomy refused, has succeeded in bad cases. 
Small pieces may be slowly swallowed (Da C). [For Croupous Laryngitis, 
see Croup, Membranous; for Spasmodic Laryngitis, see Croup, Catarrhal; 
for (Edematous Laryngitis, see Glottis, CEdema. Compare also Laryngis- 
mus Stridulus, Pharyngitis.] 



Laryngitis, Chronic. 

Iodine, painted over neck as a counter-irritant, and inhalation of its vapor 
(B.). Sulphur. Sulphurous acid as spray in syphilitic or tubercular laryn- 
gitis, or a solution of sodium sulphite (3j to the oz.) in water (B.) ; by inhala- 
tion, spray, or fumigation (R.). Carbolic Acid, where long-standing hyper- 
aemia with diminished secretion, 3j-ij to the 3 of glycerin is a most successful 
application (Morell Mackenzie). Silver Nitrate, powdered or in solution to 
chronically inflamed larynx, as in phthisis (R.); a solution of gr. x or xx ad 
^j, applied with a brush by the aid of the laryngoscopic mirror (W.). For- 
merly much used, but is objectionable (B.). Should be used with great caution, 
and only when a particular point can be seen for it with the laryngoscope 
(Da C). Ferric Perchloride, solution gr. lx-cxx ad ^j glycerini as local applica- 
tion (A.). Zinc Chloride, gr. xx-xxx ad ^j, in glycerin. Alteration of topical 
applications, of great value (A.). Copper Sulphate, gr. xx to ^j of water, 
locally twice a week (Da C). Bismuth, the subnitrate by insufflation, is highly 
recommended in the worst forms of laryngitis, even in that accompanying 
phthisis (Tr., Wa.). Guaiacum, as lozenges, very useful in mucous laryngitis 
(A.). Althaea, as pectoral lozenges to relieve laryngeal irritation (P.). Cubebs, 
the berries chewed are very efficient in relaxation of the larynx following a 
cold or long speaking (Wa.). Cocaine, a 20 per cent, solution of the hydro- 
chlorate by spray, mop, or brush, is very efficient in many laryngeal affections 
(Prosser James). Benzoin, in strumous laryngitis (Wa.) ; in chronic, benzoin 
on hot coals, or inhaled from boiling water, of great service (Tr:). Tannin, in 
chronic catarrh and ulcerations, a solution (gr. x-^j-^iv) applied by hand-ball 
or steam atomizer (B., A.). Inhalations, or spray, of the best agents very 
grateful (B.) ; air loaded with vapors of ammonium muriate by inhaler, said to 
be used successfully (W.) ; vapors from boiling tar, turpentine, etc., placed on 
hot water, or better by steam atomizer (Da C.) ; chloroform, hops, benzoin, 
etc., by atomization (Walker). Insufflation, substances to be in small quantity, 
mixed with bland powder (B.). Functional Rest of voice often requisite, especi- 
ally in phthisical and syphilitic laryngeal ulceration (A.). Chronic Laryngitis, 
includes many disorders of the larynx, which of late years have been differ- 
entiated, as — thickened vocal cords (chronic laryngitis proper), laryngeal ulcers, 
polypi, cysts, cauliflower growths, tubercular and syphilitic laryngitis, etc., in 
all the voice being similarly affected. Dysphagia, as a concomitant symptom, 
is constantly indicative of tubercular laryngitis (Da Costa). [Compare Cough, 
Phthisis, Syphilis, Dysphagia.] 



LARYNGOTOMY LEUCORRHCEA. 6 1 J 

Laryngotomy. 

Laryngotomy is more quickly and easily performed on the adult than trache- 
otomy, being farther from the lungs and less dangerous. It is usually directed 
to be performed by cutting longitudinally through the skin, then horizontally 
through the crico-thyroid membrane, which may be felt as a soft depression, 
an inch below the pomum Adami. In urgent cases, however, Professor Wood 
recommends a narrow-bladed knife to be passed horizontally through both 
skin and membrane at once, and then to enlarge the opening laterally to the 
required extent. The advantage of having a horizontal incision in the skin is 
the greater openness of the wound when the patient throws up his head under 
a sense of dyspnoea (D.). In Laryngo-Tracheotomy, the deep incision is car- 
ried downwards from the crico-thyroid membrane, through the cricoid cartilage 
and one or two of the upper rings of the trachea (CL). 



Leprosy. 

Anacardium Orientale (Oil of Cashew), has been much lauded. Investiga- 
tion established that much of its success was due to hygienic measures and 
use of fresh meat as food (P.). Arsenic, with 5 or 6 times the quantity of black 
pepper, in esteem in India (Wa.). Sarsaparilla, as tonic and alterative, valu- 
able (P.). Gurjun (Wood Oil), as ointment and emulsion, has been used with 
success in alleviating the disease, by Dr. Dougall, Port Blair, Andaman Islands. 
The ulcers of 24 lepers healed thereby. Ferri Arsenias, gr. i daily, is used 
with success (Wa.). Mercury, the oint. of the red iodide, diluted 1 to 10, or 
gr. j of the salt to 3v of unguentum, gives very good results (Wa.). Diet. 
Nutritious food, cleanliness, bath, will do much to prevent the manifestations 
of the disease (R.). Chaulmoogra Oil, see page 165, is credited with a few 
cures and many cases improved. The oil is mixed with Psoralea corylifolia as a 
liniment, and also used internally (Wa.). Hoang Nan, is considered of utility 
by a number of writers on leprosy, and is given in combination with Alum 1, 
Realgar 2 or 1, and the drug 2 parts, the whole being made into 3-grain pills, 
one pill daily being given at first and gradually increased (Pf.). Argenti 
Nitras, is said to act as a tonic and alterative, and to control leprosy for a 
limited period (Pf.). 

Leucocythaemia. 

Alkaline Hypophosphites, have been used with more or less benefit (Wa.). 
Digitalis, in young subjects (B.). Nitro-muriatic Bath, should not be neglected, 
with tonics and nutrients (A.). Iron, is of little value (B.) ; large doses may do 
good in early stage, with careful diet, and Ergot to contract the spleen (Da 
Costa). Phosphorus, gr. J-^ increased to gr. -fa, has proved successful in several 
cases (Wa.). Arsenic, in as full doses as can be borne, may be of service 
though hitherto ineffectual (Gowers). Galvanization of the spleen causes im- 
provement of the blood, increasing the number of its red corpuscles (Gowers) ; 
is curative in uncomplicated cases (B.). 



Leucorrhcea. 

Hydrastis, the fluid extract, undiluted topically, quickly improves in uterine 
and vaginal leucorrhcea (B.). Pulsatilla, 5-drop doses ter die for a few weeks ; 
also a teasp. in a pint of cold or tepid water, as vaginal enema daily, when 
pain in loins, depression of spirits, loss of appetite, etc. (P.). Silver Nitrate, 
in solution locally, also tampon saturated with Z] each of alum and bismuth, 
when leucorrhcea due to granular vaginitis (Parvin). Balsam of Peru and 
Tolu, internally (P.). Glycerin, is largely prescribed for vaginal leucorrhcea, 
and for erosions and ulcerations of the cervix uteri (B.) ; the best vehicle for 



6l8 LICHEN LITH.EMIA. 

other agents (E.). Borax, Z] to Oj water as vaginal wash for the leucorrhcea 
of pregnancy (Parvin). Cimicifuga, is said to be useful (P.). Copaiba, has 
been used with success (P.). Cocculus Indicus, when sero-purulent discharge, 
pain in lumbar region (P.). Carbolic Acid, diluted, as injection (B.) ; for 
vaginal leucorrhcea (R.). Bismuth, with mucilage, as injection ; or with 
cocoa-butter as suppository (B.). Copper Sulphate, in solution, as injection 
(R.). Tannic Acid, in chronic cases serviceable as injection, 3ss of tannic 
acid in ^viij of claret wine (B.). If os ulcerated, a suppository of tannin and 
cocoa-butter to mouth of uterus (R.). Iodo-Tannin, an excellent application, 
Z] of iodine to !|j of tannic "acid, a sufficient quantity to be packed dry around 
the cervix (B.). Alum and Borax, makes a useful injection in vaginal leu- 
corrhcea (R.). Belladonna, with tannin as bolus where neuralgia or ulceration 
of os. When disease due to over-secretion of mucous glands about the os, and 
much pain present, inject sodii bicarbonas, Z) ', tinctura belladonnas, ^ij ; 
aquae, Oj (R.). Potassium or Sodium Bicarbonate, Z) to Oj aquae as injection, 
especially when discharge alkaline and copious (R.). Pareira, Uva Ursi, suc- 
cessfully used (P.). Sumbul, recommended in atonic form (P.). Myrrh, with 
iron or aloes, beneficial (P.). Ergot, said to be useful in some cases* (R.). 
Potassium Permanganate, has no special advantage ; is used in solution (gr. 
ij-^j (B.). Potassium Chlorate, Z) to Oj of water as injection in simple cases 
(Parvin). Iron, the iodide, internally and. externally has proven serviceable ; 
the mistura ferri composita, when anaemia and general debility (Wa.). The 
styptic preparations, locally (R.). Phosphates, for the cachexia (B.). The cal- 
cium phosphate, gr. j-ij several times daily, of great value in checking profuse 
discharge (Wa.). Injections, water at 6o° F. to prevent recurrence (R.). Hot 
water injections best tonic to pelvic vessels, to relieve venous congestion ; use 
with elevated hips (E.). [Compare Endometritis, Uterine Ulceration, 
Vaginitis.] 

Prescriptions. 



&. Aluminis, £j. 

Zinci Sulph., gss. 

Sodii Boratis, gr. iv. 

Aq. Rosse, ....... ^viij. 

M. Sig. — Injection. (B.) 



&. Liq. Plumbi Subacet., . . ^jss. 

Ac. Carbolici, 3; ss. 

M. Sig. — One-fourth to be added to 
pint of water and used as an injection. 



Lichen. 

Antipyrine, internally for the itching, is efficient. Aconite, sometimes 
useful (R.). Mercury, calomel and nitrate of mercury oint. mixed (also 
tar oint. added), in patches of obstinate lichen (R.). Silver Nitrate, the 
nitrous ether solution painted every day or two over patch (R.). Baths, 
warm or of sulphides (R.) ; sponging with alkaline lotions, diluted lead 
water, fluid extract of grindelia well diluted, or solution of copper sulphate, 
gr. x to the j§, in miliaria, or prickly heat (lichen tropicus) ; with dusting pow- 
ders of lycopodium, zinc oxide or starch, singly or combined (Hughes). Potas- 
sium Citrate, or some other refrigerant diuretic, and light, unstimulating food 
(Da Costa). [Compare Eczema.] 



Lithsemia. 

Piperazine, by far the best agent to promote elimination of uric acid and 
urates, with which it forms the most soluble of all known uric acid compounds : 
relieves the pruritus of the uric diathesis. Lithium Salts, especially the citrate, 
gr. xx thrice daily, is very efficient (Da Costa) ; the carbonate invaluable (Wa.) ; 
the bromide, in solution of citrate of potassium, given after stomach digestion 
is completed, one of the very best agents (Aulde). Pichi, of great value in lithae- 
mia with cystitis (Wyman). Arsenic, in small doses, is also useful (Da C). 
Nitric Acid, 10 minim doses of the dilute acid in half-glass of water thrice daily, 



LOCOMOTOR ATAXIA. 



619 



with an occasional dose of pil. rhei compos, at bedtime, is the most efficient 
treatment for the class of patients who will not diet themselves (Hughes). Pur- 
gatives, especially alkaline mineral waters, to clear the portal system (Da C). 
Sodium Phosphate, in laxative doses, 3j thrice daily, gives good results. Alka- 
lies, in biliousness ; also the continued use of alkaline waters rich in potassium 
salts, for solution of calculi (B.). Acids, hydrochloric often of great service ; 
also lactic acid, when faulty digestion and assimilation (Br.). Potassium Per- 
manganate, prevents calculi by converting uric acid into urea (B.). Buchu, 
combined with an alkali, has been a beneficial remedy (P.). Colchicum, 15^ 
doses of the wine, twice or thrice daily ; is very useful (Wa.). Chimaphila is 
believed to check the secretion of lithic acid (P.). Aliment, farinaceous vege- 
tables and acid fruits are suitable (B.). Alcohol in any form is poison to a 
lithasmic (Da C). Succulent vegetables and fruits, occasional abstinence 
from animal food. High living, alcoholic liquors, and sedentary habits are 
injurious. Milk diet, and frequent draughts of pure water also recommended. 
Removal to a locality where pure soft water can be procured, is often curative. 
[Compare Calculi, Dyspepsia, Gout. 



Prescriptions. 



R. Lithii Bromidi, ^ S H- 

Liq. Potas. Citrat., . . . ^iv. 

Syrupi Simp., ^ij. 

M. Sig. — A teasp. in a wineglassful or 

more of water, 2 hours after each meal. 

Reduce after a week. 



R. Tinct. Belladon., . . . . TT\xviij. 

Vini Colchici Rad., . . . j^ij. 

Liq. Potas. Citrat., . . . ad^iv. 

M. Sig. — A dessertsp. well diluted, 
every 3 hours. 



R. Potas. Nitratjs., ^j. 

Ext. Pichi Fl., % j. 

Elixir Simpl., ^iij. 

M. Sig.— A teasp. every 2 hours. 



R. 



Vini Colchici Rad., . . . sjij. 
Ext. Phytolaccse Fl., . . gj. 

Potas. Acetatis, j^iij. 

Aquae, q. s. ad ^vj. 

M. Sig. — A tablesp. four times daily. 



Locomotor Ataxia. 

Belladonna and Ergot are highly recommended by Brown-Sequard (R.). 
Silver Nitrate, when motor disturbances are very marked. Improved 1 in 20 
(R.) ; gives the best results in doses of gr. % to gr. y 2 thrice daily, withholding 
it after a few weeks to prevent argyria. The Oxide may be used instead-of the 
nitrate, in half-grain doses (Da Costa). Potassium Iodide, Corrosive Sublimate, 
or Chloride of Gold and Sodium, all in full doses, often retard the progress of 
the disease (Da C). Physostigma has proved beneficial (R.). Phosphorus, use- 
ful, but may not cure (B.). Hyoscyamine, ameliorative, gr. -^ gradually to gr. 
■j^ (B.). Electricity, galvanic, relieves pain ; faradic stops wasting of muscles 
(B.) ; in stage of irritation the constant current (ascending) through spinal 
column (R.). Water, one of the most efficient agents ; friction with a cloth 
dipped in water of 60-65 F., a cold compress to head ; 4-8 minute bath of 70- 
75° gradually lowered to 6o°, then shower-bath frictions (R.). Rest, as com- 
plete as possible, must be insisted on ; with good, nutritious diet, milk being 
desirable (Da C). Pilocarpine, produces general improvement if given in the 
incipiency, gr. j to ^ j of water, of which rt^xxx twice daily (B.). Strychnine, 
gr. -^j in 3j of syr. hypophosphitum, thrice daily, when the system is saturated 
with silver (Da C.). Suspension daily, by head, has seemed to give relief to 
pain and improve condition. Is known as Charcot's treatment, but discovered 
by Matchoukowsky, of Odessa, and carried out systematically by Hessing, of 
Pesth, before Charcot took it up. Antipyrine, relieves the pains remarkably. 
Phenacetine, for the lancinating pains, is efficient. 



620 LUMBAGO LUNG DISEASES. 

Lumbago. 

Cimicifuga, said to be more effectual than any other remedy (R ) ; has some- 
times wonderful success; no indications can be given for it; 5ss-ij of fluid 
extract (B.) Curative (P.). Rhus Toxicodendron, in subacute muscular or tendin- 
ous rheumatism, worse at night ; completely relieves some cases (Pf.). Veratrum 
Viride, the tincture useful (R.). Aconite in ^ni, doses of tincture every two 
hours, with linim. aconiti locally (Wa.). Iodides, if referable to syphilis, mer- 
cury, copper, tin, or lead poisoning (B.). Ammonium Muriate, is very efficient 
in myalgic lumbago, gr. xx thrice daily for 2 days or until signs of congestion 
of the nasal mucous membrane appear, — then to be replaced by Quinine, 
gr. v, thrice daily for a week (Waugh). Antipyrine, gr. vij, hypodermically, 
completely banished it in a very bad case at the Hotel Dieu, Paris. Morphine, 
hypodermically to relieve pain (B., R.) ; gr. ye with Atropine gr. -^, hypoder- 
mically, will frequently cure lumbago in two or three hours (Da C.). Capsicum, 
a strong infusion applied on lint, and covered with oiled silk, very efficient in 
recent lumbago (R.) ; a capsicum plaster is a. very efficient application. Potas- 
sium Nitrate, in ten-grain doses hourly or every two hours, when urine scanty 
and high-colored (R.). Belladonna, as plaster, very valuable for persistent 
lumbago remaining in a small spot (R.). Turpentine, in doses of tt^xx-xxx 
(carefully, lest strangury and nephritis), of greatest value when the bowels 
regular and urine clear and abundant ( Wa.). Ether Spray, externally as freez- 
ing mixture (R.). Guarana, xv-xl-gr. doses removed severe chronic (Rawson). 
Chloroform Liniment, affords relief (Wa.). Canada Balsam, gr. v-xx, is useful 
or Burgundy Pitch, as plaster (P.). Acupuncture, occasionally gives instant 
relief (B.). Not when high fever (R). Aquapuncture, has been employed 
with extraordinary success (B.). Heat, by hot douche to seat of pain (B.) ; or 
by very hot poultices for three hours, then the skin covered with flannel and 
oiled silk ; or a hot flat-iron (R.). Galvanism, the constant current (B.) ; is 
highly useful ; faradization almost as successful as acupuncture (R.). Strap- 
ping from the thigh upwards with layers of adhesive plaster which overlap each 
other. Nothing is so instantaneously beneficial. Diet, should be generous and 
nutritive. Lemon-juice as a beverage. Absolute rest is of great importance. 
[Compare Rheumatism.] 

Prescriptions. 

R. Collodii, 
Tinct. Iodi., 
Spt. Ammonise, 

aa part geq. 
Sig. — Paint over the part with a camel's- 
hair brush. (Burggraeve.) 



& . Ext. Cimicif. Fl., . . . . g ij. 
Ammon. Chloridi, . . . . ^j. 
Aq- Laurocerasi, 

Syr. Simplicis aa ^j. 

M. Sig. — A teasp. thrice daily. 

{Potter.) 



Lung Diseases. 

Aconite, is indicated in most acute congestions (P.) ; is especially indicated 
in inflammatory states of respiratory organs (R.) ; Belladonna, in rt\, doses of 
the tincture frequently, is of great benefit in pulmonary oedema, to retard exu- 
dation of serum and to counteract the failure of the heart (A. A. Smith). 
Terebene, is very valuable in many conditions. Terpine Hydrate, is still more 
efficient and more easily administered. [See under Bronchitis.] Ammonium 
Acetate, serviceable not only in bronchitis, but in the whole range of acute pul- 
monary complaints as occurring in children (Dessau). [See under Bronchitis, 
for formula.] Veratrum Viride renders important service in acute parenchy- 
matous congestions (B.) ; gr. ]/e of resin in pill when temperature and pulse 
are high. It tends to induce prostration, collapse, etc. (A.). Blisters. Flying 
blisters to chest, and perhaps along pneumogastric nerves in hypostatic con- 
gestion (R.). Copaiba, exercises a powerful influence over the pulmonary 
mucous membrane, and is beneficial in lung diseases generally, when attended 
with excessive secretion (Wa.). Jaborandi, is serviceable for the attacks of 



LUNGS, GANGRENE OF LUPUS. 62 I 

breathlessness attendant on lung affections, but must be watched lest collapse 
ensue (Berkart). Liquor Potassae, in doses of TtLx-xv added to an ordinary 
expectorant mixture, is often attended with good results in congestions of 
bronchi and lungs, chronic bronchitis, plastic bronchitis, etc. (Walshe). Cimi- 
cifuga, is a useful sedative in many irritative affections of the lungs and bron- 
chial tubes, relieving cough, improving appetite, and ameliorating the general 
condition (Wood). Croton Oil, as liniment, is a highly useful counter-irritant in 
many chronic lung diseases, and even in the bronchitis of infancy (Park). 
Cubebs, in small and oft-repeated doses, is efficient in chronic bronchitis and 
other lung affections of old persons, checking the excessive secretion and 
gently stimulating the system (Wa.). [Compare Bronchitis, Emphysema, 
Hemoptysis, Phthisis, Pleuritis, Pleurodynia, Pneumonia.] 

Lungs, Gangrene of. 

Creasote, by inhalation, to obviate the fetor (R.). Carbolic Acid inhalations, 
are used with marked benefit (Wa.). Mineral Acids, especially nitro -hydro- 
chloric, with Quinine, the main reliances in chronic pulmonary gangrene (A.). 
Stimulants, as malt liquors, with general tonic treatment, are necessary (A.). 
Ammonium Carbonate, one of the most reliable remedies ; is best given in 
decoctum cinchonae (Wa.). Eucalyptus, the oil with alcohol, equal parts of 
each, of which Z) as inhalation by steam atomization, is useful (Wa). Turpen- 
tine, the spirit on boiling water inhaled for fifteen minutes every two hours, suc- 
cessfully employed (Skoda). [Compare Pneumonia, Phthisis.] 

Lupus. 

Aristol, as an application, has given excellent results. Arsenic, in chronic 
cases, not of syphilitic origin (B.). Arsenious acid as caustic (R.). The best 
remedy in lupus of head and face (Wa.). The oleate of arsenic, in ulcerating 
forms, constantly applied, will destroy cell-infiltration in a mild and compara- 
tively painless manner; is also well employed in the tubercular variety (Wa.). 
Iodine, useful, whether syphilitic or scrofulous ; the tinct. or a glycerin solution 
(B.) ; as tincture or liniment to edges and around (R.). Mercury, as ointments 
in erythematous lupus, calomel ointment in scrofulous and tubercular lupus of 
children (R.). Calomel int., gr. j-ij increased to iv, will quickly check (Wa.). 
Emplastrum hydrargyri very efficient in lupus erythematodes and allied affec- 
tions (Kohn). Cod-liver Oil, internally and locally (B.). Lead, liq. plumbi, 
with one or two parts of glycerin, applied warm after removal of crusts, in 
milder forms (R.). Carbolic Acid, as a mild escharotic (B.). Zinc Sulphate, 
dried, as caustic, freely dusted over surface, and a poultice to remove slough 
(B.). Jequirity, a most useful application (Shoemaker). Sodium Ethy- 
late on absorbent cotton, is the best of all caustics, followed by the Oleopal- 
mitate of Bismuth as a soothing and astringent application (Shoemaker). 
Chromic Acid, an efficient local application, gr. c-^j aquae destil. (B.). Phos- 
phorus, as substitute for arsenic (B.). Silver Nitrate, a weak solution gradually 
strengthened, in superficial forms (R). Cauterization, with the actual cautery 
at white heat, after scraping out as much as possible of the diseased parts, so 
as to destroy the lupus cell. Seek to replace the lesion by a cicatrix, to prevent 
relapse in situ, and the development of the disease elsewhere. Internal reme- 
dies only useful for the general health. 



R. Iodi, 

Potassii Ioclidi, ... aa % ss. 

Glycerini, £j. 

M. Sig. — Locally in Lupus. 

(Mc Call Anderson.) 



Prescriptions. 

R. Hydrargyri Bromidi, . . . ^jss. 

Adipis, 3 v. 

M. ft. unguentum. Sig. — To cover the 
part affected, using cod-liver oil freely, and 
the following solution internally. In tuber- 
cular lupus of the face. [Hardy.) 



622 



LYMPHANGEITIS — MALARIA. 



R. Ung. Arsenici Oleat., . . . ^ij. 

Ung. Simplicis, gj. 

M. ft. unguentum. Sig. — Use constantly 
over the affected surface. If pain sets in 
Opium may be added. {Shoemaker.} 



R. Potassii Iodidi, gr. lxxv. 

Sodii Chloridi, % ss. 

Aq. Destil., g viijss. 

M. Sig. — Tablesp. before meals, night 
and morning. {Hardy.) 



Lymphangeitis . 

Belladonna, the extract softened with glycerin, freely applied, is of great 
service ; when pain is severe, a poultice may be applied over the extract for a 
few hours only (Wa.). Lead, liq. plumbi subacet. dil., as an external applica- 
tion, constantly applied, to soothe and restrain the inflammation (Wa.). Iodine, 
in strong tincture, around glands, to prevent suppuration (Roberts). Quinine, 
or Salicin, with alcoholic stimulants freely, in septic cases (Roberts). [Com- 
pare Bubo.] 

Malaria, Chronic. 

Quinine is less curative than when the infection is recent, but in periodical 
affections depending on the malarial cachexia it is of specific value, large doses 
being required (B.). Salicylates, of quinine and ; cinchonidine are especially 
effective in chronic malarial disease (B.). Arsenic plays an important role in 
chronic malarial disease (B.) ; diminishes splenic engorgement, and com- 
bined with iron is rapidly curative of many affections due to the paludal 
miasm (Boudin) ; is a powerful prophylactic against malaria, and in chronic 
malarial poisoning, with frequent return of fever and neuralgia, the continued 
use of arsenic is of great benefit (Fayrer). Iron, the sulphate has decided 
antiperiodic power, and is particularly successful in anaemic subjects and in those 
with enlargement of the spleen (Wa.) ; it improves the anaemia of chronic 
malaria, and should generally be combined with arsenic (B.). Iodide of Iron 
and Manganese, the syrup in doses of tt\,xx-xxx, is a successful remedy for 
chronic malarial infection, and the Sulphate of Manganese gives excellent re- 
sults in jaundice of malarial origin (B.). Cornus, Calumba, and other bitters, 
are highly efficient, especially the first-named, in chronic malarial poisoning, 
and in convalescence after malarial fever (B.). Carbolic Acid and Iodine com- 
bined are of great value in chronic malarial infection ; both are highly anti- 
periodic, and the latter is the best substitute for quinine and the most active 
reducer of splenic enlargement (Gimwell). Eucalyptus is of high utility to 
reconstruct the damages in the organs of assimilation (B.). Baths, the vapor- 
bath and Turkish baths are efficient aids to medicinal treatment in breaking up 
chronic cases, and may of themselves cure such by inducing profuse perspira- 
tion (Da Costa). [Compare Intermittent Fever, Remittent Fever.] 

Prescriptions. 



}&. Cinchonidinse Salicylat., . . ^ij. 

Ac. Arseniosi, gr. j. 

Ferri Sulph. Exsiccat., . . gr. xx. 
M. ft. cachets no. xx. Sig. — One wafer 
thrice daily. 



R . Cornus, 

Calumbse, 

Liriodendri, 

Pruni Virgin., . . . . aa J vj. 

Eupatorii, 

Capsici aa ^ iv. 

Pulv. et misce. Sig. — A teasp. in cold 
or warm water, three or four times daily. 
A good tonic tincture may be made from 
the above combination. (B.) 



R. Quininse Sulph., gr. xl. 

Ferri Sulph. Exsic, . . . gr. xx. 

Ac. Arseniosi, gr. j. 

M. ft. pil. no. xx. Sig. — One pill thrice 
daily. 



R Tinct. Iodi. gij. 

Ac. Carbolici ^j. 

M. Sig. — Two to three drops three or 
four times a day in water. 

Jc. Ac. Arseniosi, gr. j. 

Mas. Ferri Carb., . . . . 5jj. 
M. ft. pil. no. xx. Sig. — One pill thrice 
daily. 



MANIA MASTITIS. 623 

Mania. 

Stramonium, of value ; allays irritation and induces tranquil sleep ; wild and 
furious delirium, but intermittent ; also in nymphomania (P.). Many facts 
seem to confirm its reported value (Tr.). Daturine, gr. t^o~¥o hypodermically 
in acute mania, but is less useful than atropine or hyoscyamine (Wa.). Duboi- 
sine, gr. ■£§ hypodermically in acute mania (Gubler). Belladonna, is useful, 
especially in monomania, with fixed hallucinations, though a large dose causes 
a temporary insanity (Tr.) ; one of the very best remedies in all hyperaemic 
conditions of the brain (P.). Hyoscyamus, in violent intermittent forms, to 
procure sleep and calm violent delirium (R.) ; delirium with hallucinations but 
not congestion ; milder and less inflammatory forms ; also in hypochondriacal 
monomania (P.). Veratrum Viride, successfully combats the excitement in 
acute mania (B.). Camphor, has been used successfully ; its action is uncer- 
tain (P.). Opium, and tartar emetic are satisfactory for many cases ; also mor- 
phine hypodermically to induce sleep (R.) ; narcotic effect of doubtful utility; 
better in insanity with depression (P.) ; will not produce narcotism in many 
cases, even in 2-grain doses. Cannabis Indica, 3j of tinct. with Z] of potas- 
sium bromide, is recommended (R.). Bromides are used in puerperal mania, 
that of pregnancy, nymphomania and other forms (R.)- The combined use of 
potassium bromide and tinct. of cannabis indica, in equal parts, 3j of each 
thrice daily for weeks and months, has proved very efficient in acute and peri- 
odical mania, senile mania, and other forms (Clouston). Chloral, as calma- 
tive, hypnotic, has induced mental improvement, gr. v-xx (B.). Coniine, most 
suitable to acute mania, quiets muscular action (tti^-iij, or hypoder., com- 
mencing with tt^xo)- Very successful with morphine conjointly injected (B., 
R.). Digitalis, 3ss-3j of tinct., valuable in acute and chronic mania, espe- 
cially when complicated with general paresis and epilepsy (Maudsley). Cau- 
tion ! watch the pulse for any marked intermittence (B.). A very valuable 
palliative in acute mania (Van der Kolk). Ergot, large doses, 3ss-j of fluid 
extract, to reduce excitement, shorten attacks, widen intervals between them, 
and prevent exhaustion, hence is very useful in recurrent and epileptic forms, 
and in chronic mania with lucid intervals (Crichton Browne). Iron, as a resto- 
rative, is frequently used in chronic mania with benefit, the tincture of the chlo- 
ride in 5-10 minim doses (B.). Gelsemium, is more useful than conium in 
mania with great motor excitement and wakefulness ; large doses required, 
rri^xv-xx of tincture. Croton Oil, as a purgative, ^%-yi every hour, as revul- 
sive in mania from cerebral congestion (R.). Cimicifuga, is often efficiently 
used in cases of mania occurring during the puerperal or pregnant condition 
(R.). Galvanism, of the head and cervical sympathetic, has produced distinct 
improvement (B.). Paraldehyde, as a hypnotic, in doses of n\,xxx-l, is often 
decidedly useful. (R.). Cold Douche, in maniacal delirium, the patient being 
in a warm bath during the application of the douche to the head (R.). Re- 
moval from home, from sympathetic friends, and from surroundings connected 
with the origin of the malady, is a prime necessity to a cure. [Compare De- 
lirium, Puerperal Mania.] 

Mastitis. 

Belladonna, Atropine locally (see Lactation), or combined with morphine 
and chloral, when much pain (B.). Especially as liniment to check secretion 
of milk when inflammation is imminent (R.) ; or when distended by milk (P.). 
When inflammation has set in, continuous application of Belladonna for 24 
hours often arrests it. It is also useful when an abscess has formed. Fomen- 
tations useful in addition, but skin must be dried well before the belladonna 
is rubbed in (R.) ; rr^v-x of tinct. internally as well (P.). Camphor, a saturated 
solution in glycerin, locally, in mammary congestion threatening abscess 
(Wa.). Phytolacca, has power to arrest inflammation of the mammae and to 
prevent suppuration ; the fluid extract in 10-minim doses internally, and the 
solid extract on a cloth to the inflamed breast (B.). Conium, the extract in 
small doses several times a day, of striking benefit in mastitis and impending 



624 MASTODYNIA — MEASLES. 

abscess of breast (Wa.). Calcium Sulphide, internally in abscess, occasionally 
increases pain (R. ). Hyoscyamus, as plaster, to relieve painful distention from 
milk (P.). Stramonium, fresh leaves as cataplasm to discuss indurated milk 
(P.). Iodine, tmct. and ointments to remove indurations of breasts after inflam- 
mation (B.). Mercury and Morphine, the oleate locally in mammary abscess 
(R.). Tobacco, leaves as poultice in abscess (R.). Digitalis, the infusion 
locally as fomentation in severe inflammation of the breasts, causes it to yield 
speedily (Fairbank). Ammonium Chloride, Z) and Oj spt. rosmarini, as lotion 
on linen rags, kept constantly to the part, especially in induration, after abscess 
has suppurated (Wa.). Tartar Emetic, in small and frequent doses, given 
early, is beneficial ( Wa.). Oil frictions in first stage of inflammation of breasts, 
from circumference toward the nipple (L.). Rest, by supporting mammse with 
strips of plaster, and bandaging the arm to the side, to prevent motion (T.). 
Sponging, with alcohol (over proof) until part is cold ; renewed if heat return. 
Heat, applied by a basin lined with flannel saturated with hot water, to relieve 
pain and prevent suppuration. [Compare Abscess, Lactation.] 

Mastodynia. 

Dr. Tanner advises non-interference in simple cases of enlargement and 
tenderness, which will spontaneously subside if let alone. In severe cases sup- 
port by strips or bandage, if breast pendulous ; belladonna ointment or lini- 
ments ; amputation of mamma has been necessary. Conium, has specific 
anodyne action on the mammse and generative organs. Cimicifuga, relieves 
infra-mammary pains of uterine origin in spinsters. Olive Oil, 2 parts, to 1 of 
tinct. opii, may be used by gentle friction to painful breasts after parturition 
(Parvin). 

Measles. 

Aconite, for febrile symptoms, and especially to arrest the catarrhal pneu- 
monia (R.) ; a valuable remedy (P.) ; the best drug when fever is very high, 
^-drop doses of the tincture every 2 hours (Da Costa). Jaborandi, with a hot 
bath, as diaphoretics, in cases of delayed eruption (Da C). Asclepias, an 
infusion or decoction freely as a diaphoretic, to promote the eruption (W.). 
Veratrum Viride, has been employed (R.). Pulsatilla, for the catarrhal oph- 
thalmia, nasal and intestinal catarrh ; £j-ij of tincture to ^iv water as wash 
(P.). Ammonium Carbonate, dissolved in a solution of the acetate, is much 
vaunted. When feeble circulation, cyanosis, delirium, gr. v-x.to ,§ss-^j liq. 
ammonii acetatis (B.) ; gr. iij — vj or vij, every hour or two, in cinnamon-water 
or milk ; one of the reliable remedies (W.). Camphor, the mixture, with liq. 
ammon. acetatis, excellent when cough and catarrh the most urgent symp- 
toms (A.). Ipecacuanha, for cough and catarrh, gr. j-ij every 401- 6 hours (A.). 
Antimony, preferred to ipecac by some (A.). Quinine, in small doses for the 
adynamia (gr. j-iij), or large (gr. xv) for hyperpyrexia, and catarrhal pneumo- 
nia, etc. (B.). Carbolic Acid, has been employed in several hundred cases with 
decided advantage ; most useful at early stage (Wa.). Cod-liver Oil and Iron, 
to scrofulous children, a long course of such medication after convalescence 
(Da C). Purgatives, must be given with caution (R.) ; the milder purging salts, 
as magnesium sulphate, to be preferred (A.). Mustard, as bath on sudden retro- 
cession of rash (R.) ; often increases the fever without benefiting the pneumonia 
and other complications (A.). Water, cold affusion at commencement ; pack- 
ing, especially when retrocedent (R.) ; hot foot-baths for convulsions (A.) ; tepid 
bath with cold douche to head, if cerebral symptoms are severe (Da C). Oil 
Inunctions, cocoa-butter very grateful, and reduces temperature. Also in 
roseola (B.). Hands and feet to be rubbed with a firm fat to remove heat and 
tightness produced by rash (R.). Aliment, low diet and slops ; no animal food 
during whole course (A.). Hygiene, dark room, complete disuse of eyes, strict 
cleanliness (A.). [For Sequelae see Bronchitis, Cough, Ophthalmia, Otor- 
rhea, Pneumonia, etc.] 



MELANCHOLIA MENINGITIS. 



625 



Prescriptions. 



R . Ac. Carbolici, 

Ac. Acetici, aa 3J-gjss. 

Tinct. Opii Deod., . . . . 3J. 

Spt. Chloroformi, . . . . £j. 

Aquae, q. s. ad % viij. 

M. Sig. — A tablespoonful every 4 hours, 
until fever abates. {Keith.) 



Tinct. Tolutanse, . . . . 7, ij. 

Syr. Senegas, 3 ss. 

Ac. Acetici, • ^jss. 

Syr. Pruni Virg., . . . ad giv. 
M. Sig. — A teaspoonful as required for 
cough after convalescence. 



Melancholia. 

Aurum, gives excellent results, gr. ■£$ to ^ of chloride ter die, especially 
when cerebral anaemia coexists (B.). Bromides, sometimes affords relief which 
no other agent will; no indications (B ). Potassium Bromide for townspeople, 
especially women with unendurable despondency (R.). Cocaine, a useful tonic, 
especially beneficial in nervous affections accompanied by depression (Br.). 
Cimicifuga, in puerperal or uterine despondency, of singular value (P.). Ig- 
natia, has soothing effect in great mental depression (P.). Arsenic, in melan- 
choly of aged persons gives great comfort. Best with small doses of opium. 
Fowler's solution, gtt. ij ; tinctura opii, gtt. iij-v, ter die (B.). Opium, in stimulant 
doses of tincture, gives good effects (B.) ; especially when paroxysms of acute 
anguish and despair, or when suicidal impulse (Wa.). Morphine hypodermi- 
cally is of great benefit in some persons who have a peculiar idiosyncrasy 
therefor (R.). Camphor has been highly recommended (R.). Musk and 
Castoreum are employed in melancholia with benefit (R.). Cannabis Indica, 
sometimes relieves (B.). Phosphorus, depression from overwork (R.). Chloral, 
as hypnotic, has been followed by marked amelioration and cure (Wa.). 
Valerian, in hysterical or suicidal melancholia, is often beneficial (Wa.). 
Caffeine has been useful (B.). Iron, as restorative. Tincture of chloride (B.). 
Water-cure, shower-bath, 15-20 seconds, or warm-bath, 95 Fah. for 30 min- 
utes ; the shower or cold douche may be usefully employed in certain cases 
where reaction takes place after it (Wa.). [Compare Hypochondriasis, 
Hysteria.] 



Meningitis, Cerebral. 

Aconite, is as serviceable in this as in the other acute inflammations; during 
the stage of excitation, the- tincture, gtt. ij with gtt. v of deodorized tincture 
of opium, every 2 hours, gives admirable results (B.). Belladonna, in all 
hypera?mic conditions of brain and spinal cord one of the very best remedies, 
especially during the period of excitement (P.). Hyoscyamus, valuable in sub- 
acute form (P.) ; for nervous irritability during convalescence (A.). Gelsemium, 
extremely useful ; tt\,v of fluid extract every 2 hours (B.). Mercury, as ointment 
gives good results in children (A.) ; Calomel in small, frequent doses, so as to 
bring the system under it quickly, a most valuable remedy apart from its purga- 
tive effects (Wa.). Potassium Iodide, has cured (Niemeyer), especially valuable 
in the tubercular form (B.). Ergot, the fluid extract in £ss doses, with 3ss of 
potassium bromide, every 4 hours, to diminish the vascular excitement (B.). 
Potassium Bromide, in the convulsions following simple meningitis (R.). Opium, 
in small doses; by clinical evidence proved to be the best treatment, especially 
for the acute stage before exudation, or during the stage of excitation (B.). 
When collapse, may sustain powers of life ; with tartar emetic has proved 
most beneficial, but should be used with great caution, as it may do great harm 
(Wa.). Bryonia, exceedingly valuable for serous inflammations in stage of 
effusion (P.). Pulsatilla, valuable in the acute form (B.). Purgatives, as soon 
as possible, unless exhaustion. Calomel and jalap the most active and search- 
ing (A.). Croton oil as a derivative and revulsive ; also locally to the shaven 
scalp, productive of the best results in tubercular meningitis (Wa.). Venesection, 
or arteriotomy (temporal artery) gives good results (B.) ; when high cerebral 
40 



626 



MENINGITIS. 



excitement and vascular action (A.). Blisters, on nape of neck if coma, after 
active symptoms are subdued (A.). Water. Cold water for hyperpyrexia 
(C.) ; pounded ice in bag or bladder, as a cap to the head (R.). [Compare 
Hydrocephalus.] 

Meningitis, Cerebro-Spinal. 

Opium, no remedy so effective in small doses. Utility ends when effusion, 
stupor, and coma ensue (B.) ; large doses (Valleix), gr. j every hour in very 
severe cases (S.) ; has been used in France and Germany with much success 
(Tr.) ; is the best remedy of all, gr. j every hour for 4 days ; even such doses 
will not narcotize (Da Costa). Aconite, useful combined with opium (B.) ; 
affects the cranio-spinal axis from 3d nerve to phrenics, the region where this 
disease is most manifest (Harley). Gelsemium, extremely valuable, rr\,v of 
fluid extract every 2 hours, to maintain constant physiological effect (B.) ; 
efficient for the delirium. Belladonna, in all hyperaemic conditions of brain 
and spinal cord, especially during stage of excitement (P.). Iron, the tincture 
of the chloride, in 20-30 minim doses, every two hours, suggested by the simi- 
larity of the disease to erysipelas, has made many successful cures without 
leaving any sequelae (Klapp). Bromides to guard the opium and enable the 
latter to be pushed, 20-grain doses every 4 hours (Da C). Hydrocyanic Acid, 
dilute, TT\j-ij, with gr. iij-v of sodium bicarbonate, every 3 or 4 hours, for 
severe vomiting (Delafield). Quinine in large doses at the commencement 
(B.) ; has been exhaustively tried in this disease and failed (Da C). Potassium 
Iodide for the sequelae, a long course of iodides during convalescence is the 
best treatment (Da C). Cold to the spine, the most satisfactory treatment 
(Radcliffe) ; to head and upper spine for 5 minutes only at a time, for the 
headache and tetanic symptoms (Da Costa). Venesection, or arteriotomy 
(temporal artery), probably of service, but cautiously (B.) ; leeches at back of 
neck and on temples, to relieve the terrible headache, if patient is strong and 
vigorous (Da C). Digitalis, in early stage (Rummel). Ergot, one of the best 
remedies (B.). Turpentine, enema, as derivative (B.). Stimulants, in small 
quantities (A.). Counter-irritation, by actual cautery freely applied to back, 
alleviates pain (A.). Water, cold baths or wet pack for hyperp) rexia ; warm 
bath in uraemia (B.) ; hot-water bottles or sand bags to trunk and extremities 
to keep up warmth. Bath of 102-106 for short time only, then wrapped in 
blankets (A.). Heat to the body, except the head and neck (Da C). Aliment, 
nutritious and suitable food at short intervals, day and night (A.) ; tonics with 
fresh air and good diet during convalescence (A.). Ventilation, of dwellings, 
the best sanitary precaution when the disease is epidemic (Simon). 



Prescriptions. 



R . Morphinas Sulph., . . . . gr. ss. 
Ac. Sulph. Aromat , ... . £j. 
Tinct. Cinchonce Co., . ad ^vj. 
M. Sig. — Tablesp. every 2 hours, for a 
boy of 12 years old. 

{Meigs & Pepper.) 



&. Potass. Iodidi, giv. 

Tinct. Gentian. Comp., 
Syr. Sarsse Co., ... aa ^ij. 
M." Sig. — Teasp. thrice daily, to pro- 
mote absorption during convalescence. 



Meningitis, Spinal. 

Aconite, is very useful (B.) ; with Ergot and an Opium impression to reduce 
the amount of blood in the vessels of the cord (Da Costa). Potassium Iodide, 
see below. In the chronic form, with the bichloride of mercury when a specific 
history present (Hammond). Belladonna, strongly to be relied on, even when 
brought on by external violence (P.). Bryonia, in serous inflammations, when 
effusion is extremely valuable (P.). Purging, by magnesium sulphate, combined 
with tinct. hyoscyami (A.). Quinine, when paralysis occurs, in 3-grain doses thrice 



MENORRHAGIA MENSTRUAL DISORDERS. 627 

daily, with ^f-grain doses of extract, belladonnas, or 20-30-grain doses of potas- 
sium iodide, and flying blisters along the spine (Da Costa). Opium, in some 
form must be used for pain (Bastian). Mercury, gr. -^ of the bichloride, with 
increasing doses of potassium iodide, to promote absorption of inflammatory 
products, if the inflammation subsides (Bastian) ; a mercurial impression often 
benefits the paralysis (Da C). Cold, by ice to spine is deemed necessary, and 
no doubt alleviates the pain, though heat would be a more rational application 
for the inflammation (Bastian). 

Menorrhagia. 

Opium, has specific action in reducing the uterine circulation, should be pushed, 
even to inducing habit, in severe cases (Lutaud). Ipecacuanha, in full emetic 
doses (Wa.) ; is excellent (B.) ; Ergot is better (P.). Savine, enlarged, relaxed, 
and passively congested«uterus (B.). In 5-10 drop doses of tinct. in water every 
half-hour to three hours, has proved useful (P.) ; when due to want of tone in 
uterus (R.). Ergot, large spongy uterus ; bromides better (B.). Ergotin gr. j 
or ij in glycerin and water, undoubtedly efficacious as hypodermic injection 
(P.) ; all forms (R.) ; minim doses of the fluid extract are very beneficial (A. A. 
Smith). Hamamelis, has decided influence on venous system ; of high repute 
(Pf.). Arsenic and Iron, when from anaemia (B.). Cannabis Indica, often suc- 
cessful (R.) ; gtt. v-x of tinct., thrice daily, productive of extraordinary success 
(Wa.) ; has a stimulant action on the uterine muscular fibre, and may be given 
in combination with Ergot (B.). Iron, when dependent on anasmia (B.). Rue, 
low vascular tonus ; should never be used in the pregnant state (B.). Oil of 
Erigeron, in 10-drop doses, is efficient (Wa.). Gossypium, a favorite uterine 
hemostatic in many hospitals, in 30-minim doses of the fluid extract every four 
hours (Parvin). Quinine, has been recommended (R.) ; after Ergot it is the 
very best agent, in 6-grain doses every 3 hours (Parvin). Digitalis, very useful, 
especially when from heart disease, in plethoric subjects (B., R.) ; ^j-jss of infu- 
sion as dose will arrest menorrhagia when unconnected with any disease (P., 
R.). Aloes, debilitated and relaxed subjects, with Iron (B.). Cimicifuga, pas- 
sive, coagulated and dark (P.); for accompanying headache (R.). Gallic Acid, 
is very efficient (R.). Potassium Chlorate or Bromide, in doses of gr. xv thrice 
daily, combined with Ergot, has an almost infallible influence over uterine 
hemorrhage, unless caused by cancer, polypi, adherent placenta, or other similar 
affections (Tait). Bromides, usually arrest promptly (B.). That of potassium 
most useful in young women if loss occurs at natural period only ; commence 
bromide a week before and discontinue when discharge ceases till a week before 
next time. If loss occurs every two or three weeks give bromide continuously, 
ic-grain doses, but more when organic changes in womb (R., Wa.). Ammonium 
Chloride, for headaches (R.). Calcium Phosphate, in anaemia from excessive 
menstruation (R.). Magnesium Sulphate, very small doses with a little dilute 
sulphuric acid and syrup, is exceedingly useful (Wa.). Oil of Cinnamon, in 
drachm doses (R.). Water, hot-water bag to lower dorsal and lumbar verte- 
brae (R.) ; cold sitz-bath, feet in warm water, especially valuable. 6o°-65° Fahr. 
for 5-15 minutes, patient then quickly dried and put to bed. [Compare 
Metrorrhagia.] 

Prescriptions. 



R- . Ext. Ipecac. Fl., . . . . 3 ij- 

Ext. ErgotgeFl., giv. 

Ext. Digitalis Fl., . . . . 3 ij. 
M. Sig. — A half teasp. to a teasp. as 

required until emesis. (B.) 



R- . Ext. Ergotae (Squibb's), . gr. xij. 
Ext. Opii Aquosi, . . . . gr. vj. 

M. et div. in pil. no. xij. 

Sig. — One pill every hour, in profuse 
menstruation of atonic type. 



Menstrual Disorders. 

Aconite, gtt. j every half-hour to hour promptly restores discharge when 
sudden suppression from chill (P., B., R., Wa.) ; as emmenagogue (Tr.). Pul- 



628 MENTAGRA METRITIS METRORRHAGIA. 

satilla, often of the greatest value when menses scanty or delayed, or suppressed 
by fright or chill (P., B.). Ignatia, in suppression of hysteria (P.). Savine, a 
powerful uterine tonic ; as emmenagogue certain, powerful, safe (P.). Ferrum, 
in anaemic subjects (B.). Aloes, as emmenagogue [vide Amenorrhgea]. 
Cocculus Indicus,for irregular menstruation with colicky pains and scanty dis- 
charge. Should be given for a few days prior to and during period (P.) ; fl\,ij-iij 
of a saturated tincture thrice daily. Opium, in suppression from violent mental 
emotions, a valuable remedy (Wa.). In many menstrual disorders opium 
proves invaluable, but must be cautiously administered lest the habit be formed. 
Cimicifuga, relieves heat and pains in the head, flushings in the face, pains in 
back and limbs, etc., when occurring as the result of menstrual perversion 
(Wa.). [Compare Amenorrhcea, Dysmenorrhcea, Menorrhagia, Climac- 
teric Disorders.] 

Mehtagra. 

Mercury, the oleate, or the bichloride, gr. ij to ^j water, applied as lotion after 
each epilation (R.). Citrine oint. extensively employed (Wa.). Sulphurous 
Acid, with an equal part of glycerin, is an efficient application (Jenner). Arsenic 
has a more or less powerful influence, used internally in doses of Tt\,v of liquor 
arsenicalis thrice daily (Wa.) ; the oleate of arsenic is an efficient local applica- 
tion. Sulphur Iodide, as ointment (3j to ^jss, is efficient, with Donovan's solu- 
tion internally (Sir E. Wilson). Copper Sulphate, as lotion, 3j to 3XVJ of water, 
with ^ss of zinc sulphate, and jfjss of aquae laurocerasi (B.). 



Metritis, Acute. 

Opium, locally, in suppositories or enema is more effectual than if admin- 
istered internally (Wa.). Aconite, is invaluable in early stage of simple in- 
flammatory fevers (P.). [Compare Puerperal Fever.] Heat, to the feet, 
and by large poultice to the abdomen. Also hot water vaginal injection 
literally for hours, if possible ; repeated at short intervals, from a Davidson 
syringe. The only means of aborting an attack of cellulitis (E.), which is the 
condition generally present in cases which are usually supposed to be ones of 
acute metritis (Playfair). Turpentine, as hot epithems ; few measures are more 
generally serviceable (Wa.). Linseed Poultices, produce great relief to pain 
and favorably affect the course of the disease (Duncan). Leeches, to the hypo- 
gastric region, may be required in patients of full h^bit. [Compare Puerperal 
Fever, Puerperal Metritis.] 



Metrorrhagia. 

Ipecacuanha, possesses considerable energy in arresting flooding (P.) ; in 
full emetic doses, gr. xx in evening, followed by an acidulated draught in the 
morning (Wa.). Hamamelis, when persistent oozing (R.). Ergot, the most 
valuable ; full doses ; repeated every hour or so (R., P.). [See Menorrhagia 
for formula.] Savine, 5 to 10-drop doses of tincture in cold water every y 2 hour 
to 3 hours (P.). Iron, styptic preparations as injections (B.). [See Hemor- 
rhage, Post-Partum,] Opium, has specific action on the uterine circulation 
(see ante, page 302), and should be given freely in intractable cases of metror- 
rhagia from uterine fibroids or cancer, in which the establishment of the opium- 
habit is often advisable (Lutaud). Cannabis Indica, often arrests, especially when 
at climacteric ; tincture gtt. v-xx ter die (P.) ; has had extraordinary success in 
number and rapidity of cures (Wa.). Sulphuric Acid, sometimes very effective, 
especially when due to fibroid or polypus. Ac. sulph. dil., gtt. v-xx, well 
diluted (B.); long extensively prescribed (Wa.). Cinnamon, is used with good 
effect (P.) ; has a specific action on the uterus (T.). Digitalis, in plethoric sub- 
jects. The infusion best, a tablesp. bis die (B., P.); the effect is prompt and 
decided (Wa.). Magnesium Sulphate, often succeeds (B.). Senegin, in 2-grain 



MILIARY FEVER MYALGIA MYELITIS. 



629 



doses, successfully employed (P.). [Compare Amenorrhcea.] Ice, to abdo- 
men, or within the uterus (B.) ; ice in every form first thing to try (Wa.). Rest, 
absolutely necessary. Dry cupping over sacrum is found useful (R.). [Com- 
pare Menorrhagia, Uterine Tumors.] 



Prescription. 



R. Ext. Ergotre Fl., £ss. 

'Ext. Senec. Aur. Fl., . . . \). 
Ext. Viburn. Prunif. Fl., . gj. 

01. Myristicae TT\xx. 

Syr. Simplicis, . . . . ad §vj. 



M. Sig. — A dessertsp. every % hour 
until relieved, then reduce dose. Keep 
the head low, and apply cold over hypo- 
gastrium. 



Miliary Fever. 

Aconite, for the hyperpyrexia (R., P.). Cooling Drinks, purgatives and anti- 
phlogistics, in mild cases ; malignant ones sometimes occur, and are dangerous 
(A.). Lime-water applied by sponging, is very useful ; or a lotion of zinc 
oxide suspended in lime-water, gr. xl to jfj, painted on the affected parts of the 
skin, and permitted to dry thereon (E. Wilson). 

Muscat Volitantes. 

Potassium Iodide, very effectual in curing muscae depending upon hepatic 
derangement (Wa.). Valerian, often found curative (Wa.). Muscae Volitantes 
are due to shadows cast on the retina by fibrillse floating in the vitreous body, 
and are most visible to myopic persons. They do not merit attention unless 
very abundant, or steadily increasing (C). Rest of the eye necessary. Neu- 
tral-tint glasses may be worn to render the muscae less visible, if troublesome. 

Myalgia. 

Arnica, the best agent for contused muscular fibre ; also for shake, concus- 
sion, shock. Tt\,v-x every 2 or 3 hours in water (P.) ; a few drops of tincture 
internally removes stiffness, after packing with cold, wet sheet (R.). Cimici- 
fuga, often succeeds wonderfully, as often fails ; no indications for its use (B.) ; 
general bruised sensation (R.). Ammonium Chloride, in 10 to 20-grain doses, 
the most efficient remedy (Anstie) ; is effective (R.). Veratrine, the ointment 
externally may control (B.). Belladonna, as liniment, is often successful (R.). 
Gelsemium, frequently cures, but large doses are necessary, rr^v-xx of the fluid 
extract every 3 hours (B.). Coca, to relieve the sense of fatigue (P.). Opium, 
by frictions or poultices (R.). Iodine, ointment for pain and tender muscles of 
the chest, when skin may be pinched without pain (R.). Ammonium Muriate, 
is very efficient. (See Lumbago.) Xanthoxylum, externally and internally, 
has a deserved reputation (B.). Chloroform Liniment, with friction, often affords 
great relief (Wa.). Firing, sometimes very beneficial (B.). Packing, with 
dripping wet sheet (R.). Counter-irritation, by firing, aquapuncture, acupunc- 
ture (B.). Electricity, the constant current (B.). Baths, Turkish, in aching 
muscles, from over-exertion (R.). Poultices, very hot, followed by applications 
of lint and oilskin (R.). Rest, is the remedy, of course (Wa.). Rest and support 
to weak muscles important till they regain their tone ; especially in painful 
muscular affections following prolonged or excessive exertion, or in the sore- 
ness or stiffness which occur during convalescence from any long illness, or 
accompanying general debility. These are generally better after repose, but 
increase with fatigue. [Compare Pleurodynia, Lumbago.] 



Myelitis. 

Belladonna, is decidedly effective, especially when brought on by external 
violence (P.). Ergot, most successful ; large doses are necessary (B.). Elec- 
tricity, in chronic, not in recent form (B.). Silver Nitrate, in chronic inflam- 



63O MYOPIA — NjEVUS NASAL AFFECTIONS. 

mations of the cord, one of the few remedies which are ever of service ; gr. 
%-Yz (W.). Phosphorus, of marked benefit in myelitic paraplegia from 
excessive venery (W.). Water-cure, ice-bag to spine, feet in hot water; or 
better, hot douche to spine (B.). Cold, externally, by ice-bags, along the spine, 
with cupping or leeching if much localized pain or tenderness ; spoon diet 
and a sparing amount of stimulants, also copious warm enemata to relieve the 
bowels and act as derivatives. Little, if anything, is to be done with mere 
drugs. Posture should be prone, or on side ; absolute rest (Bastian). [Com- 
pare Meningitis, Spinal.] 

Myopia. 

Atropine, by daily instillation, systematically, for the purpose of sacrificing 
either the convergence or the accommodation, in cases where failure of the 
internal recti occurs, the disability assuming the form of muscular asthenopia 
(C). Glasses, properly adjusted, should be worn from the commencement. 

Nsevus. 

Ferrum Perchloride, injected, is effectual ; but dangerous when applied thus 
to nsevi about the head (Wa.). Creasote, pencilled over twice a day, may 
remove nsevi (Wa.). Chromic Acid, as escharotic, or local application, gr. c ad 
3j aquae destil. (B.). Electrolysis, or galvano-cautery, to remove nsevi (B.). 
Nitric Acid, strong, as escharotic for small superficial naevi, followed by ol. 
olivse (B.). Zinc Chloride, Iodide and Nitrate, locally, especially the first 
named (R.). Setons, threads passed across the growth in various directions, to 
produce suppuration ; when pus appears the threads should be removed. So- 
dium Ethylate, prepared by adding the metal sodium, piece by piece, to abso- 
lute alcohol in a wide-mouthed bottle ; the crystalline substance found deposited 
after effervescence ceases is an excellent caustic for nsevi ; painted over them it 
causes a rapid eschar, and usually gives but little pain (Richardson). Mercury, 
the Acid Nitrate an excellent caustic for removing moles from the face (Thomas). 

Nails, Ingrowing. 

Liquor Potassae, a solution (3ij-^j) on cotton-wool in ingrowing toenail, to 
margin of nail at ulcerated surface, to soften the nail (B.). Glycerin, or Silver 
Nitrate, on a fold of lint, to the ulcerated surface (C). Lead Carbonate, a 
piece softened between the fingers, and applied as plaster beneath the fungous 
cushion, cures in a few days (Tr.). Paring the nail, after softening in warm 
water, and cutting a V-shaped incision in centre of nail ; the ingrowing portion 
should not be cut. 

Nasal Affections. 

Ammonia, by inhalation, in pain and inflammations of nose and frontal bones 
(R.). Potassium Iodide, large doses (gr. xxx-lxxv daily), valuable in syphilitic 
affections of the nose (Wa.), Glycerite of Tannin, to excoriations of inside of 
nose, after measles, scarlatina, etc. Also for impetiginous eruptions of inside, 
most severe where hair grows, epilation sometimes needful. Also in discharge 
of greenish, black, stinking mucus (R.). Glycerin of Starch, or Zinc Ointment, 
applied often, a good supplementary application (R.). ' Hydrastis, in chronic 
catarrhal conditions and nasal ulcers, used internally and externally, with great 
benefit (P.). Pulsatilla may be employed both internally and externally in 
nasal inflammations (P.), and in acute inflammation of nose (B.). Cod-liver 
Oil for chronic discharge (R.). Injections, by nasal douche, are used with 
benefit in catarrhal states (Wa.). Zinc Chloride, gr. ij to the J, or the Sulpho- 
carbolate, gr. v to the 3, as solutions locally by cotton-wrapped probe to dimin- 
ish sensibility of the nasal mucous membrane (Sajous). Cocaine, has many 
applications in treatment of nasal affections ; a 4 per cent, solution by mop or 



NAUSEA NECROSIS NERVOUS AFFECTIONS. 63 I 

spray will empty the engorged venous sinuses, and is very useful in acute 
catarrh, hay fever, etc., also in posterior and anterior rhinoscopy (R.). [Com- 
pare Acne, Catarrh, Epistaxis, Hay Fever, Influenza, Oz^na, Polypus, 
Sneezing.] 

Nausea. 

Ipecacuanha, has no rival in sickness of pregnancy, scarcely less useful in 
that of chronic alcoholism. Very small doses, gr. -^ equals fry" of wine (P.). 
Pulsatilla, in dyspeptic nausea, with coated tongue, flatulence, sick-headache 
(P.). Cocculus Indicus, in cephalic nausea, violent but ineffectual efforts at 
vomiting (P.). Calumba, in nausea of languid stomach with flatulence, has 
considerable reputation (P.). Cinnamon or Cloves, will check nausea (P.). 
Nutmeg-, the simple powder in wine (P.). Pimenta, Pepper, Peppermint, relieve 
(P.). Tartaric Acid, as effervescing draught, with a few drops of tinct. opii, 
tinct. calumb?e, or hydrocyanic acid added, when from morbid gastric irritation 
(Wa.). Cold Compress or Ice-bag, over the stomach very useful. Bismuth Sub- 
nitrate, or the Liquor Bismuthi, when the salt in substance disagrees, is a rem- 
edy of established value in nausea and vomiting arising from gastric disorders ; 
may be combined with Hydrocyanic Acid (Wa.). [Compare Vomiting, Vom- 
iting of Pregnancy, Seasickness.] 

Necrosis. 

Sarsaparilla, a very useful medicine in diseases of the bones (P.). Rest, in 
a " Salter's swing," with poultices, water-dressing, or stimulating lotions, to aid 
work of repair (CI., Hilton). Tonics, nutritious food, baths, good hygiene, all 
are necessary adjuncts to local treatment (Andrews). Acid Solutions, of no use 
as solvents, may be employed with benefit for detergent and alterative effects 
to expedite the sloughing and restorative processes (Gross). Operation to re- 
move sequestrum is generally necessary ; or resection of the devitalized bone, 
the latter in young subjects greatly exhausted, where delay would endanger life 
(Gross). Potassa cum Calce introduced into fistulas, to convert them into large 
openings, permitting the removal of diseased bone (Kirkpatrick). [Compare 
Caries, Bone Diseases, Syphilis, Scrofulosis.] 

Nervous Affections. 

Arsenic, of especial value in nervous affections resulting from malaria, in 
which large doses are required ; rr^x of Liq. Arsenicalis, increased to ttlxxx 
thrice daily ( Wa.). Asafcetida, is a remedy of much value in nervous affec- 
tions connected with uterine derangement, also in dyspeptic hypochondriasis 
and other nervous affections ; may be combined with bitter tonics and mild 
aperients (Wa.). Potassium Bromide, takes precedence in epilepsy, epilep- 
tiform convulsions, hysterical convulsions and spasms, tetanus, etc., is of 
great value in chorea, insanity, acute mania, insomnia, delirium tremens, some 
forms of neuralgia, and the numerous symptoms of vaso-motor disturbance, 
such as — numbness, coldness, deadness, pricking sensations, indefinable but 
distressing sensations in abdomen, hypogastrium or epigastrium ; feelings 
similar to rigors, with anxiety, palpitation or fluttering of the heart, — all due 
to interference with the local circulation (Reynolds). Valerian and Valerian- 
ates, are thought to exercise some special influence over nervous affections, 
especially the Valerianate of Zinc, in half-grain to grain doses in pill, or the 
Ammoniated Tincture of Valerian, from which every good that can be expected 
from the valerianates will be more certainly obtained (Wa.). Sumbul, acts as 
a nervous stimulant, and is especially efficacious in neurotic migraine, also in 
hysteria and the obscure paralytic affections associated therewith (Wa.). Caf- 
feine, is of signal value in neuralgia, hemicrania and other nervous affections 
(Shafter) ; grain - doses in solution hypodermically, afford great relief in 
dorso-intercostal neuralgia attending shingles, insomnia, etc. (Anstie). Cocaine 



632 NERVOUS EXHAUSTION NERVOUSNESS. 

is a powerful nerve stimulant, destroying the sense of fatigue, and often 
evincing marked analgesic power in neuralgiae. Is effective in melancholia, 
hypochondriasis, etc., as well as locally in nerve pain over a limited area. It 
acts as an excitant upon the central nervous system (R.). Opium, is a remedy 
of marked value in insanity, melancholia, mania, and all nervous affections 
accompanied by pain (W.) ; gives general repose to both body and mind, is 
of decided value in diabetes, and produces marked improvement in melan- 
cholia and despondency (R.). Lupulin, is peculiarly useful in nervous affec- 
tions when Opium cannot be tolerated, especially in chronic hysteria attended 
with morbid vigilance, 10-grain doses every 6 hours afford great relief, without 
causing any unpleasant symptoms (Eberle). Santonin, in convulsions, epilepti- 
form seizures, and affections regarded as choreic, etc., the result of reflex irrita- 
tion from worms (Wa.). Phosphorus, of occasional utility in affections of the 
nervous system induced by mental exertion or over-excitement. Danger from 
its use is its liability to produce fatty degeneration of the internal organs (Wa.). 
Phosphate of Silver is regarded as of special value in myelitis with disturbance 
of bladder and rectum, and in sclerosis of the nervous substance (Wa.). 
Nitrate of Silver, the only remedy which has done good in progressive locomo- 
tor ataxia ; gr. x^-i two or three times daily, with Hypophosphite of Sodium, 
both to be discontinued when blue line appears on gums (Althaus). Cold 
Shower Baths, are often beneficial in nervous diseases unconnected with disease 
of the brain. [Compare Hysteria, Melancholia, Mania, Diabetes, Loco- 
motor Ataxia, Hemicrania, Neuralgia, Nervousness, Insomnia, Hemi- 
plegia, Paralysis, Spinal Paralysis, etc.] 

Nervous Exhaustion. 

Ammonia, the Aromatic Spirit proves very serviceable; ^ss-j in water 
thrice daily (Wa.). Hypophosphites of lime or sodium, or iron, are actively 
tonic in cases of nervous depression and torpor, with occasional shooting 
pains (Wa.). Strychnine Acetate, a remedy of great promise, when com- 
bined with a rigid system of diet, mental discipline, etc. (Marshall Hall). 
Oxide of Zinc, often excellent as a tonic and sedative, in nervous irritability 
and depression from anxiety, over-study, etc. (Wa.). Phosphorus, of occasional 
utility in nervous breakdown from over-study, etc. (Wa.). Caffeine, gr. j or 
more in a cup of coffee, to relieve brain weariness arid nervous exhaustion 
(Wa.). Cocaine, in y z -grain doses proves serviceable in nervous exhaustion 

Prescriptions. 



$. Strychninse Acetatis, . . .gr. j. 
Ac. Acetici Diluti, .... TTlxx. 

Alcoholis, 3 ij. 

Aquae destill. , gvj. 

M. Sig. — Ten drops thrice daily. 

{Marshall Hall.) 



R. Ac. Phosphorici Dil., . . . ^j. 
Elixir Calisayse (U. S. Disp.), t ^ vj. 
Elix. Ammonii Valerian, . ^ij. 

Glycerini, ^ iij. 

Vini Xerici, . . . . q. s. adO). 
M. Sig. — ^j thrice daily. 



Nervousness. 

Aconite, gtt. j of tinct. at bedtime, repeated if needful, for restlessness and 
" fidgets " of men as well as women (R.). Ignatia, in small doses better than 
morphine for mental excitement and nervous erethism (P.) ; for the nervous 
exaltation of cinchonism (Pf.). Caffeine, for restlessness due to great lowering 
of nervous power (P.). Chamomile, lowers reflex excitability (P.) ; minim doses 
of the tincture every 15 minutes an excellent sedative for children (A. A. 
Smith). Potassium Bromide, especially for women who are despondent, irrita- 
ble, and sleepless, from overwork, grief, worry, etc. ; often connected with 
migraine (R.) ; gr. ss-j of any bromide every ^-hour, is very efficient for the 
nervous disturbances of children (A. A. Smith). Conium, where a great deal 
of motor agitation, especially in the typhoid-like condition often resulting from 



NEURALGIA. 



633 



mental overwork, with insomnia, exaggerated nervousness and delirium, — it 
acts charmingly in securing sleep, by removing the motor agitation ; rtvx of a 
fluid extract of the unripe fruit, every l / z hour, carefully watched (Madigan). 
Strychnine, affords relief in functional irritability of the nervous system, mani- 
fested by restlessness and wandering neuralgic pains (B.) ; especially useful as 
a tonic in nervousness from over-use of tobacco (H.). Valerian, extremely 
useful as a sedative to reflex excitability, calms nervousness, does much good 
in fevers where restlessness, fidgets, anxiety, etc. (P.). Musk, serviceable in 
nervous affections when from uterine derangement (Wa.). Opium, calms the 
nervous system and gives general repose to both body and mind (R.). Sumbul, 
often invaluable in restlessness of pregnancy ; nrxxx-xl of tinct. with a little 
Chloric Ether as draught (P.). Camphor, a powerful subduer of reflex excita- 
bility (P.). Chloral, where restlessness, debility (R.). Chloroform, the spirit 
of chloroform internally (R.). Hops, the hop-pillow is deserving of trial. Lu- 
pulin, peculiarly useful when opium cannot be tolerated (Wa.). Water, warm 
sponging to induce sleep and calm restlessness in convalescence. Also, cold 
sponging (R.). [Compare Insomnia, Irritability.] 



Prescriptions. 



R . Strychninge Sulphatis, . . gr. j. 
Quininae Sulphatis, . . . gj. 
Tinct. Ferri Chloridi, . . 3 v. 
Ac. Phosphor. Dil., 
Syrupi Limonis, . . . . aa^ij. 
M. Sig. — A. teasD. in water thrice daily. 

(M.) 



R 



Potassii Bromidi, 
Ext. Guaranse Fl., 
Syr. Tolutani, . . 
Aquae, .... 
M. Sig. — Teasp. to : 



. . . . ,^jss. 

• • • • |"j. 

q. s. ad 3 vj. 
dessertsp. three or 



four times daily. To relieve nervousness. 



Neuralgia. 

Phenacetine, Antipyrine and Acetanilide, are giving great satisfaction in 
many forms. Of the three, Phenacetine in 10-grain doses, is the safest and 
most efficient. Salipyrin, has been e'm ployed with excellent results ; a dose of 
8 grains is often sufficient. Morphine, hypoder. in the neighborhood of the 
affected nerve, the best treatment. Caution : morphine-habit (B.) ; gr. T X F to % 
often relieves and frequently cures after a few repetitions (P.). No remedy 
promises more speedy and permanent relief than morphine by subcutaneous 
injection in sciatica, lumbago, tic douloureux and other neuralgic affections 
(Wa.). Aconite, when arterial excitement (B.); in congestive neuralgias, and 
acrodynic, at extremities ; has important role (P.) ; as ointment or liniment, 
especially when fifth nerve affected ; also in neuralgic headache (R.). A rem- 
edy of great value (Wa.) ; a perfect physiological remedy against neuralgia, 
especially those forms which are based on congestive or sub-inflammatory 
affections ; but its action is often slow, so that Morphine must be given with it 
as a palliative. Aconitine, with Veratrine as an ointment locally, a good appli- 
cation (Da Costa) ; internally the best agent of all in essential neuralgia ; should 
be combined with quinine in intermittent forms and those which resist quinine 
alone. (See formula below.) Belladonna, must be persisted in with full doses ; 
gr. -g^ of atropine, or gr. -J-q to -^ hypodermically, in vicinity of nerve, has spe- 
cial utility in tic douloureux and sciatica ; also in peri-uterine and dysmenor- 
rhceal neuralgias (B.). rnj of solution of gr. j-^ij of water hypodermically (P.). 
Spinal irritation, intercostal neuralgia. The liniment or ointment of atropine in 
facial (R.). Gr. 0.15 of the extract every hour till giddiness, then lessen doses. 
Continue for several days (Tr.). Veratrum Viride, tincture, said to be very 
useful (R.). Veratrine, ointment for facial and sciatica (R.). Oint. (gr. viij-^i) 
frequently of much benefit (P.). Nux Vomica, is most useful in visceral neu- 
ralgias, as gastralgia, hepatalgia, etc., the tincture with carminatives in the former 
affection ; or strychnine, gr. y^- to -^ twice or thrice daily. In all forms of neu- 
ralgia this remedy should be used in small doses (P.). Arsenic, cures by its 
influence on bodily nutrition ; directly so in neuralgias of malarial origin, 
though inferior to quinine (B.). In various neuralgias, also in angina pectoris 



634 NEURALGIA. 

(R.). Phosphorus, gr. T ^ every few hours, has made very effective cures (B.). 
Gr. y-^y to T x ^ every 3 hours. Very useful in all forms, especially when uncom- 
plicated (R.) ; always a good remedy except for cases due to cold or inflamma- 
tion, and those not depending on depraved nutrition (H.). Quinine, large 
doses (gr. v-xx, in sherry), just before attack in periodical neuralgia, whether 
malarial or not. Useful also in small, frequently repeated doses in other types, 
especially of supra-orbital nerve (P.) ; has selective action upon supra-orbital 
form (Spender). Salicylates in large doses cured a case of tic doul. of 12 years' 
standing (Dercum). Sumbul, for certain types, of more value than any other 
remedy. Facial, sciatic, or ovarian, in women of nervous constitution, often 
yield to it at once (P.). Cimicifuga, in neuralgia of the 5th from cold, and in 
ovarian neuralgia (B.). Gelsemium, successful in neuralgia of 5th (B.) ; espe- 
cially dental branches (R.) ; of value in trigeminal, ovarian, etc. (W.) ; in suita- 
ble cases small doses answer as well if not better than large ones (Pf.) ; rr\jij ot 
the tincture every y z hour often succeed miraculously with no ill results in neu- 
ralgise about the head and face (A. A. Smith) ; no better remedy in tic doulou- 
reux, but must be given in large closes, tt\,x-xv of a strong tincture or fluid 
extract (H.). Zinc Valerianate, extremely beneficial in neuralgia from reflex 
irritation of female pelvic organs (B.). Spigelia Anthelmia, useful in facial (P.). 
Ammonium Valerianate, or Zinc Val. in neuralgia of face or head (R.) ; the 
latter in nervous cases, and uterine (Wa.). Chamomile, in neuralgia of 5th 
nerve (R.). Staphisagria, internally and externally often curative in obstinate 
facial and cervical neuralgia (P.). Ignatia, in hysterical and intercostal neu- 
ralgia, with nervous erethism, is valuable (P.). Ergot, much employed in 
visceral forms, especially gastralgia (P.) ; said to be useful (R.)- Ammoniated 
Copper, in neuralgia of the 5th, lately used by Fereol with remarkable success ; 
l / 2 -grain doses pushed. Eserine, very efficient in neuralgia of the eyeball, a 
solution of gr. ij to the ^ by instillation. Cannabis Indica, %-Yz gr. doses of 
extract 2 or 3 times a day ; especially for neuralgic headache (P.) ; found useful 
(R.). Cod-Liver Oil, when low nutrition, faulty assimilation (W.). Iron, when 
from anaemia. Tincture of chloride (rr\xxx-xl ter die), also chalybeate waters 
(B.). Moderate doses only required (R.). In chlorotic subjects, of whom 
nearly all will have neuralgia (Tr.). Iodides, for neuralgia of fifth, dependent 
on syphiloma of the nervous system, pain nocturnal chiefly (B.). Bromides, 
benefit some kinds, especially ovarian (B.) ; potassium bromide occasionally 
relieves (R.). Ammonium Chloride, half-drachm doses in facial and other 
neuralgia?, is much used (R.) ; a very efficient and diffusible stimulant, gr. xx 
-Z] at first, repeated every hour during the attack (H.). Chloroform, as anaes- 
thetic to relieve pain, is occasionally useful locally, also as spray for uterine 
neuralgia (R.) ; by deep injection into vicinity of affected nerve n\,v-xv of pure 
chloroform, a very efficient method of dealing with long-standing cases (B.) ; 
used in one case it caused symptoms so severe as to imperil the life of the 
patient (W.). Theine, hypodermically, is promptly analgesic, and has pro- 
longed influence, but must be aided by remedies to improve the nutritive state ot 
the affected nerves or which are capable of removing the diathesis upon which 
the neuralgias depend (Mays). See Formula below. Caffeine, hypodermically 
has been found useful, especially in cervico-brachial neuralgia (P.). Cocaine, 
as a hypodermic injection, a 4 or 5 per cent, solution is very effective if admin- 
istered in the vicinity of the aching nerve (R.) ; also by instillation in neuralgia 
of the eyeball, and whenever it can be applied to the mucous surface in the 
vicinity of the pain. Croton Chloral, very effective, especially in tic douloureux 
and sciatica, gr. ij-v every hour till gr. xv are taken (B.) ; in facial, that from 
carious teeth, that of neck and back of head, tic douloureux, etc. (R.)= Gr. j, 
every %, hour is a very efficient dose (A. A. Smith) ; rarely of any value, but 
when used is best given in 20-grain doses twice daily (H.). Chloral and Cam- 
phor, partes aequales, triturated together, and painted over surface (B., R.) ; 
also with morphine (B.). Aquapuncture, strangely relieves pain in a superficial 
nerve, so much so, that some hold the curative effects of morphine injection 
to be due to the water (B.). Counter-irritation. Mustard poultices in neuralgic 
pains (P.). Blisters to a posterior branch of the spinal nerve-trunk from which 



NEURALGIA. 



635 



painful nerve issues (Anstie). Amyl Nitrite, inhaled in dysmenorrhceal neu- 
ralgia (B.) ; and when of 5th nerve (R.). Nitro-glycerin, has often afforded great 
relief (Wa.). Carbonic Acid Gas, injected into vagina for neuralgia of uterus 
(R.). • Digitalis, is strongly recommended in sciatica, also locally in earache 
(P.). Valerian, serviceable in facial neuralgia of hysterical type (P.). Bibiru 
Bark, in intermittent forms (P.). Pyrethrum, root, is chewed with benefit in 
facial neuralgia (P.). Capsicum, a strong infusion on lint covered with gutta- 
percha (R.). Coccus Cacti, has been very successful in 20-30 minim doses of a 
^th tincture twice daily, the larger dose in the paroxysm (W.). Peppermint, Oil 
of, painted over the part in facial neuralgia (R.) ; especially the Chinese oil, 
which contains a large excess of Menthol, a very useful application in superfi- 
cial neuralgias (W.). Turpentine, has cured tic douloureux and sciatica (B.) ; 
often of wonderful service (P.). Potassium Chlorate, for facial neuralgia (B.). 
Alcohol, with much volatile ether ; care must be taken in prescribing it (R.). 
Piscidia, almost specific in many forms, useless in many cases (W.). Tonga, 
is efficient in facial neuralgia, ffLx-xx every two hours (H.). Osmic Acid, a one 
per cent, aqueous solution with glycerin to prevent change, of which 5 to 10 
drops hypodermically has made striking cures of inveterate neuralgias, with 
no ill effects resulting (Shapiro). Wet Pack, is of great benefit, especially in 
sciatica. Intense Cold, produced by a spray of Chloride of Methyl, or concen- 
trated carbonic acid gas, directed along the nerve from special apparatus, 
immediately relieves the pain, and usually cures (Jacoby). Compressed Air, 
by insufflation into the middle ear, in cases of persistent and paroxysmal tem- 
poro-occipital neuralgia, due to chronic follicular pharyngitis and inflammation 
of middle ear (Legal's Disease). If these insufflations result in diminution of 
the pain, treatment should be directed to the naso-pharynx and Eustachian 
tubes (Masucci). Galvanism of the affected nerve, one of the most important 
curative measures ; a continuous current of 4 to 8 cells down the nerve gen- 
erally answers best, though some cases are helped more by a rapidly inter- 
rupted faradic current. Electricity is of no value in cases dependent upon 
organic lesions, and in any individual case is purely experimental (W.). Diet. 
Animal fats necessary, as cod-liver oil, butter, cream, etc., in as large quantity 
as can be digested. Rest often needed, with protection from cold and damp, 
flannel clothing, bathing and shampooing. [Compare Gastralgia, Hepa- 
talgia, Sciatica, Tic Douloureux, Hemicrania. etc.] 



Prescriptions. 



R. 



aa 



Local Use. 
Chloroformi, 
Tinct. Aconiti, . . . 

Linim. Saponis, ^j. 

M. Sig. — Apply on flannel and cover 
with oiled silk for superficial neuralgia. 



R. 



Aconitinse (Duquesnel), 
Veratrinse 



gr. iv. 

gr. xv. 

Glycerini, gij. 

Cerati, gvj. 

M. Sig. — To be rubbed over the part, 
avoiding any abraded surface carefully. 

{Da Costa.} 



R . Mentholi, gr. xlv. 

Cocainae gr. xv. 

Chloralis, gr. x. 

Vaselini, gv. 

M. ft. ung. Sig. — For local use. 

{Potter. 



R. 



Internal Use. 

Phosphori, gr. ss-jss. 

Alcoholis, q. s. ad solv. 
Spt. Menthae Piperita^, q. s. 
Glycerini, ... q. s. ad ^iv. 
M. Sig. — A teasp. after each meal. 

(H.) 



R. Cupri Ammonio-sulphat., . gr. j-iv. 
Syr. Aurantii Flor., . . . . ^j. 

Aqua? Destil., ^iij. 

M. Sig. — One-third as a dose, thrice 
daily. (^ro/. Pereol.) 



R. 



M 



Quininae Sulphatis, . . . . ^j. 
Ferri Pyrophosphatis, . . . gj. 
Slrychninae Sulphat., . . . gr. ss. 
Ac. Phosphor. Diluti, . . . 3 ij. 

Syr. Zingiberis, 3 ij. 

Aquae, q. s. ad % iv. 

. Sig. — A tablespoonful twice daily. 



6 3 6 



NIGHTMARE NYMPHOMANIA. 



R. Veratrinse, . . . . 

Adipis, vel Unguenti 
M. Sig. — Local use. 



. . gr. xl. 
(Da Co si a.) 



R 



Theinae, 

Sodii Benzoatis, . . . aa gj. 

Sodii Chloridi, gr. x. 

Aquae Destil., ^j. 

M. Sig. — 3 to 20 drops hypodermically 

at central seat of disturbance. (Mays.) 
rr^vj = gr. ss of Theine. 



R 



. Aconitinae Crystal., . . . gr. ¥ ^. 
Quininae Hydrobrom., . . gr. xx. 
M. ft. massa, et div. in pil. no. xij. 
Sig. — One every 4 or 5 hours. (Potter. 



R . Tinct. Aconiti, 

Tinct. Colchici Sem., 

Tinct. Cimicifugae, 

Tinct. Belladonnae, aa part. aeq. 
M. Sig. — 6 drops every hour until re- 
lieved. (Metcalfe 



Nightmare. 

Potassium Bromide, in nightmare of adults ; and children's attacks ot 
night-screaming often associated with squinting. Digestive organs may also 
require attention (R.). Camphor-water, a teaspoonful or two the most suitable 
medicine (H.). Sleep, in abundance, may prevent (H.). Diet, light ; avoid late 
meals. 

Nipples, Sore, Fissured. 

Benzoin, an admirable local application (P.) ; the tincture locally for slight 
erosions (Parvin). Arnica, the cerate or Glycerin of Starch, or glycerin, 1 to 2 
of eau de cologne (R.). Silver Nitrate, touched lightly ; effectual (Wa.). 
Sulphurous Acid, solution neat or diluted, constantly applied, or with equal 
quantity of glycerin as lotion (R.). Collodion, sometimes used (R.) ; useful for 
protection (P.) ; as coating (B.). Alcohol, brandy and water as lotion before 
delivery and after each suckling to prevent cracking (R.). Borax, saturated 
solution, beneficial (Wa.). Iron, the solution of the subsulphate diluted with 
3 parts of glycerin, and applied with a camel's-hair brush, an effective applica- 
tion for fissured nipples (B.). Tannin, the glycerite, one of the best applica- 
tions to fissured nipples (B.). Lead Nitrate, in glycerin, or ointment 3j-^j, 
in fissured nipples (B.). Zinc Shield, constantly worn (R.). Balsam of Peru 
or Tolu, valuable as application, with oil of almonds, gum arabic, and rose- 
water (P.). Rhatany, as wash or cerate, has had great success in fissure 
(Tr.) ; 1 part of extract to 15 of cocoa butter (Wa.). Nipple-shield, to give the 
nipple rest while the child sucks, gives great comfort. [Compare Lactation, 
Mastitis.] 

Prescriptions. 



R. Balsam. Peruvian., . , . . gij. 

Olei Amygdalae, . . . . . gjss. 

Mucil. Acaciae, gij. 

Aquae Rosae, q. s. 

M. Sig. — Apply to the nipples after 
each nursing. (Phillips^) 



R . Liq. Plumbi. Subacet. Dil., ;§ ss. 

Ext. Opii Aquosi, . . . . 3J. 

Aquae Rosae, ^ U J SS « 

M. Sig. — Lotion, to be used after a 
bread-and-milk poultice, for inflamed nip- 
ples. (F. Barker.) 



Nodes. 

Mercury. The oleate of mercury and morphine externally, is very valuable 
(R.). Potassium Iodide, as ointment in conjunction with internal use, in syph- 
ilitic nodes of children; also in non-syphilitic periosteal thickenings (R.). In 
syphilitic nodes it holds the first place, especially when pains are worse at 
night, and by heat of bed (Wa.). Stramonium leaves, locally, relieve (Wa.). 
[Compare Exostosis, Periostitis.] 



Nymphomania. 

Potassium Bromide, when from plethora ; not useful when relaxation, or 
from cerebral lesion (B.) ; large doses required, at least gr. xx ter die (R.) ; an 



OBESITY ODONTALGIA. 637 

abundance of evidence testifies to its value (W.). Tobacco, to nausea, effect- 
ually cures, but is horribly depressing (B.). Camphor, in considerable doses 
said to control inordinate sexual desire (R.) ; at present not much relied on 
(Wa.). Lupulin, seems worthy of fair trial (Wa.). Sulphur, or dilute sul- 
phuric acid internally, when arising from hemorrhoidal congestion, not an 
infrequent cause (Wa.). 

; Obesity. 

Banting Dietary is alone sufficient to improve the condition. Its chief fea- 
ture is the exclusion of two elements — starch and sugar — from the food. There- 
fore bread (except toast, or the crust of a common loaf), potatoes, sweet roots, 
butter, sugar, cream, beer, porter, and champagne, should be avoided. In one 
year, on this diet, Mr. Banting reduced his weight 46 pounds, and his girth 
about 12 inches; at the same time, his numerous corporeal infirmities were 
greatly mitigated or altogether removed. Cannot be recommended indiscrimi- 
nately. This was the method of Hippocrates, avoiding all fats, starches, and 
sugars ; in fact, all roots or vegetables grown underground (B.). Meat Diet, 
very successful in 42 cases, the diet being confined to rump-steak, hot water 
and codfish, for 14 days, absolutely excluding everything else. (Dr. Smith, in 
Brit. Med. Jour., Nov. 20th, 1888). The Schweninger or CErtel method is 
similar, using chiefly albuminous food, excluding fat and carbohydrates, limit- 
ing the fluids drank, especially at meals, and enforcing exercise. Iodoform is 
highly efficient, but causes wasting, and anaemia by injuring red blood cor- 
puscles (B.). Iodol, in 2-grain doses thrice daily, is equally effective (B.). Al- 
kalies. Solutions of oxides or bicarbonates (R.) ; alkaline mineral waters, 
with exercise and dietary (B.) ; serviceable (Wa.). Liquor potassae gss in 
milk, thrice daily, of established value (Wa.) ; generally fails (R.). Ammo- 
nium Bromide, sets up gastric catarrh (B.) ; but lessens corpulency (Wa.). 
Sulphurous Waters, especially Blue Lick, ^iv before each meal (B.). Potas- 
sium Permanganate, for attendant dyspepsia and flatulence ; also useful for the 
obesity ; gr. %-) ter die, in aq. dest. (B.). Vinegar, only successful at expense 
of serious injury to the body (R.). Fucus Vesiculosus, has power to reduce 
adipose tissue. An extract is sold under the title " Antifat " as a proprietary 
medicine (W.). Exercise, daily, in the open air is necessary, and if carried on 
systematically is the most efficient and least injurious method of reducing an 
excess of adipose tissue. 

Odontalgia. 

Aconite ointment or liniment for facial neuralgia due to diseased teeth, will 
succeed quickly if at all (R., Wa.). Arsenic, gr. -£$, as escharotic to destroy 
pulp, when used for pain may be mixed with opium. It sometimes at first 
aggravates pain (R., W.). Staphisagria, the alcoholic solution dropped into 
the cavity (P.). Alum, a solution of nitric ether (o^j-Svij) is said to be an 
effectual application (B.). Alum and salt powdered and placed in the cavity, 
excellent when nerve exposed. Chloral, rubbed up with equal weight of 
camphor, rubbed or put into camphor (R.). Chloroform or Croton-Chloral, 
equal parts of the former and creasote, a good application (R.). Tannin, a 
solution in ether is a good application to a carious tooth (B.). Creasote, with 
tannin or opium or chloroform, placed in the cavity of a decayed tooth, often 
gives relief (R.). Cocaine, a 5 per cent, solution of the hydrochlorate on 
cotton applied to a cavity will often bring instant relief. Coniine, solution in 
alcohol placed into a hollow painful tooth (R.)- Collodion and Carbolic Acid, 
equal parts as jelly for stopping carious teeth (R.). Opium, mixed with tannin or 
creasote inserted in cavity of painful tooth (R.). Morphine, hypodermically 
for severe toothache (R.). Oil of Cloves, inserted into cavity (B., P.). Camphor, 
with morphine and flaxseed, as a cataplasm to the cheek (B.). Xanthoxylum, 
a domestic remedy (B.). Capsicum, a strong infusion on lint (R.). Gelse- 
mium, useful in some forms (R.). Zinc Chloride, to destroy exposed painful 
pulp (R.). Ginger, Mezereon, Pyrethrum, are useful masticatories in tooth- 
ache (P.). 



6 3 8 



ONYCHIA OPHTHALMIA. 



Prescriptions. 



R. Linim. Aconiti (B. P.), 

Chloroformi, . . . . aa giij. 

Tinct. Capsici, ^j. 

Tinct. Pyrethri, 
Olei Caryophylli, 
Pulv. Camphorae, . . aa ^ss. 
M. Sig. — A few drops to be placed on 
a pellet of cotton and applied to the cavity. 

{Mason.) 

R. Ac. Tannici gr. xx. 

Mastiches, gr. x. 

^Etheris, ^ss. 

M. Sig. — On cotton to cavity. (D.) 



R. 



M 



Creasoti, gij. 

01. Caryophylli, 7>™. 

01. Menth. Piperit., . . . 5j. 

Camphorae, J ijss. 

Alcoholis, . . . . q. s. ad Oj. 
Sig. — " Toothache Drops." 



R. Morphinse Sulph., . . . . gr. iv. 

Atropine Sulph., . . . . gr. j. 

Aquae Destill., i|j. 

M. Sig. — A few drops on cotton, placed 
in the cavity. (B.) 



(Esophagus, Affections of. 

Belladonna, the liniment with frictions to the sternum, often very useful as a 
palliative in stricture of the oesophagus (Wa.), Conium, in spasmodic contrac- 
tions, with crampy pains of stomach, flatulence, and globus hystericus, has 
proved very serviceable (Wa.). Hyoscyamus, or Conium, in stricture of oesoph- 
agus, if much irritability ; with occasional leeching to relieve exacerbations 
of pain or spasm (D.). Silver Nitrate, in stricture of the oesophagus, a weak 
solution on sponge probang (D.). Anaesthetics, should be used only to meet 
temporary indications ( W.). Nutrient Enemata, in stricture of the oesophagus, 
when swallowing impossible (R.) ; may, in some cases, even preserve life (Wa.). 
[See Enemata.] Bougie Dilatation, in non-spasmodic (structural) stricture, 
the only appropriate treatment (H.). [Compare Dysphagia, Choking.] 



Onychia and Paronychia. 

Silver Nitrate, a strong solution in nitrous ether, painted over the adjacent 
tissue, will abort if applied early (B.) ; frequently causes resolution of the 
inflammation (Wa.). Lead Nitrate, dusted over night and morning (R.) ; 
relieves pain, and hastens healing process (B.). Turpentine, applied on a piece 
of lint or other absorbent material, stops the pain at once, and seems to kill the 
felon. Mercury, as ointment, for 10 minutes in every hour ; poultices in interim 
(R.). Arsenic, gr. ij ad ^j Adipis, as ointment, almost specific in onychia 
maligna (Wa.). Tartar Emetic, will shorten course, and render it milder .(R.). 
Iodoform, oint. or powder dusted on (B.) ; or i part to 9 of Ether applied by a 
dropper in, syphilitic onychia (Fox). Iodine, a strong alcoholic solution locally 
will often subdue the disorder (Wa.). Chloral, a solution locally, as antiseptic, 
and to promote healing (B.). Sodium Chloride, common salt roasted until 
chlorine is driven off, equal parts of this, castile soap and Venice turpentine, 
as a poultice, is a very efficient application. Carbolic Acid, to benumb surface 
during incision (R.) ; which should be carried down to the bone, especially in 
tendinous whitlow (D.). Cocaine, hypodermically, will accomplish the local 
anaesthesia more thoroughly, if delivered deeply into the tissue. Morphine, 
powdered, as local application to relieve pain. Heat, by poultices, is very use- 
ful. In Opening a felon avoid the lines of the arteries, on the sides of the 
fingers, and that of the flexor tendons, which is the median line on the palmar 
surface. The incision should be made midway between these lines. If the 
sheath of the tendon be opened the tendon may slough, and the finger be ren- 
dered useless (Ashhurst). 

Ophthalmia. 

Silver Nitrate, a strong solution (gr. xx ad ^j) in granular lids ; cautiously 
when corneal ulcers exists (B.); solid stick diluted with 2 to 4 parts of potassium 
nitrate, applied lightly and quickly, or a solution (gr. ij-x ad ^j) painted over 



OPIUM HABIT. 639 

everted lids, which should be washed with a solution of common salt, and then 
with water before being replaced (C.) ; in solution, gr. v ad %j aquae destillatae 
locally once a day in purulent ophthalmia of the new-born, washed off with a 
weak solution of common salt (Noyes) ; in solution, gr. iij to the £ to abort the 
discharge in catarrhal ophthalmia (Fox). Boro-Glyceride, in many catarrhal 
affections, especially ophthalmia neonatorum, is a most efficacious application, 
the solutions used being of 10, 25 and 50 per cent, strength (Fox). Alum, gr. 
viij ad 3j aquae, applied every X or K hour in purulent ophthalmia of children ; 
success depends on the frequency of the application (R.) ; a crayon formed of 
a crystal of alum, a mild and occasionally useful application (C). Mercury. 
Calomel dusted over membrane in phlyctenular ophthalmia ; or after detaching 
scales rub in brown citrine ointment every night for eczema of margin of lids 
(B). Pulsatilla, as a lotion to conjunctiva 8 or 10 times in 24 hours, also inter- 
nally (P.) ; much used by homoeopaths (B.). Spigelia, useful in rheumatic 
ophthalmia (P.). Antimony. Tartar emetic, gr. -£% to ^g-, three or four times a 
day in strumous ophthalmia, with sharp purgation at commencement (R.). 
Belladonna, or Atropine, locally, of great service in strumous ophthalmia to 
relieve pain ; constitutional treatment also required (Wa.) Atropine, gr. ij of 
neutral sulphate to the £ of aqua destillata, twice or thrice daily, as soothing 
application (C). Arsenic, invaluable in inveterate cases of strumous ophthal- 
mia, especially when complicated with cutaneous eruptions (Wa.). Copper 
Sulphate, gr. j ad §j aquae camphorae as collyrium in purulent ophthalmia of 
infants ; in substance to inner part of lids in granular conjunctivitis (Wa.). 
Tannin, powdered (or in solution gr. j-x ad ^j) produces remarkable results 
(B.). Lead Acetate, gr. j ad ^j aquae destillatae, applied by camel's-hair pencil 
to surfaces of everted lids, washed away before the lid is replaced. Or the 
Tannate of Lead 1% ad 3 parts fine oil, and 1 of fresh lard, a very small piece 
as ointment to lid (C). Carbonic Acid Gas, said to relieve the pain and photo- 
phobia of strumous ophthalmia when locally used (R.)- Physostigma, to reduce 
pupil and shut out the light (P.). Iodine, is employed in scrofulous ophthalmia, 
locally for its alterative stimulation (W.). Iodoform, in gonorrhoeal ophthalmia, 
and purulent conjunctivitis, of very gveat value locally, but should be pulver- 
ized very finely (Grossmann) ; does not bear out the claims made for it (Keyser). 
Zinc Chloride, gr. j ad Jj aquae as collyrium, in gonorrhoeal ophthalmia, used 
with marked benefit ; also a stronger solution (gr. ij-iv ad ^j), effectually 
arrests the muco-purulent discharge remaining after subsidence of purulent 
ophthalmia, and has succeeded admirably in diphtheritic conjunctivitis and 
pustular ophthalmia (Wa.). Zinc Sulphate, as collyrium, gr. j-iv ad 3J, is very 
serviceable in ophthalmia of infants or adults; liquor plumbi added improves 
(Wa.). Staphisagria, especially in tarsal ophthalmia (P.). Colchicum, when 
gouty diathesis (P.). Cod-liver Oil, in strumous subjects, tends to remove the 
manifestations of the disease (R.)- Cold Wet Compresses, or iced, are held to 
be essential in early stage of acute purulent and gonorrhoeal ophthalmia (C). 
[Compare Blepharitis, Conjunctivitis, Keratitis.] 

Opium Habit. 

Capsicum, very serviceable from its power as a stimulant to the stomach, and 
its sedative action on the cerebrum (B.) ; removes the sinking sensation at the 
pit of the stomach experienced by alcoholics, when trying to break off that habit 
(R.). Bromide of Sodium, in large and increasing doses, Z) twice daily, 
increased by 20 grains each day, to a maximum of 100 to 120 grains twice in 
twenty-four hours, with simultaneous gradual reduction of the opiate dose, so 
that from the 8th to the 10th day it is entirely abandoned. Each dose of the salt 
should be given in 6 or 8 fluid ounces of cold water (Mattison). A combination 
of bromides (see formula below), commencing with 40 grains twice daily, 
increasing to 100 grains twice daily, at 10 a. m. and 4 p. M., freely diluted with 
water, does not depress vitality, or produce the injurious results of the bromides 
as commonly administered. This, with 3j of Warburg's tincture before break- 
fast each morning, with the use of Spt. Etheris Nitrosi to eliminate the bromides 



64O OPIUM HABIT. 

rapidly, electricity, a mixture of iron and strychnine, and an occasional hypo- 
dermic of 5 or 10 minims of a 4 per cent, solution of Cocaine for nervous rest- 
lessness, is the general line of my treatment (Mann). Bromides may do great 
harm, if recklessly administered, paralyzing the muscular system and causing 
prolonged delirium. Cocaine, or the fluid extract of Coca (Erythroxylon), has 
been used to relieve the depression caused by the withdrawal of the drug (B.) ; 
has been, by many careful observers, pronounced of great benefit, restoring 
appetite, inducing sleep, promoting digestion, while soothing the brain and 
inducing a feeling of contentment and calm (R.). Should never be entrusted 
to the patient, lest he jump out of the frying-pan into the fire. Gelsemium, 
subdues the restlessness and motor excitement; proved of great value in one 
case where 30 grains of morphine were used daily ; TnJ of tincture every y z 
hour (Pennoyer). Conium, in 10-drop doses of a good fluid extract, to check 
motor activity and relieve the wandering pains. Sparteine, in doses of gr. ^ 
to Yi hypodermically, at moment of systolic cardiac depression which answers 
to the period of craving, and corresponds to the truncated curve of the sphyg- 
mographic trace, which is characteristic of the period when the stimulant effect 
of morphine has passed (Jennings). Nitroglycerin acts in the same manner, 
but its effect is more rapid and more ephemeral (Idem). Cannabis Indica, may 
be required in full doses, for restlessness after withdrawal of the opiate, 3-doses 
of Squibb's fluid extract, repeated every hour, or two, as required (M.). Galvan- 
ism, is very efficient for the neuralgic pains in various parts ; a strong faradic 
current sometimes acting better (M.). Baths, if hot, 105 to 112 F., are ot 
great value to relieve disquiet ; warm baths are worthless (M.). Chloral, as a 
hypnotic, fails in the first few days of abstinence ; later in full doses, 45 grains 
at once, rather than three 15-grain doses, alone or with a bromide, it can be 
relied on (M.). Hyoscyamine, Merck's amorphous, gr. y 1 ^ to \ hypodermically, 
or more, is useful as a hypnotic, and perfectly safe, in patients of good general 
condition, in whom the disuse of Opium produces unusual insomnia and motor 
activity (M.). Lupulin, with Phosphoric Acid (see formula below), helps to 
sustain the patient, lessens the force of his suffering, and shortens its duration 
(Fleming). Zinc and Iron as blood tonics, given for a month at least, are 
valuable, and are best given on alternate days (see formula below) (Fleming). 
Piscidia Erythrina, has been proposed as a substitute, and highly commended, 
but is worthless, as are also Avena sativa and many other falsely termed sub- 
stitutes (M.) ; there is no remedy for the opium-habit (Da Costa). Zinc Oxide, 
for the vomiting and diarrhoea, beginning with gr. j once daily and increasing 
to tolerance (Da C). Withdrawal of the drug suddenly and completely, is 
the method of Levinstein and other Germans, and is preferred when we can 
have absolute control and surveillance of the patient (Da C); entails horrible 
suffering, and is utterly inexcusable (M.). A more gradual reduction is the 
method usually employed, taking off one-third the first day, one-fourth the 
second day, and then gradually reducing the amount until the sixth or seventh 
day, when it is entirely withdrawn. No agent is of any value unless strengthened 
by moral courage and perseverance on the part of the patient (Squibb). Use- 
less to try to cure a patient while he is pursuing his ordinary avocations. 
Failure will result unless there is complete seclusion and entire giving up to 
the treatment (Mann). 

Prescriptions. 



$ . Tinct. Capsici, giv. 

Potassii Bromidi, 3 iv. 

Spt. Ammoniae Aromat., . ^iij. 

Aquae, Camphorae, . . ad % vj. 
M. Sig. — A dessertsp. several times 
daily, in the depression of alcoholism and 
opium-habit. Instead of the bromide, Fow- 
ler's Solution (Liq. Potass. Arsenitis), mj, 
may be added ; or Tinct. Nucis Vomicae 
3 ij, or Tinct. Aurantii Amari 3 v. 

{Ringer.) 



R . Strychninae Sulphatis, . . gr. ss. 

Tinct. Belladonnae, 

Tinct. Capsici, . . . . aa giij. 
M. Sig. — Ten drops every three hours, 
increasing three drops daily. 

Be . Tinct. Cannabis Ind., . . T^xl-lx. 

Spt. JEiheris, 5jj. 

Aquae, q. s. ad Jj. 

M. Sig. — One dose, if insomnia is very 
protracted. {Fleming.) 



ORCH ITIS OTALGIA OTITIS. 



64I 



Combination of Bromides. 

R. Ammonii Bromidi, 

Sodii Bromidi, . . . . aa % ss. 

Potassii Bromidi, . . . . %')• 

Liq. Potass. Arsenit., . . . 5{j. 

Syr. Tolutan., ^j. 

Aquae Mentha Piper., . . jf jss. 

Syr. Hypophos. Comp., . . ^iij. 



M. 

daily. 



Sig. — ^j to 31J 



water thrice 



Has a total of Bromides, gr. 2; 



in each £ 



(Mann.) 



R. Strychnine Sulphate. , . . gr. ss-j. 

Tinct. Gentianae Co., 

Tinct. Cinchonse Co., . aa ^ij. 
M. Sig. — Teasp. before each meal, as a 
stimulant to the appetite and nervous sys- 
tem. 



R- . Tinct. Nucis Vomicae, . . giij. 

Ac. Phosphor. Diluti, . . . ^v. 

Syr. Pruni Virg., Iij. 

Aquae, q. s. ad J iv. 

M. Sig. — gij twice daily as a nerve 
tonic. (Potter.} 



Orchitis. 

Pulsatilla, rr\j or less, every hour, relieves pain rapidly, though not the 
oedema (St.). Belladonna, int., and as oint. (extract j ad iij adipis) when in- 
flammation has subsided (Wa.). Sodium Salicylate, in gonorrhceal orchitis, 
subdues pain in a few hours. Iodine, tinct. locally to remove swelling after the 
acute stage has passed (B.). Mercury, the oleate locally (B.) ; Calomel gr. iij 
with Ipecac, gr. x at once, followed by a saline next morning, and smaller 
doses of calomel and ipecac, every 6 hours, with morphine hypodermically, gr. 
% into cellular tissue of scrotum (McElroy). Ammonium Chloride, makes a 
good evaporating lotion, in solution with alcohol and water (R.). Silver Nitrate, 
a strong solution to the scrotum, with gentle pressure (Wa.). Tartar Emetic, 
in acute orchitis (R.). Digitalis, locally, is found most useful (P.). Alcohol, 
with equal quantity of water, as evaporating lotion (B.). Ice, benefits and 
relieves pain (B.). [Compare Epididymitis.] 

Prescriptions. 



R . Ammonii Chloridi, . . . . gr. xl. 
Alcoholis, Aquae, . . aa ^ij. 
M. Sig. — Lotion, to be applied on 
cloths to the part. 



R . Hydrarg. Ammoniat., . . jjj. 

Cerati Simplicis, ^j. 

M. ft. unguent. Sig. — Apply locally, 
with gentle friction. 



Otalgia. 

Aconite and Opium, equal parts of the tinctures, a few drops well down the 
external meatus, will often subdue the pain. Blistering Fluid, or Croton Oil 
Liniment, behind the ear often relieves earache (R.). Glycerin, for dryness 
of meatus (R.) ; or oil for accumulation of wax in external meatus dropped in 
every night, gentle syringing in the morning with warm water (CI.). Opium, 
Morphine in solution, gr. iv to the ^, with gr. j-ij of Atropine, is an excellent 
application (B.). Atropine, gr. -^ in 3xx of water, a teasp. every three hours 
for a child in the acute otitis media of children from coryza, very successfully 
used to abort the otitis, and relieve the earache (Miot) ; a solution locally is 
especially applicable in the earache of children from whatever cause ; — gr. j to 
the oz., of which gtt. iv dropped into ear to remain for 10 or 15 minutes. 
Pulsatilla, internally and externally, is often used with advantage (P. j. Cocaine, 
a 4 per cent, solution sprayed over the tympanic membrane through the exter- 
nal meatus, and forced into the Eustachian tubes by inhaling the vapor and 
then expanding the tubes by Valsalva's method ; this repeated every three 
minutes is a very sure method of curing otalgia (R.). 



Otitis. 

Pulsatilla, in inflammation of external auditory canal ; in otitis, as lotion 
warmed and applied by syringe, three or four times a day (P.). Aconite, 
quickly relieves the pain (R.) ; should be used internally and locally. Carbolic 
Acid, a 20 per cent, solution instilled into ear in moderate otitis, relieves 

41 



642 OTORRHCEA — OVARIAN NEURALGIA OVARITIS. 

pain at once and checks progress. A solution in glycerin is best (Rohrer). Atro- 
pine, in the acute otitis media of children, is very efficient. See Otalgia, above. 
Blisters, behind ears, either kept discharging or repeated, often very useful 
(Wa.). Leeches, behind the ear, afterwards a small blister upon the same 
place, when leech-bites have healed (H.). Warm Douche frequently, to the 
ear, to secure cleanliness, then drying the parts (Roosa). 

Otorrhcea. 

Mercury, in chronic cases, the brown citrine ointment (B.). Lead lotions 
much employed (B.). [See Gonorrhoea, for formula.] Potassium • Perman- 
ganate, as injection or spray, gr. j-gj aq. destil. (B.). Silver Nitrate, locally, 
a solution of gr. iv to the 3$ (B.) ; gr. x to the g (Roosa). Copper Sulphate, 
gr. j-v to the ^ (Roosa). Tannin, the glycerite, locally, is successful (B.) ; 
especially in children (Wa.). Zinc Sulphate, locally, in solutions of gr. ij-viij 
to the % (B.) ; gr. j-v to the g (Roosa). Cadmium, gr. ij-^j rose-water (B.). 
Liquor Sodae Chloratse, TTVxv xxx ad £j aquae when discharge fetid; is highly 
useful as injection (Wa.). Quinine, wiih sulphuric acid, advisable in otorrhcea 
after scarlatina (Wa.). Boracic Acid, finely pulverized, as astringent and dis- 
infectant application ; may be mixed with pulv. Alum, and just enough pow- 
dered Lycopodium to keep it dry; — this packed carefully through speculum, 
after washing with a weak and tepid alkaline solution. Absorbent Cotton, on 
holder, may be used every few hours by patient to keep pus removed from the 
canal. Syringing with warm salt water, once daily, as absolute cleanliness is 
essential in the treatment. Politzer Bag is a useful adjunct in keeping secre- 
tions out of tympanum and breaking up adhesions (Roosa). [Compare Otitis.] 

Ovarian Neuralgia. 

Atropine, subcutaneously, the best remedy for pain in the pelvic viscera 
(Wa ). Ammonium Chloride, gr. xxx with gtt. ij-v tinct. aconiti, repeated in 
j^-hour if necessary to remove pain (W.). Camphor, with Cannabis Indica, of 
great service in relieving ovarian pain, especially when spasmodic in character 
(Wa.). Opium, often the cause; if use stopped entirely improvement may 
ensue (E.) ; one of the best remedies in ovarian pain of non-inflammatory 
character (Graily Hewitt). Codeine, has especial value against ovarian pain 
(Freund), whether of inflammatory or neuralgic origin, in dose of gr. ^ at least. 
Conium, or, better still, its alkaloid, used as a vaginal pessary, in all cases of 
ovarian pain, whether neuralgic or inflammatory, is quite a specific (Meadows). 
Hot Water, vaginal injections, night and morning; sunlight baths, fresh air 
(E). Ether, the compound spirit, in doses of tt^xxx-xl as a palliative (Anstie). 
Gelsemium, deserves a trial ; its power is great but not certain (Wa.). Leeches 
over the groin, or inside the thigh, where ovarian pain persistent, or tenderness 
and aching (Wa.). Surgical, Battey's operation as a last resort (E.). [Com- 
pare Dysmenorrhcea.] 

Ovaritis. 

Turpentine Epithems, may be applied hot over the seat of the disease (Wa). 
Tartar Emetic, as ointment for counter-irritation over seat of disease, in sub- 
acute ovaritis ; at same time a pill of opium, hemp and camphor. See for- 
mula below (Hewitt). Opium, in suppository or enema, more effectual than 
internally (Tilt). Mercurial Ointment, combined with camphor and bella- 
donna, over the seat of the disease by friction (West). Blisters, in subacute 
ovaritis are often of great service, placed over the region or to the cervix uteri 
(Wa.). Enemas, of warm water, simple or medicated, in subacute ovaritis, 
are warmly recommended ; they should be retained as long as possible (Wa.). 
Salix Nigra, the " pussy willow," in doses of rr^xxx of the fluid extract thrice 
daily, ot decided benefit in ovarian hyperesthesia, etc., of highly nervous 
women. Ergot, is valuable in chronic ovaritis, with rest and Potassium Bro- 
mide (Tait). Ice, in bag, over seat of pain, when intolerable, and patient too 



OXALURIA OZ^NA PAIN. 



643 



much reduced to bear leeches ; is often of benefit (Wa.). Poultices of Linseed 
meal, as light as possible, often produce great benefit in ovarian inflammation. 



Prescriptions. 



s 



gr. nj. 



Ext. Opii, 

Ext. Cannabis Ind., 

Camphorae, aa gr. vj. 

M. ft. pil. no. vj. Sig. — One pill twice 
daily. (Graily Hewitt.) 



Be. Ung. Hydrargyri, . . . . sjvj. 
Camphorae, . . „ . . . . gr. xl. 
Ext. Belladonnae, . . . . Ejij. 
M. ft. unguent. Sig. — To be rubbed in 
twice daily. ( West. ) 



Oxaluria. 

Mineral Acids, when eructations of sulphuretted hydrogen (R.). Nitro- 
muriatic Acid, is of important service (B.) ; especially in the condition show- 
ing general malaise, weakness, and depression of spirits, with oxalate crystals 
in the urine (W.) ; also in sciatica and other forms of neuralgic rheumatism 
accompanied with oxaluria, full doses (n\,yj-x) of this acid, with an occasional 
brisk purgative, and cold douche, followed by friction (Wa.). Zinc Sulphate, 
often very serviceable in irritability of the nervous system, associated with dys- 
pepsia and oxaluria (Bird). Lactic Acid, aids imperfect digestion (B.). 

Ozaena. 

Gold, the auric salts are very serviceable in syphilitic ozsena (B.). Mercury, 
ointment of the nitrate in syphilitic form ; the white or red precipitate with 58 
times its weight of sugar snuffed after clearing the nose in non-syphilitic forms 
(R.). Potassium Permanganate, 3j-Oj solution as an injection or spray (B.). 
Hydrastis, the fluid extract locally (B.) ; o\j-^viij solution as lotion with n^v 
of the tincture thrice daily internally (P.). Bromine, as inhalation (see for- 
mula below) ; or Iodine with Carbolic Acid, or the latter in one per cent, solution, 
as inhalations (B.). Carbolic Acid, inhaled, 1 per cent, solution (B.). Silver 
Nitrate, applied behind veil of palate; — gr. v-xx ad 3J (B.). Alum, solution 
(3j-Oj) for irrigation (R.). Glycerite of Tannin, by irrigation (R.). Salicylic 
Acid, in very weak solution (1 to 500), as cleansing, astringent, and disinfectant 
wash, used by retro-pharyngeal syringe, and followed by applications of Calo- 
mel, in powder, to the ulcerated portions of the mucous membrane (Massei). 
Cubeba, the oleo-resin, gtt. xv-xx on sugar after each meal, to restrain the 
secretion and perhaps modify its character (Cohen). Chloride of Lime, 
gr. xxx-lx with ^j decocti kramerias ; of which 3^ i j — i i j , diluted with an equal 
quantity of water, should be injected twice daily after cleansing with salt and 
water (Cohen). [Compare Catarrh, Chronic Nasal.] 



Prescriptions. 



R. Tinct. Iodi, 3 iv. 

Ac. Carbolici, 3J-ij- 

M. Sig. — Use on sponge in a wide- 
mouthed bottle as inhalation. 

{Potter.) 



R. Bromi, % ss. 

Alcoholis, |jss. 

M. Sig. — Inhalation when vaporized 
by heat ot the hand. 



R. Sodii Carbonatis, 

Sodii Boratis aa sjij.. 

Liq. Sodae Chloratae, . . . ^ss-gij; 

Glycerini, 5j. 

Aquae, q. s. ad gvj. 

M. Sig. — Apply by means of a hand- 
spray apparatus. ( Thornton.) 



R 



. Acidi Carbolici, rr^xx. 

Aquae Calcis, Oj. 

M. Sig. — Use as wash or spray. 



Pain. 

Opium, is universally used to quiet pain. Morphine, hypodermically, in 
vicinity of nerve, is curative when not so by stomach. Morphinae acetas vel 



sulphas gr. l /6-}i, with atropine gr. 



Caution, morphine habit (B.). 



644 PAIN. 

Sometimes a single injection curative of sciatica and neuralgia. Poultices con- 
taining laudanum useful in inflammation. Linimentum opii by friction, relieves 
pleurodynia, neuralgia, etc. The conjoint administration of Morphine and 
Antipyrine is much more efficient than the use of either agent alone to relieve 
pain. Opiates soon lose their influence in any certain dose, requiring increased 
quantities to keep up analgesic influence, so in chronic cases it is best to exhaust 
all other means before resorting to it (R.). Codeine, has special influence over 
abdominal pain, and that of the ovaries, besides being safe as to habit. 
Chloral, has no direct pain-relieving power, except in dangerous doses. To 
relieve pain and promote sleep, the best agent is a combination of chloral and 
morphine, cautiously, if heart trouble, or to old drunkards; gr. xv-xxx -j- gr. 
X (B.). Sometimes relieves neuralgia, chronic rheumatism, gall-stones, colic, 
gastralgia, and even cancer (R.) Aconitine, locally over seat of pain ; one of 
the most certain and powerful palliatives in neuralgic, rheumatic, and gouty 
affections (Wa.); especially serviceable in neuralgia of 5th nerve (B.). Bella- 
donna, the best remedy for every kind of pain in pelvic viscera (Anstie). Atro- 
pine hypodermically in local pain, neuralgia, sciatica, glaucoma, etc. When it 
succeeds, has more lasting effect than morphine (R.) ; sciatica, tic douloureux, 
etc. (B.). Iodides, are magical in syphilitic nocturnal pains of head (B.). The 
iodide of ammonium, gr. iij ad ^j ol. olivae, with friction ; causes the disap- 
pearance of nocturnal syphilitic pains (W.). Cimicifuga, relieves many kinds ; 
neuralgia of 5th, rheumatic headache, ovarian neuralgia, dysmenorrhcea. 
Inferior to ergot in labor-pains or after-pains. 3j doses (B.). Conium, in can- 
cer, rheumatism, neuralgia, ovarian pain, etc. (R.) ; also for the fulgurant pains 
of locomotor ataxia, chronic alcoholism, sciatica, phthisis, etc., doses of tr^x of 
a fluid extr. of the unripe fruit, every y z hour, well watched (Madigan). Iron, 
with Belladonna, for the wandering pains of anaemia, in which morphine is 
dangerous and bromides useless (Waugh). Antipyrine, a most efficient anal- 
gesic, may be administered hypodermically. Is especially adapted to neuralgiae, 
migraine, and gouty pains. [See ante, page 108, also Opium, above.] Theine, 
of very great value for neuralgic pain, affects the nerve outwardly along its 
course from the site of the injection (Mays). Chloroform, locally, inferior to 
other local anaesthetics, two or three drops on cotton into the ear for faceache 
or toothache ; vapor on raw surface of cancers, neuralgia of uterus, photopho- 
bic eye, etc., by inhalation in renal and biliary colic, and to produce general 
anaesthesia, which see (R.). Ether, spray for local anaesthesia ; inhaled for 
general anaesthesia (R.). Carbolic Acid, as local anaesthetic (R.). Cocaine, as 
a local anaesthetic to mucous surfaces, or hypodermically for minor opera- 
tions involving a small area, as circumcision, eye operations, etc., has no equal ; 
a 4 per cent, solution of the hydrochlorate is generally employed (R.) ; has 
many applications, as odontalgia, otalgia, neuralgia of superficial nerves, etc., 
etc. Iodoform, as suppository in painful diseases of the rectum or bladder (R.). 
Stramonium, is used as ointment (R.). Duboisine, used instead of atropine (B.). 
Rhatany, relieves the pain of ulcerative disease of mucous membranes, pain 
of burns, ulcers, and especially of blisters (Tr.). Cannabis Indica, formerly 
used (B.). Aquapuncture (B.). [See Neuralgia.] Galvanism, of an affected 
nerve gives certain relief. Positive pole on point of emergence ; negative over 
superior ganglion of cervical sympathetic (B.). Heat, if pain is without fever 
or inflammation (B.) ; warm injections soothe the pain of cystitis, prostatitis and 
abdominal pains generally (B.). Hot Water, as bath, relieves pain most wonder- 
fully. Napoleon, on St. Helena, suffering from cancer of the stomach, appre- 
ciated highly the pain-relieving power of the hot bath ; often staying half and 
even whole days therein. Cold, when pain is inflammatory (B.). [See After- 
pains, Anesthesia, Boils, Chest-pains, Colic, Gastralgia, Headache, 
Hepatalgia, Inflammation, Lumbago, Myalgia, Neuralgia, Odontalgia, 
Otalgia, Ovarian Neuralgia, Rheumatism, etc.] 

Prescriptions. 

R. Antipyrinae, gr. xv. M. Sig. — One-half as hypodermic in- 

Aquse Destil., ...... Trrxv. jection, or the whole when rapid action de- 

Cocainae Hydroch., . . . . gr. ss. sired. (Sie.) 



PARALYSIS PAROTITIS. 



6 4 ; 



Paralysis. 

Strychnine, gr. g 1 ^ to -^ [gr. g 1 ^ to -^ (R-)] ! a ^ so hypodermically into the 
affected muscles, — for hemiplegia, paraplegia, local, mercurial, paludal, rheu- 
matismal, facial, infantile, and diphtheritic paralyses ; in that of spinal mus- 
cles, of bladder and all local forms (B.) ; often of use in hysterical (P.) ; all 
forms, except, according to Barwell, in cerebral and spinal paralyses (R.). Nux 
Vomica, in hysterical, and in that from lead-poisoning ; only in chronic cases 
(P.) ; in paraplegia from softening and wasting of cord (Brown-Sequard). 
Hyoscyamine, gr. -^-gradually increased to-j^in par. agitans, locomotor ataxia 
(B.). Rhus Toxicodendron, certainly efficacious in cases depending on rheu- 
matism (P.). Ammonium, the iodide and carbonate to aid in absorption of 
thrombi and thus promote cerebral nutrition in cases of incipient hemiplegia, 
due to endarteritis deformans reducing the lumen of the vessels in the brain 
(B.). [See formula below.] Arnica, paralysis of the bladder, and many forms 
(P.). Phosphorus, with cod-liver oil in paralysis agitans, small doses; also in 
the paralysis of white softening of the brain (B.) ; in hysterical paralysis (R.) ; 
in myelitic paraplegia from excessive venery ; the only drug which really 
affects the nerve-centres (W.). Belladonna, when depending on chronic 
inflammation of the cord (R.) ; externally as ointment along spine, with Ergot 
internally (Brown-Sequard). Physostigma, into the eye in, ocular paralyses 
(B.); in general paralysis of the insane, also in progressive muscular atrophy 
without much mental disorder, long-standing hemiplegia, paraplegia, loco- 
motor ataxia (R ). Coniine, in some cases of paralysis agitans (B.). Ergot, 
in paralysis of bladder from over-distention (B.) ; paralytic dysuria, sensa- 
tion of but partial emptying of bladder (P.); said to be useful in paraplegia 
(R.) ; in paraplegia complicated with menstrual irregularity and forms of 
paralysis arising from spinal congestion (Wa.) ; has cured cases of constipa- 
tion of the paralytic when all the most powerful cathartics failed (Curran). 
Cocculus Indicus, valuable in hemiplegia, paraplegia, and paralytic stiffness 
(P.). Ignatia, in paralysis of lower extremities (P.). Cannabis Indica, for 
retention of urine from spinal disease (R.). Capsicum, in y z to 2-grain doses 
every 4 hours as general stimulant (P.). Colocynth, in cerebral paralyses, 
sometimes seems to act favorably upon principles of revulsion or counter-irrita- 
tion (P.). Mustard, as an emetic to stimulate failing heart in certain forms of 
paralysis (P.). Senega, in rheumatic, is a powerful help (P.). Nutmeg, the 
oil as external stimulant (P.). Oil of Bay, has been given ; is obsolete (P.). 
Cajuput Oil, efficacious in palsy (P.). Counter-irritation, by blistering fluid in 
peripheral paralysis of the 7th nerve (R.). Cod-liver Oil, Anstie insists on it 
when low nutrition and faulty assimilation (B.). Galvanism, in hemiplegia 
and many forms (B.). Electricity, faradization of the muscles affected. Local- 
ized electricity probably of more importance in confirmed spinal paralysis than 
medicinal treatment. Massage, in infantile paralysis, given with lactophos- 
phate of calcium and cod-liver oil. Strychnine injected into the muscles (B.). 
[Compare Hemiplegia, Locomotor Ataxia, Tongue.] 



Prescriptions. 



R. Strychnine Sulph gr. ij. 

Aquas Destillatse, .... 3J. 
M. Sig. — For hypodermic administra- 
tion : TILv — gr. ? L of strychnine sulphate. 



R. Ammonii Iodic! i, gj. 

Ammonii Carbon atis, . . ^ij. 
Liq. Ammonii Acetatis, . . Jvj. 
M. Sig. — A tablesp. thrice daily. 
Ammonium ) above. 



See 
(B.) 



Parotitis. 

Aconite, in febrile conditions (R.). Mercury, j| grain of gray powder, 3 
or 4 times a day, very useful, relieving pain and swelling (R.). Poultice of 
flaxseed meal, a good local application for gland. Leeching, often gives speedy 
relief, when pain is great and resists hot fomentations (Wa.). Care to avoid 
chilling, important. Incision, when suppuration occurs. Stimulants and 



646 PEDICULI PEMPHIGUS PERICARDITIS. 

Tonics internally are very necessary in symptomatic parotitis, occurring as a 
complication or sequel of other diseases, with adynamic symptoms. 

Pediculi. 

Mercury. Citrine ointment or wash of corrosive sublimate, for lice on all 
parts of body. The oleate destroys lice immediately, and also kills the ova (R.). 
For crab-lice the ordinary blue oint. is very disagreeable, and often toxic in its 
effect on the patient. A better preparation is Calomel in 5 per cent, oint., or the 
Bichloride, a 1 per cent, solution in alcohol, of which a teasp. to a pint of water, 
as a bath to parts twice daily. Cocculus Indicus, destroys pediculi (P.) ; the tinc- 
ture undiluted as a wash. Staphisagria, as oil or ointment of the powder (R.) ; 
"lice-bane" (P.); the tincture a very efficient application, and much more 
cleanly than an oil or an ointment. Acetum. Vinegar will kill the nits, as it 
softens the adhesive chitin by which the ova are glued to the hairs. Ether, 
washed over the parts, effectually destroys crab-lice. Tobacco, a decoction of 
the leaf is an efficient application, but requires care, especially if the surface is 
abraded (Wa). Essential Oils, will kill, as rosemary, anise (P.) ; or powdered 
pyrethrum (R.). Cleanliness, cannot be dispensed with, and in many cases 
may alone be sufficient. Boil underclothing. Isolation of person, and of 
brushes, towels, etc., to prevent infection. In Vienna the following prescrip- 
tions are used : — 

Prescriptions. 



R . Bals. Peruvian., 

Petrolei aa pait. xv. 

Oil of Laurel, part. j. 

To be applied and washed off after 3 
hours. 



R. Ac. Salicylici, parr, ij-iij. 

Toilet Vinegar, . . . .pait. xxv. 

Alcohol (80 per cent.), . part. lxxv. 
To be rubbed on with a bit of flannel. 
Once often enough. 



Pemphigus. 

Antipyrine, internally, for the itching, is efficient. Arsenic, is curative, espe- 
cially when chronic (B.) ; largest dose, m^v liquor arsen. 3 times a day, on full 
stomach (R.); exercises a powerful influence (Wa.). Mercury. Citrine oint- 
ment is largely used (Wa.). Potassium Iodide, improves the condition in 
pemphigus (Wa.) ; with good, simple diet ; quinine, cod-liver oil, etc. Silver 
Nitrate, in pemphigus, after the bullae have burst, and excoriations remain (gr. 
ij ad ^j aquae) (Wa.). Water Dressings, on lint, covered with oiled silk, con- 
stantly, in pemphigus and rupia (Wa.). Cod-liver Oil, with nutritious diet, is 
a powerful auxiliary to treatment (Wa.). Puncturing the blebs and evacuation 
of their contents is necessary as soon as formed. Then dusting-powders of zinc 
oxide, starch, or buckwheat flour, or lotions of liquor plumbi subacetatis dilutus. 

Pericarditis. 

Aconite, when violent throbbing and extreme pain (R.) ; of great value, if 
given early (P.) ; proves in the highest degree serviceable, when object is to 
diminish vascular excitement or irritability (Wa.). Spigelia Anthelmia, useful 
in rheumatic pericarditis (P.). Digitalis, when rapid and feeble heart, cyan- 
osis and dropsy (P. N.) ; in second stage when heart flags, a tablespoonful of 
the infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in 
second stage, that of exudation ; fully equals any remedy in pericarditis (P.). 
Opium, regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial 
(Wa.). Veratrum Viride, extract made by inspissating the juice of the root, of 
which gr. ij, with j of calomel, every 2 hours, valuable (Waring- Curran). 
Quinine, gr. xv-xx may suppress an acute attack, if given at critical moment 
(B.) ; may be used as an antipyretic. Counter-irritation, has been much 
abused ; useful at commencement, but not in acute inflammatory stage (B.). 
Iodine painted over the cardiac region, or flying blisters in the second stage. 
Iron, the tincture in full doses may be required in the second stage. Poultices, 



PERIOSTITIS PERITONITIS — PERSPIRATION. 647 

large, hot, often renewed (R.)- I ce may be used instead of poultices in the 
early stage. Paracentesis, by aspiration may be required in the second stage. 
[Compare Endocarditis.] 

Periostitis. 

Mezereon, in the rheumatic and scrofulous form (P.). Mercury and Mor- 
phine. The oleate externally (R.). Potassium Iodide, in syphilitic children, 
also in non-syphilitic periosteal thickening (R.) ; holds the first place for syphi- 
litic affections of the bones (Wa.). Ammonium Iodide, cures periostitis most 
readily when syphilitic (Wa.). Staphisagria, when long bones affected (P.). 
Iodine, the tincture, or blisters locally of great service in chronic form (R.) ; 
under the external use of Iodine it often rapidly improves (Wa.). Poultices, 
after an early and free incision, when suppuration takes place (C). Incisions, 
carried deeply, should be made without waiting for fluctuation, when great ten- 
sion exists and there is a tendency to suppuration. The sides of the abscess 
should then be brought together with compresses and a bandage (Gross). 
Tonics and stimulants, as milk-punch, quinine, iron, and opium, in full and 
sustained doses, are imperatively demanded in many cases (Gross). [Compare 
Nodes, Onychia.] 

Peritonitis. 

Phenacetine, as an antipyretic ; is efficient and safe. Aconite, of great 
utility when sthenic reaction ; see Opium (B ) ; should be given early in all 
inflammations of serous membranes (P.). Bryonia, exceedingly valuable 
in second stage, when exudation (P.). Mercury, when tendency to fibrinous 
exudations, is employed with good effect (W.). Opium, to quiet intestinal 
movements (R.) ; by far the best agent (P., B.). Morphine, gr. ]/ 2 hypoder- 
mically, will often abort, if given early. Aconite and Opium, the tinctures, 
gtt. ij of the former with gtt. vj of the latter, in water every hour or two ; a 
larger dose of opium if pain is severe (B.). Large doses easily borne in 
this affection (Wa.). Cocculus Indicus, for tympanites ; a few doses will often 
remove the pain and relieve distention (P.). Quinine, strongly urged by Trous- 
seau ; is naturally indicated in most inflammations (P.). Turpentine, for tym- 
panites (P.) ; turpentine stupes, v-xv drops of turpentine on flannel wrung out 
of hot water during acute stage, then blisters for a short time (B.). Leeches, to 
abdomen, if patient plethoric, and sthenic reaction, relieve pain (B.). Purga- 
tives, are inadmissible when from perityphlitis or inflammation of appendix 
vermiformis (B.). Poultices, large, hot, and frequently renewed. Should be 
thin, and covered with cotton-wool (R). Ice, to abdomen (B.). Cold relieves 
(W.). "Water, hot fomentations to relieve pain, sometimes cold compress better. 
Ice, sucked or swallowed, to assuage the -vomiting; sips of cold water. Diet, 
after acuteness of attack passed, should be mild and unstimulating. [Compare 
Puerperal Peritonitis.] 

Perspiration. 

Belladonna, as liniment locally, also the tincture internally, especially in 
weakly children who sweat profusely (R.). Atropine, gr. -^-^ to -^q hypoder. 
(or in exceptional cases even gr. ■£$ in pill) in sweating of phthisis and exhaust- 
ing diseases (R.) ; gr. ^ at bedtime for sweats of phthisis (B.). Jaborandi, gr. 
■£§ of pilocarpine, thrice daily, checks profuse perspiration (R., Pf.). Naphthol, 
in a 5 per cent, ointment or alcoholic solution, is a very efficient application for 
local sweating (Kaposi). Potentilla Sarmentosa, the Cinquefoil, an infusion of 
the vine, leaves, and root, may be drunk ad libitum, and is a very efficient 
remedy for night-sweats, having stopped them when Atropine failed to relieve 
(Pope). Agaricine, is used very successfully. (See formula below.) Salvia, the 
ordinary sage-tea is very efficient, used internally and locally by sponging the 
body. The infusion for night-sweats of phthisis (Da C). Quinine, in exhaust- 
ing diseases. In many, a night-draught of quinine, sulphate of zinc, and sul- 
phuric acid, useful (R.). Opium, as Dover's powder, may succeed in profuse 
colliquative sweating (R.) ; a fact, though hard to account for it. (Wa.). Aro- 



6 4 8 



PERTUSSIS. 



matic Sulphuric Acid, to check sweats of phthisis. Bad for digestion (B.). 
Muscarine, has been used with great success in the sweats of phthisis and of 
other morbid states (R.). Zinc Oleate, rapidly controls excessive and offensive 
sweating on slight exertion in the axillae and groins, also the night-sweats of 
phthisis (Murrell). Zinc Oxide, gr. iij, with gr. ss of ext. belladonnae, in a pill 
at bedtime for the sweats of phthisis (R.). Gallic Acid, is very useful for the 
same condition, and may be combined with extract of belladonna (B.). Tannic 
Acid, may also be used with benefit. Aluminium, the oleate, checks hyperi- 
drosis and antiseptizes the sweat, thus forming a useful application to the axillae 
and groins of children (Wa.). Potassium Permang., gr. j-^j, for fetid perspira- 
tions of axillae, feet, etc. (B.). Salicin, profuse sweats of hectic fever (Wa.). 
Salicylic Acid, in solution with borax, the most agreeable and efficient deodor- 
ant for fetid perspirations (B.). Carbolic Acid, 2 parts to 3 of glycerin and water, 
twice daily for fetid sweat (Wa.). Oils, rubbed into the whole skin to prevent 
sweating accompanying exhausting diseases, as phthisis ; but sponging with a 
weak acid wash better (R.). Ergot, said to arrest sweating (R.). Sponging, 
with acidulated water, or very hot sponging in phthisis (R.). [Compare Feet.] 

Prescriptions. 



R . Acidi Gallici, gr. xxx. 

Ext. Belladonnae, . . . . gr. ij. 
M. ft. pil. no. x. Sig. — Two pills at bed- 
time (B.). For sweating of phthisis. 



R . Acidi Tannici, gr. xxx. 

Pulv. Digitalis, gr. xv. 

Ext. Cinchonse, q. s. 

M. ft. pil. no. xx. Sig. — One pill at bed- 
lime. 



R. Agaricinae (Merck), . . . gr. x. 

Atropines Sulph., . . . . gr. j. 

Ac. Sulph. Aromat., . . . X\ 1200. 
Solve et filtra. 



Dose, rr^x in syrup or simple elixir, 5 or 
6 hours before retiring, as action is slow. 



Pertussis. 

Antipyrine, is successfully employed. Phenacetine, is highly praised. Aco- 
nite, in all acute congestions (P.) ; as a preventive or abortive remedy very 
efficient, when associated with ipecac, and cherry-laurel water (Dervieux). 
See formula below. Amyl Nitrite, with Carbolic Acid, in steam atomizer, has 
proved a very efficient inhalation (Bayliss). Ipecacuanha, useful in many cases 
(R.) ; mj for 5 years of age, every hour or two, with the greatest relief (P.) ; 
when bronchitic or pneumonic complications, combined with ammonium bro- 
mide (Wa.). Pulsatilla, gr. \- j of anemonine (P.). Belladonna, obviously of 
value in febrile stage, is of special use when dentition is in progress ; relieves 
the congestion of air-passages and also the determination of blood to the head 
(P.) ; good when profuse bronchial secretion ; best in spasmodic stage. Chil- 
dren bear this drug well ; tt\,x of tinct. may be given hourly to a child 2 or 3 
years old (R.). Benzoate of Sodium is highly efficient. See formula below. 
Conium, or the Hydrobromate of Coniine, in doses of gr. -fa to gr. ^ according to 
age, a very efficient remedy (W.). Drosera, small doses are very effective 
(Murrell). Chamomile Oil, a very useful remedy (P.). Coccus Cacti (Cochi- 
neal), in doses of gr. y^ thrice daily for infants, has been highly recom- 
mended (W.) ; proves very effective in most cases. Hydrocyanic Acid, very 
serviceable in cough by habit, after cessation of whooping-cough proper, or in 
nervous sympathetic cough of mothers (B., P.). Opium, in convulsive stage, 
to produce and maintain slight heaviness (R.). Cocaine, a 5 per cent, solution, 
painted on tonsils, fauces, back of tongue, and if possible on larynx, is very 
efficient (Labrie). Bromides, relieve spasmodic element (B.) ; that of ammo- 
nium will readily cure many cases ; gr. ij or iij ter die for infants (Wa.). Lobelia, 
in spasmodic stages ; well tolerated by children ; tr^x of tinct. every hour for 
child 2 years old ; also additional dose when cough is imminent (R., P.). Alum, 
when acute stage over and no complication, gr. ij-vj every three hours, or less 
every hour in glycerin or honey (R.). Chloroform or Ether, to lessen severity 



PHARYNGITIS. 



649 



of the paroxysms; as inhalations (R.). Chloral, gr. v-x in spasmodic stage, 
relieves quickly (B.) ; gr. iij-viij every 4 hours (Porter). Carbolic Acid, as 
vapor, with steam atomizer; found to be very beneficial (J. L. Smith). Castanea, 
a decoction of chestnut leaves has been used with much success ; dose ad 
libitum (B.) ; the fluid extract, in 3-doses, exercises a remarkable influence 
over the cough (W.). Valerian, said to control the paroxysms (R.). Nitric 
Acid, well diluted in sweetened water, after the subsidence of the catarrhal 
stage (B.). Gelsemium, in spasmodic stage (B.). Monobromide of Camphor, 
gr. v. in mucilage and syrup, tolu. 3 or 4 times a day, has been very serviceable 
*(B.). Zinc Sulphate, gr. #-j with ext. belladon., gr. %-}&, has varying degree 
of success (B.). Lactucarium, the syrup as vehicle for cough mixtures (B.). 
Quinine, in solution, locally to fauces (Dawson) ; the tannate with sodii bicarb, 
of each 5, and pulv. acaciae 100 parts, used with an insufflator (Pollack). Petro- 
leum, on rags around head of the bed, is recommended highly by Hildebrandt. 
Silver Nitrate, when acute stage passed (Tr.) ; probably inferior to alum (Wa.). 
[Compare Cough.] 

Prescriptions. 

R . Sodii Benzoatis, . . , 



&. Chloralis £j. 

Potassii Bromidi, . . . . 3jij. 
Syr. Pruni Virgin., . . . . %). 

Aquae, . . %). 

M. Sig. — A teasp. thrice daily for in- 
fants in the convulsive stage. 

(Dessau.) 



R . Ext. Aconiti, gr. j. 

Syr. Ipecacuanhae, .... n\xlv. 
Aquas Laurocerasi, .... gj. 

Mucil. Acaciae, ,l v jss. 

M. Sig. — A teasp. to a tablesp. accord- 
ing to age, every hour. 

(Dervieux.) 



R 



. Olei Morrhuae, 

Mellis Despumat., 

Succi Limonis, . . . . aa p. aeq. 
M. Sig. — A teasp. or two as required. 
{Sir Wm. Guli: 



. . gr. lxxx. 
aa 3 x. 



Aquae Menth. Pip., 
Aquae Destillatae, 

Syr. Aurantii, gij. 

M. Sig. — A dessertsp. every hour or 
two. (Letzerich.) 



R . Acidi Carbolici, gss. 

Potassii Chloratis, . . . . sjij. 

Glycerini, giv. 

Aquae, q. s. ad ^vj. 

M. Sig. — Use with steam atomizer thrice 
daily. (J. Lewis Smith.) 



R. Amyl. Nitritis, ^ss. 

Acidi Carbolici, rt^x. 

Glycerini, 

Alcoholis, aa ^ ss. 

M. Sig. — Use by inhalation with steam 
atomizer. {Bayliss.) 



Pharyngitis. 
Aconite and Belladonna, for acute attacks (B.) ; when high temperature (R.). 
Belladonna, is very useful, relaxes the pharyngeal muscles (W.). Capsicum, as 
gargle, Z) ad 0]/ z aquae, in very early stage only (R.). Alum, gargles, in chronic 
inflammations (R.). Silver Nitrate, gr. v-xx ad ^j, on sponge probang, suc- 
cessful if systematically applied (B.) ; in early stage of inflammation ; also in 
chronic on brush, or as spray (R.). The solid stick to each diseased follicle, 
after scraping (A.). Ammonium Chloride, gr. ij with tt\,xv of tinctura cubebae, 
every half-hour, often controls acute pharyngitis ; when a gouty diathesis exists 
add tt\,x of the ammoniated tincture of guaiac, and give every hour (A. A. 
Smith). Xanthoxylum, a decoction of the bark locally to throat, and tt\,x-xxx 
of the fluid extract thrice daily, a very successful remedy for chronic pharyngitis 
(B.). Tannin, insufflation to affected surface (B.). Cubebs, powdered, locally, 
useful (B.). Glycerin, pure, locally, with tannic acid, very serviceable (B.) ; in 
chronic inflammation of the throat (R.). Hydrastis, the fl. extr., locally, and 
gtt. v-x per stomach (B.). Alcohol, dilute, gargle in relaxed throat (R.). Cimi- 
cifuga, when pharynx dry and spotted over with inspissated mucus (R.). Ipe- 
cacuanha, the wine as spray in non-inflammatory sore throat, with hoarseness 
from congestion of vocal cords (R.). Pomegranate Bark, as gargle (P.). 



650 



PHIMOSIS PHLEBITIS PHLEGMASIA. 



Potassium Chlorate, as lozenge to stimulate the follicular secretions to a healthy- 
condition (A.). Iron, Quinine, and Strychnine, as tonics, are mainly indicated 
(A.). Zinc Sulphate, as gargle, occasionally employed in relaxed throat (R.). 
Inhalation of vapors, or of pulverized fluids, by the atomizer, found very bene- 
ficial (Wa.). Food, of piquant kind, spices, pepper, mustard, etc., should be 
strictly prohibited. All fluids should be used at a moderate temperature (A.). 
Water, by throat compress, relieves ; also in daytime, in obstinate cases. Rest 
to voice, and cultivation of beard, are useful aids. 



R. Tinct. Aconili, 

Tinct. Belladonnas. 
Tinct. Guaiaci Amnion. 
Syr. Limonis, .... 
Aquae Cinnamomi, 



Prescriptions. 

H . Aluminis, 



aa ^ss. 

, . ^ ss. 
ad Siv. 



M. Sig. — A teasp. every 3 hours for 
acute pharyngitis. 



R. Tinct. Aconiti, gss. 

Ac. Hydrocyan. Dil., . . . nixl. 
Liq. Ammonii Acetat., . . 3; iv. 
M. Sig. — Teasp. every 2 or 3 hours 
according to the severity of the case. In 
■acute and subacute pharyngitis. 



gr. xxx-ljij 

Sodii Boratis, 3J SS - 

Glycerini, 3 ij. 

Tinct. Myrrhae, . . . . 5jij. 
Aquae, . . . . q. s. ad Hj iv. 
M. Sig. — Use as an astringent gargle, 
4 or 5 times a day. 



R. Acidi Tannici, gr. lx. 

Alcoholis, n\xxx. 

Aquae Camphorse, . . . . ^ iv. 
M. Sig. — An astringent gargle, to be 
used several times a day. 



Phimosis. 

Belladonna, as ointment, extract vij-ad xx of lard, has proved effectual 
(Wa.). Lupulin, 5-15 gr. doses, of advantage after operation, to keep penis at 
rest (Wa.). Surgical. Division of the prepuce by a bistoury and director ; 
circumcision (D.). Cocaine, a 4 per cent, solution injected at several points 
around edge of prepuce, as local anaesthetic during the operation of circumci- 
sion. Chloroform, or Ether, may be used as an anaesthetic in paraphimosis, 
before attempting reduction (Wa.). 

Phlebitis. 

Hamamelis, has as decided an influence on the venous system as Aconite on 
the arterial (Pf.). Mercury, in frequent and liberal doses, to early and decisive 
constitutional impression, the best form being Calomel, or Calomel and Blue 
Mass (Gross). Rest, fomentations, poultices, early incision of abscesses, aperients, 
opium to relieve pain and insure quiet of mind and body (D.). Blister, over 
course of an inflamed superficial vein (R.). Diet, nutritious, and wine, espec- 
ially if great loss of blood (D.). Stimulants, as Quinine and Iron, especially 
the tincture of the Chloride, also milk-punch, are needed to combat the depres- 
sion which is sure to arise. The disease is always dangerous and often fatal 
(Gross). Incisions, must be freely made if abscesses form, and the internal 
organs watched for multiple abscess. Ulceration, if it occur, must be watched 
for hemorrhage, which should be arrested by compression and styptics (Gross). 
[Compare Phlegmasia, Varicosis.] 



Phlegmasia Alba Dolens. 

Belladonna, and Mercury, equal parts, as ointment, often of much benefit 
(Wa.). Hamamelis, has specific action on venous system (P.) ; extolled by Dr. 
Preston (R.). Blisters, in early stage; are extremely useful if judiciously em- 
ployed (L.). Ammonium Carbonate, often valuable where great prostration ; 
full doses (Wa.). Creasote, injections daily (Wa.). Hydrochloric Acid, Z] of 
dilute acid in Oij of barley-water, with 3jss of potassium chlorate, to be taken 



PHLEGMON PHOTOPHOBIA PHTHISIS. 6$ I 

daily (Mackenzie) Opium, large doses internally, with leeches and anodyne 
ointments (Wa.) ; laudanum, if pain severe, sprinkled on hot fomentations (L.). 
Leeches, of great service during the acute inflammatory stage (Wa.). Bandag- 
ing, when the more acute symptoms subside ; at first with flannel, afterwards 
with ordinary roller bandage (L.). Regimen, should be tonic (L.). Water, 
compresses in active stage ; douches, hot and cold in chronic form. 

Phlegmon. 

Aconite, or Belladonna, are certainly efficacious. Aconite best (R.). Sulph- 
ides, to abort, or, inevitable, to promote ; gr. ss-j every hour or two of Potassa 
Sulphurata (B.). Silver Nitrate, strong solution may check if applied early in 
the vicinity (B.). Carbolic Acid, injections ; a 2 per cent, solution (B.) ; used 
with great success (W.). Iodine Injections, after evacuation (B.). [Compare 
Erysipelas.] 

Photophobia. 

Atropine, a neutral solution of the sulphate, gr. j ad ^j, for adult, dropped 
into the eye every 4 hours (C). If much lachrymation, so as to dilute the 
solution, it may be applied more frequently. In some cases belladonna irritates 
and has to be abandoned (Wa.). Conium, in scrofulous photophobia, gr. ss of 
Coniine in Z] of 01. Amygdalae, locally twice or thrice daily; or the vapor of 
Coniine (Wa.). Mercury, Calomel by insufflation (C). Canthoplasty, for the 
spasm of the orbicularis in severe photophobia (C). Glasses, of cobalt blue, 
the best (R.). Arsenic, in the condition described by old writers as strumous 
ophthalmia, with its attendant photophobia, is very valuable as an internal 
remedy (C). Chloroform, the eye exposed to the vapor of a few drops in 
severe photophobia will be speedily relieved (Jones). Croton- Chloral, gr. v-x, 
in young people and those suffering from syphilitic corneo-iritis (Bader). Potas- 
sium Chlorate, internally, is most useful in some cases (Vernon). Cocaine, 
a solution of the hydrochlorate, from 2 to 4 per cent., a few drops upon the con- 
junctiva, will be found promptly efficient in most cases. 

Phthisis. 

Creasotum, gives excellent results (Bouchard) ; is directly curative, at least in 
the initial stage of the disease (Frantzel); promotes the sclerotic change by 
means of which recovery is found to occur (Jaccoud) ; Morson's beechwood 
creasote should be used, in doses ofTT\j in whiskey and glycerin, every 3 or 
4 hours. Should be largely diluted to prevent irritation, and continued for 
many months, — relieves cough, diminishes expectoration, stops night-sweats, 
increases weight, decreases fever, promotes appetite, and in many cases im- 
proves the local condition, as shown by the physical signs (Robinson). Crea- 
sote, tar or carbolic acid, to check expectoration (R., P.) ; Creasote is often 
curable in many forms, gr. iij in a pill with Bals. Tolu., three or four times 
daily, the dose being increased until urine is darkened ; or it may be inhaled 
with Iodine from hot water (B.). Iodine, or Iodoform with creasote, carbolic 
acid, eucalyptus, chloroform, alcohol and ether, as combination for an antiseptic 
inhalation (Br.) ; extremely useful ; also as intra-pulmonary injection, a solu- 
tion of the compound tincture of iodine 1 to 4 of distilled water, of which 
TTLx-xx injected once every 4 or 5 days, through the 1st, 2d or 3d intercostal 
spaces, anteriorly or in the axillary region, avoiding the pericardium and great 
vessels (Robinson). Iodoform, internally, has proved extremely effective in all 
forms, as witnessed by numerous observers in various countries (S. Smith) ; 
though not one of the most active germicides, it is very destructive to the 
bacillus tuberculosis (B.). Iodol may be advantageously substruted for Iodo- 
form (B.). Cod-liver Oil, holds first rank as a remedy and food in the chronic 
forms ; a teasp. after meals ter die is enough ; when not well borne may be 
combined with aqua calcis, comp. tinct. of gentian ; or, when not digested, with 
ether (B., R.) ; is of great utility by improving nutrition, and by affecting the 



652 PHTHISIS. 

tubercle ; give ^ss thrice daily one hour after meals, with Tt\,x-xv of Ether, or 
an equal quantity of malt or whiskey ; do not give it in hot weather (Da C). 
Terebene, with Thymol and Carbolic Acid, equal parts of each, and £ss to a 
pint of hot water as an inhalation : is extremely useful for the dyspnoea (Cam- 
man). Aconite, in small doses for the irritative fever, is a remedy of much value 
(DaCosta). Antipyrine in a 2 X / Z grain dose hourly for 3 doses daily, for the hectic 
fever. Phenacetine is better borne and is efficiently antipyretic ; extensively 
employed in the hectic of phthisis. Cinchona, for the hectic and sweats, gr. xv- 
xx quinine (B.) ; if small doses fail, a dose of 6 or 8 grains at once, or in portions 
repeated hourly (R.). Ipecacuanha, spray to throat when bronchial asthma and 
emphysema combined with fibroid phthisis (R.). Opium, or Morphine, in a 
viscid vehicle for cough, or morphine lozenges when cough due to inflamed 
throat (R.) ; must in time be given for the cough, which is an irritative one. 
Codeine, gr. y% to % in simple elixir, is useful and does not constipate (Da C). 
Alcohol, an important remedy ; may be given with cod-liver oil ; or spt. fru- 
menti ^j-^ij with some bitter, immediately after meals, or the stronger wines. 
If it disagrees, it harms. Curiously, it induces an intractable form of phthisis 
(B.). Verbascum, the Mullein-plant, has long been a popular remedy in 
phthisis ; it facilitates expectoration, improves the general condition, and palli- 
ates the cough. Calcium Phosphate, in diarrhoea, and in chronic forms of 
phthisis, with little or no fever (R.). Iodine, should be more used than it is ; 
the compound solution, gtt. j-iij thrice daily, or when anaemia and not much 
fever use Iodide of Iron, gr. xv. of the syrup pushed to Z) ter die (Da Costa) ; 
as inhalation in chronic phthisis ; to lessen expectoration and cough ; also as 
liniment painted under clavicles, to allay harassing cough, and to check secre- 
tion (R.). Cimicifuga, useless in tuberculosis, but in phthisis it relieves cough, 
improves appetite, lessens intercurrent bronchitis, and so improves the patient's 
general condition (Wa.). Arsenic, valuable in chronic forms as in no other 
remedy ; but not in caseous, or where much hectic ; may be given by stomach 
or fumigation (B.). [See under Asthma.] As cigarettes, useful in the diar- 
rhoea, probably diminishes temperature ; caution required (R.) ; of great value 
in early stage, in later stages it is of no avail. Arsenious Acid, gr. ^, or tt\jij 
of Fowler's solution, thrice daily (Da Costa). Cocaine, locally for the throat 
symptoms, to be applied just before meals are eaten (Da C). Sulphurous 
Acid, by inhalation, spray, or fumigation, in chronic phthisis (R.). Sanguinaria, 
helps expectoration, and revives the enfeebled stomach (P.). 

Chloroform, with glycerin or honey, for the cough in fibroid phthisis (R.); by 
inhalation continuously as germicide, in connection with other agents of same 
action (Potter, see Pacific Medical Journal, October, 1890). Chlorine gas, 
by inhalation, also the hypodermic use of Iodine and Chloride of Gold and 
Sodium, extensively employed in pulmonary consumption with good results. 
(Gibbes and Shurly in Therapeutic Gazette, April, 1891, and April, 1892.) Fer- 
rum, often prescribed ; has no especial influence on deposit (B.). Prescribed 
in tuberculosis (Tr.). Liquor Ferri Perchloridi, 3j ad %] aquae, the most ser- 
viceable local application in laryngeal phthisis, diminishing irritability of the 
mucous membrane, and quieting cough (Mackenzie). Mercury, gr. y^ of 
corrosive sublim. every two or three hours, for the diarrhoea (R.)- Benzoin, as 
inhalation, to lessen cough and expectoration (R.). Acids, Mineral, for the in- 
digestion. The acidum muriaticum dilutum (B.). Prunus Virginiana, the wild 
cherry has a domestic reputation, probably due to its influence over cough ; 
the syrup is much used as vehicle for cough-mixtures (B.). Hypophosphites, 
are very useful in chronic cases (B.); have no special effect (Da C). Digitalis, 
as antipyretic; deranges intestinal canal, therefore injurious to phthisis (B.). 
Phosphate of Copper in nascent form soluble in an alkaline body, is held to be 
specific by Prof. Luton of Rheims. His formula contains Neutral Acetate of 
Copper 0.15, Cryst. Phosphate of Sodium 0.75, Glycerin and Pulv. Licorice, aa 
q. s. for one pill. Copper Sulphate, gr. T ^, or Silver Nitrate, gr. % , or Bismuth, 
gr. xx, for the diarrhoea (Da C). Gaseous Enemata, Bergeon's treatment, made 
a noise for a few months, but soon fell into contempt. Baths, sea-bathing, if 
chronic, little or no fever, without active deposition of tubercle, or scrofulous 



PHTHISIS. 



653 



pneumonia ; Turkish baths for the cough (R.). Grape-cure, is serviceable (B.). 
Aliment, should be nutritious and digestible, malt liquors better than wine or 
spirits. Extract of malt, cod-liver oil, plenty of meat, and alcohol in moderation 
(Da C). Warm clothing, bathing and friction of skin, moderate exercise, and 
a suitable climate. Forced Alimentation, when anorexia appears, and super- 
alimentation at all times, necessary to successful treatment. Washing out the 
stomach daily by syphon-tube, with warm water alkalinized with borax, and 
then feeding through tube (Robinson). Climate, the best by far is that of Egypt, 
or Algeria ; next coming New Mexico, Southern California, especially in the 
desert along the Colorado River, South Carolina and portions of Georgia and 
Florida ; the latter being especially suitable for cases having a co-existing bron- 
chitis. For some cases Colorado is very good, and the Adirondack region for 
early cases in which there is no tendency to hemorrhage (Da Costa). Tuberculin 
or Koch's Lymph has been a deceptive bubble which for a short time com- 
manded the attention and admiration of the whole world, but which has been 
ruthlessly pricked by the critical scalpel in the hands of the father of modern 
pathology (Senn). [Compare Cough, Hemoptysis, Hectic Fever, Perspira- 
tion.] 

Prescriptions, 



R. Quininae Sulphatis, . , . . gr. xviij. 

Pulv. Digitalis, gr. vj. 

Pulv. Opii, gr. iij. 

M. ft. pil. no. xij. Sig. — One pill thrice 
daily, for the irritative fever. {Niemeyer.) 



R. Pepsini (Jensen), .... gr. xl. 

Ac. Hydrochlor. Dil, . . . sjijss. 

Glycerini, 3; v. 

Succi Limonis, ^iv. 

Aq. Aurantii Flor., q. s. ad ^iv. 
M. Sig. — Dessertspoonful with meals 
for the dyspeptic symptoms. 



R . Creasoti (beech-wood), . . rr^vj. 

Glycerini, ^j. 

Spt. Frumenti, ^ ij. 

M. Sig. — For one day's use, as directed , 
in ^?s doses. {Robinson.) 



R . Iodoformi, gr. xxiv. 

Creasoti, rrijv. 

01. Eucalypti, TTLviij. 

Chloroformi, tt\xlviij. 

Alcoholis, 

Etheris, . . . aa q. s. ad ^ss. 
M. Sig. — 10 to 20 drops on the sponge 
of perforated zinc inhaler, to be worn 20 
minutes thrice daily. {Brunton.) 



R . Petrolei Massce, ^.j. 

Pulv. Cubebae, 

Pulv. Doveri, aa Jss. 

Cinchonidinae Sulph., . . 3 ij» 
M. ft. massa, et div. in pil. no. cclxx. 
Sig. — One pill every 3 or 4 hours. 

{Griffith.) 



■vnj. 



R . Codeinae Sulphat., . . . . gr. 

Ac. Hydrocyan. Dil., . . . rn^xx. 

Syr. Tolutani, 3 ij. 

M. Sig. — A teaspoonful several times 
daily, for the cough. {Potter.) 



R. Tinct. Belladonnas, . . . ^ij. 

Syr. Scillae, 25 lj. 

Morphinae Sulph., . . . . gr. j. 

Syr. Tolutani, .... ad ^ iv. 
M. Sig. — Tablespoonful at bedtime, for 
cough and restlessness, to be repeated if 
necessary. {H. Gibbons, Jr. ) 



R. Extr. Opii Fluidi, . . . . 3J. 

Syr. Rhei Aromat., . . . . 3 iv. 

Syr. Glycyrrhizae 3J. 

Liq. Ammon. Acet., . . . ^v. 
M. Sig. — Shake well. A teaspoonful 
every 2 or 3 hours. A soothing mixture, to 
quiet cough, allay nervousness, and stimu- 
late the patient. {Johnson.) 



R. 



Iodoformi, 
Creasoti, 
Pulv. Benzoimi, 

Bals. Tolu., aa 

In pill, of such 2 to 4 daily. 



gr.J- 

' Huchard.) 



R. 



01 ei Morrhuae, . . . 
Mucil. Acaciae, . . . 
Sacchari, , , . . . 
Tinct. Lavandulae Co., 

Aquse, 

M. Sig.— Teaspoonful for children. An 
agreeable mixture. {Farquharson .) 



o ss - 

nycx. 
2ss. 



[For a Cod-liver Oil Emulsion see formula on page 467.] 



654 PITYRIASIS PLETHORA PLEURITIS. 

Pityriasis. 

Alkaline and Tonic Remedies generally control mild cases, together with 
baths and emollients ; the more severe ones requiring constant envelopment in 
oil, as linseed or cod-liver oil (Bulkley). Mercury, in obstinate cases, Dono- 
van's solution of Arsenic and Mercury is highly successful (Wa.) ; the green 
iodide, gr. x to ^j of lard, or a 5 per cent, solution of the oleate of mercury in 
oleic acid with one-eighth part of ether, applied by a camel's-hair brush (B.) ; 
citrine ointment, especially when the hairy parts of the face are affected (R.) ; 
an ointment of ammoniated mercury and calomel is very useful in ordinary 
cases of dandruff or pityriasis simplex (Bronson). Sulphur, Z) of sulphur 
lotum to Sjj of vaseline applied every morning to the scalp, with sweet almond 
oil anointing at night (Jackson). Soap, the tincture of green soap as shampoo 
every morning for cleanliness, or Borax and water, or the yolks of three eggs 
beaten up in a pint of limewater with ^ss of alcohol, all of which make good 
shampooing mixtures (Jackson). Borax, to cleanse the scalp, a saturated 
solution ; or the glycerite of borax (R.). Lead, the liquor plumbi, with glycerin 
equal parts, and two parts of water, as lotion for cases where there is high in- 
flammation and abundant weeping (R.). Carbolic Acid, 2 parts to 3 of glycerin 
and water, twice daily, with the daily use of acarbolized soap, is often effectual 
(Wa.). Sulphides, ^ss of Potassa Sulphurata to Oj of Lime-water, as a lotion, 
or the Bareges Pomade, see formula below (B.). Baths, frequently, and hard 
rubbing after shampooing the scalp ; avoid stimulating food in bad cases, as 
well as the use of a fine-toothed comb on children's heads. [Compare Sebor- 
rhea, and for Pityriasis Versicolor, see Tinea Versicolor.] 



Prescriptions. 



R . Sodse Sulphurate, 

Sodii Carbonatis, . . . aa 5jij. 

Axungias, ^ij ss - 

M. Sig. — Pomade de Bareges. 



Be . Hydrarg. Amraoniat., . . gr. X) 
Hydrarg. Chlor. Mitis, . . gr. x. 

Petrolati, ^j. 

M. ft. unguent. Sig. — Local use. 



Plethora. 

Aconite, is useful for affections of plethoric subjects. Decidedly the best 
remedy for apoplexy in the plethoric (P.). Arsenic, used with advantage when 
determination of blood to the head (Wa.). Sulphur, as mild purgative for 
plethora, from cessation of the menses (Wa.). [Compare Abdominal Ple- 
thora.] 

Pleuritis. 

Aconite, no remedy more effective prior to stage of effusion (R., P.). [See 
Inflammation]. The tincture in doses of j4 drop every 3 hours to a child 3 
years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride. Opinions 
differ as to whether it should be used in sthenic or asthenic forms (R.) ; gtt. 
viij of tincture every 3 hours, with a drop added to each dose until pulse 
reduced or nausea (Wa.). Bryonia, exceedingly valuable in second stage ; 
should follow aconite (P.). Tartar Emetic, see Inflammation. In early 
stages and young plethoric subjects, when much febrile action, small doses 
(gr. T V to X) ma Y De useful (Wa.). Digitalis, as antipyretic (R.) ; deranges 
intestinal canal (B.) ; aconite preferred (P.) ; the tincture in doses of one drop 
every 3 hours to a child of 2 years old (J. Lewis Smith). Potassium Iodide, 
to promote absorption of effusions, steadily for a long time (R.) ; also chest 
painted with tincture of iodine, one day on each wall alternately ; may be 
washed off with iodide of potassium, alcohol or ether (B.) ; as a diuretic to 
remove effusion (Clark). Iodine, also as injections, with great benefit and with- 
out risk, in empyema and hydrothorax (B., R.). Quinine, has abortive power, 
increased by combination with morphine (gr. xv -f- gr. ss) ; also as restorative 
tonic in low-type cases (B.). Opium, cannot be too highly extolled (P.) ; is es- 
pecially beneficial ; gr. ss of morphine hypodermically at beginning will often 



PLEURODYNIA PNEUMONIA. " 655 

cut short an attack. During the disease its effects are very beneficial. A slight 
physiological effect should be maintained (B.). Morphine for severe pain (R.). 
Burgundy Pitch, plaster externally as a mechanical support (P.). Asclepias, 
the popular " pleurisy-root," is a favorite remedy in the south (W.). Pilocar- 
pus, in subacute cases to remove fluids (Caro) ; or the nitrate of pilocarpine, gr. 
\ bis die, for children (Vigier) ; is too depressing and therefore unsafe (Smith). 
Sodium Chloride, gss j n gj f water, flavored with licorice, in tablesp. doses 
every 3 hours, often very useful in causing absorption of pleuritic serous exuda- 
tions ; but is contraindicated when exudation is purulent (Br.). Bloodletting, 
by cups or leeches, useful by reason of counter-irritation produced, and to relieve 
pain, only in robust sthenic cases (B.). Blisters, often greatly abused ; are 
harmful during inflammatory stage (B.). Poultices, large, hot, and frequently 
renewed (R.)- Water, cold wet-pack to chest probably better than a hot one, 
pinned tightly to limit movement of chest-walls (B.). Thoracentesis, by 
aspiration, if the quantity of fluid seriously embarrasses respiration. [For 
Chronic Pleurisy see Empyema, also compare Hydrothorax, Pleuro- 
pneumonia.] 

Prescriptions. 



R. Potassii Acetat., gj. 

Infusi Digitalis, . . . ad J iv. 
M. Sig. — Teasp. every 3 hours to a 
child of 4 or 5 years, in the second stage. 



. Morph. Sulphat., . . . . gr. j. 

Tinct. Aconiti, rrvxxiv. 

Liq. Potas. Citratis, . . . ^ij. 
M. Sig. — A teasp. every 3 hours. 



Pleurodynia. 

Cimicifuga, curative when rheumatic, valuable in sympathetic cases from 
irritability of uterus (P.) ; or uterine derangements (R., Wa.). Croton Oil, in 
obstinate pleurodynia especially when blackened feces (R.). Belladonna, 
plaster or liniment ; the latter generally best (R.). Chloral, made liquid with 
equal weight of camphor, rubbed in gently, often affords instant relief in severe 
pleurisy (R.). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful in most 
cases (Hughes). Ether, as spray, sometimes immediately and permanently 
removes the pain (R.). Opium, liniment rubbed in after warm fomentations 
(Wa.) ; or a hypodermic injection of morphine (R.). Iodine, as liniment painted 
on the chest, often relieves where mustard fails (R.). Blistering, often success- 
ful when other means fail; sometimes strong vesication necessary (R.). Rest, 
is important and may be obtained by strapping the affected side with strips of 
adhesive plaster. Poultices, very hot, followed by application of lint and oil- 
skin. Belladonna liniment generally better (R.). Mustard, as a poultice, is 
generally efficient, and can be renewed when pain returns (R.). [Compare 
Neuralgia, Myalgia.] 

Pleuro-Pneumonia. 

Bryonia, often of great service ; limits effusion and assists absorption (P.). 
Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice 
a day, has had remarkable success (B). Sanguinaria, as a contra-stimulant 
(P.). Turpentine, as a fomentation (P.). Arnica, the tincture in doses of 
n\,x every 3 or 4 hours, very useful in controlling the heart's action (Wa.). 
Pilocarpine, gr. ss, or gij of the tincture of Jaborandi, benefits cases of pleuro- 
pneumonia (Wa.). [Compare Pneumonia.] 

Pneumonia. 

Aconite, gives good results in catarrhal and fibrinous (B.) ; has marked effect 
(R.) ; very valuable in first stages (P.) ; in several cases it apparently cut short 
the attack (W T a.) ; to reduce circulation either Aconite or Veratrum Viride, until 
pulse is impressed (Da Costa). Veratrum Viride, valuable (P.) ; in the very 
incipiency (B.) ; opinions differ as to whether it should be used in sthenic or 
asthenic cases (R.). Bryonia, when pleural complications {P.). Phosphorus, 
especially when typhoid symptoms ; approved by Fleischmann (R.). Bella- 



656 



PNEUMONIA. 



donna is useful in the first stage (P.) ; Harley esteemed it highly in pneumonia 
(Wa.) ; as an adjuvant to Digitalis in infantile pneumonia, to soothe the irri- 
table nervous system and curtail superabundant secretion (Brown). Tartar 
Emetic, formerly given in large doses ; now abandoned ; small doses may 
be useful, but should be used with care, lest depression ensue (B.) ; at com- 
mencement with alcoholic stimulants, if patient be weak (R.) ; may benefit 
young, robust subjects (Wa.). [ See Pleuritis.] Sanguinaria, as a contra-stimu- 
lant, when fever abated, and graver symptoms have amended (P.). Iodides, 
none more efficient ; the Iodide of Ammonium with Arsenic, to prevent casea- 
tion of inflammatory products (R.) ; Ethyl Iodide, gtt. v-xx ter die by inhala- 
tion, very valuable in catarrhal form (B.). The Iodide of Sodium is useful in 
catarrhal pneumonia (Da C). Ipecacuanha, the wine in infantile pneumonia, 
should never be dispensed with, as it promotes expectoration, controls hemor- 
rhage and regulates secretion (Brown). Senega, in advanced stages as expec- 
torant, when cough is dry, irritating and painful, tightness and oppression of 
chest (P.). Opium, morphine by injection, sometimes needed for severe pain 
(R.) ; opium is very desirable in many cases, relieves the symptoms and arrests 
delirium (Wa.). Copper Acetate, Kissel regards it curative; under it the mor- 
tality was only 4^ per cent. Ammonium Carbonate, at crisis for depression ; 
give in infusion of senega (B.) ; see formula below ; is useful as expectorant 
late in disease when lung tissue breaks down (Da C). Digitalis, of doubtful 
value ; may be useful for high temperature, ischsemia, and low tension of ves- 
sels (B.) ; as case goes on and circulation is to be further controlled, digitalis is 
indicated (Da C.) ; the best agent to slow the heart in infantile pneumonia, with 
Belladonna as an adjuvant (Brown). Antipyrine, to reduce pyrexia; is deci- 
dedly more serviceable in pneumonia than quinine (Wa.) ; gr. xv several times 
a day, or 3 hourly doses each of gr. xxx, then stopping until temperature rises 
again (R.). Stimulants, in asthenic cases, those of malignant type, and those 
occurring in aged people (Wa.). Ammonia, the aromatic spirit as substitute for 
Ammon. Carbonate, in doses of gss i n simple elixir (Da C.). Turpentine, as 
stimulant at crisis (B.). Serpentaria, with carbonate of ammonium in low 
types, as a stimulant about the crisis. Quinine or Salicylic Acid, to reduce tem- 
perature (R.) ; Quinine as a tonic in cases which are asthenic from the first 
(P.) ; in conjunction with Aconite and Veratrum, gr. viij-xij daily at start, is 
beneficial (Da C). Blisters, useful at very beginning only or at crisis of dis- 
ease ; harmful in inflammatory stage (B.); to lessen the pain, but should be 
used in moderation (R.). Wet-pack, hot, tightly pinned to limit motion of chest- 
walls (B.). Poultices, encircling whole chest in children (R-)- Diet, farina- 
ceous, mucilaginous drink, and rest in warm room (R.). 



Prescriptions. 



R. Tinct. Verat. Viridis, . . . rr^xl. 

Spt. iEtheris Nitrosi, ... 3 v). 

Liq. Potassii Citratis, . . . zivss. 

Syr. Zingiberis, . . q. s. ad J, vj. 
M. Sig. — A tablesp. every 3 hours, in 
the early stage. {Da Costa.) 

R. Sodii Iodidi, 3J SS - 

Morphine Sulph., . . . . gr. ss. 

Elixir Simplicis, j| ij.. 

M. Sig. — Teasp. thrice daily, with blis- 
ters over the apex, in catarrhal pneumonia. 
{Da Costa.) 



R. Potassii Iodidi, gj. 

Ammonii Muriatis, .... £.jss. 

Mist. Glycyrr. Comp., . . Jv). 
M. Sig. — Tablesp. 4 times daily, to pro- 
mote absorption, together with blisters to 
the chest. [Univ. Penna.) 



R. Ammonii Carbonat., . . . gr. xl. 

Infttsi Serpentariae, . . . . J iv. 

M. Sig.— A teasp. every 3 hours, as a 
stimulant about the crisis. (B.) 



R . Ammonii Iodidi, gr. xl. 

Spt. Ammon. Aromat., . . 5pj. 

Elixir Simplicis, %j. 

Aquae, q. s. ad Jjviij. 

M. Sig. — One-eighth thrice daily, in 
syphilitic lobar pneumonia, together with 
the following pill. {Da Costa.) 

R . Digitalis, gr. vj. 

Quininse Sulph., gr. xij. 

Extr. Opii, gr. iij. 

Extr. Ipecac, gr. iij. 

M. ft. pil. no. xij. Sig. — One pill thrice 
daily, with the preceding mixture. 

{Da Costa.) 



POLYPUS POU LTICES PREGNANCY. 657 

Polypus. 

Sanguinaria, has been employed as snuff for nasal polypi (P.) ; with doubtful 
benefit (W.). Tannin, finely powdered, as snuff blown daily into nostrils 
through a quill, is especially adapted to the soft and gelatinous varieties ; while 
it has apparently no effect on the healthy mucous membrane, it causes the 
complete withering of the polypus (Wa.). Zinc Chloride, has been injected 
interstitially with success in a case of naso-pharyngeal polypus (Barthelemy). 
Iron, a solution of the perchloride is advised as an interstitial application 
(Auger). Acetic Acid, glacial, injected into the body of the tumor, will cause it 
to shrink up and to drop off in a few days. Alum, in powder, applied to point 
of origin to prevent recurrence (D.). Surgical. A nasal polypus should be 
seized with polypus forceps and twisted off at the neck ; it may be removed 
through the mouth or the nostril. In a few cases the nostril must be dilated 
with a speculum, or the ala slit to give access to root of tumor (D.). 

Poultices. 

Poultices and Fomentations are simply local baths utilizing warmth and 
moisture, relaxing the tissues and relieving pain. If applied early they will 
check inflammation, or assist the evacuation of pus when suppuration has set 
in. Poultices should be applied thick (thin in peritonitis), as hot as possible, 
covered with cotton wool, and frequently changed ; large at onset, very small 
after maturation. Belladonna and Glycerin, partes aequales, smeared over tis- 
sues under a poultice, aid the latter greatly, also Tinctura Opii, especially where 
skin is broken. Linseed-meal or Oatmeal, Starch, Bread, Bran, are best in the 
order mentioned ; add meal to boiling water, stir and spread quickly on warm 
linen. Charcoal under the poultice, when foul sores are being treated. 

An excellent method of preparing poultices is to make a lot of bags of various 
sizes, and of the fabric known as " Swiss," filling each one half- full of the lin- 
seed meal or other agent employed before sewing up its open end. When 
wanted for use one of these bags is submerged in boiling water for a few minutes 
and on taking it out the meal is found to have swelled so as to fill the bag, which 
should then be squeezed enough to rid it of the superfluous water, laid on the 
part and covered with oiled silk and a bandage. 

Fomentations. Flannel should be wrung very dry out of boiling water, and 
covered with oiled silk. Spongio-piline, a fabric composed of sponge and wool, 
coated with india-rubber, is an excellent vehicle for the application of warmth 
and moisture. The inner surface is moistened with hot water; and its utility 
may be increased by sprinkling the moistened surface with charcoal, yeast ; or 
saturating it with any desired lotion or liniment. 

Pregnancy, Disorders of. 

Mercury, a few grains of blue pill to correct clay-colored stools (L.). Iodine, 
the tincture internally for cardialgia (Wa.). Aloes, have cured piles in preg- 
nancy, by removing constipation ; cautiously (P.). Alum, Tannin or Catechu, 
in medicated pessaries for vaginal leucorrhcea (L.). Castor Oil, an excellent 
laxative (P.) ; to clear out the bowels in diarrhoea (L.). Cocculus Indicus, 
when intestines much distended with flatus, and frequent desire to urinate from 
flatulent pressure on bladder (P.). Bismuth, Calumba and Antispasmodics, 
with minute doses of Opium, for gastrodynia'and pyrosis (L.). Potassium Bro- 
mide, with chloroform, as an antispasmodic in dyspnoea (L.). Sumbul, is invalu- 
able in restlessness ; — tt\, xxx-xl of tincture with a little chloric ether, giving 
quiet nights for along time (P.). Galla, unguentum gallae cum opio, the best 
local application to hemorrhoids, also fomentations with sponges wrung out in 
very hot water, to relieve pain (L.). Digitalis, in infusion, very beneficial in 
albuminuria (L.). Potassium Acetate, with Basham's mixture (Liq. Ammonii 
Acetatis), when albuminuria with anaemia. Calcium Phosphate, believed to 
exert an influence on the foetus if administered during pregnancy, so that mothers 
42 



I 



658 PROLAPSUS ANI PROSTATITIS. 

who have borne only rachitic or scrofulous children will bear healthy ones (W.). 
Berberine, found very useful in the periodical neuralgias of pregnancy, even in 
cases in which quinine had previously failed (Maclagan). Camphor, liniment, 
for lumbar pains (Wa.). Senna, the confection proves a mild and efficient 
purgative in the constipation of pregnancy (Wa.). Milk-diet, for albuminuria 
of pregnancy the best remedy, if strictly carried out(Parvin). Injections, must 
be used carefully, even tepid water often induces uterine contractions (L.). 
[Compare Vomiting of Pregnancy, Ptyalism, Albuminuria, Nephritis, 
Nervousness.] 

Prolapsus Ani. 

Nux Vomica. Strychnine, especially when in children, with constipation ; in 
the latter event add nux vomica to a purgative, as tincture of rhubarb (R., P.), 
or strychnine hypodermically, gr. -^ for an adult every 48 hours, }( inch from 
anus and parallel to rectum, into the cellular tissue ; generally requires 4 to 8 
injections (Weber). Piper, the confectio piperis in doses of gr. lx-gr. cxx, 
persevered in for 3 or 4 months, in chronic, weak subjects (Wa.). Sulphur, 
has a beneficial effect in addition to its laxative value (R.). Alum, in solution, 
gr. vj to the ^ (R-)» ^ ce > locally, when parts inflamed (R.). Ergot, the fluid 
extract injected into the perineum, is followed by immediate relief (Vidal). 
Ferrum Sulphate, Z] to 3 viij aquae, of which one-third by enema twice daily. 
Podophyllin, in small doses for rectal prolapse in children (P.). Tannin, injec- 
tion to restrain the prolapsus (R.). Hydrastis, by enema, or as a lotion (P.). 

Prolapsus Uteri. 

Cimicifuga, to prevent miscarriage in prolapsus uteri (R.) ; has a remarkable 
effect upon the uterus (P.). Astringents, decoctum quercus, decoctum gallae, 
(Wa.). Pomegranate bark (P.). Tannin, as catechu, kino, red gum, rhatany. 
Alum, a solution gr. vj ad %) (R.) ; lb. j ad Cj aquae, as hip-bath, also should 
be passed well up vagina (Wa.). Ice, locally when parts inflamed (R.) ; ap- 
plied to the spine (Wa.). Pessaries, in any form, are of but temporary benefit, 
and in the end positively detrimental (E.) ; but many cases cannot be treated 
without mechanical support of some kind. 

Prostate, Hypertrophied. 

Alkalies, for the cystic irritation with acid urine. Great benefit from liquor 
potassae, citrates and acetates of potassium (B.). Triticum Repens, benefit 
follows its use in the prostatic enlargement of old men (Sir H. Thompson). 
Ammonium Benzoate, for the cystitis, urine alkaline (B.). Ammonium Chloride, 
is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa.). Iodine Injections, 
through rectal walls (B.) ; a weak ointment applied by rectum (Wa.). Iodine, 
has been tried in all forms, but is of no value (Thompson). Iodoform, as sup- 
pository in rectum, has proven of great value (B.). Colchicum, in persons of a 
gouty diathesis (Wa.). Medicine is not likely to have any control over this 
condition, which is a simple hypertrophy. [Compare Cystitis.] 

Prostatitis. 

Cantharides, gtt. j of tincture (5 may be required) 3 or 4 times a day (R.). 
Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino-Genitals, 
especially turpentine, cubeb, juniper, cantharis (B.) ; cubeb, in doses of gr. xx 
daily, is found of much benefit (Wa.) ; buchu relieves (P.). Silver Nitrate, a 
solution (gr. v-x ad ^j), applied to the prostatic urethra in chronic prostatitis, 
maybe useful (Wa.). Blisters, in chronic prostatitis, a small blister on each 
side of the raphe of the perineum, kept open 4 to 6 weeks, has given the best 
results (Wa.). Tonic medicines and regimen should be prescribed (Wa.). Hot 
Injections, to relieve pain (R.). [Compare Prostatorrhcea.] 



PROSTATORRHCEA PRURIGO PRURITUS. 659 

Prostatorrhcea. 

Iron, the tincture of the chloride, when there is much debility (B.) ; chalybeate 
tonics with quinine and strychnine (Gross). Atropine, indicated in all cases, 
with potassium bromide (Gross). Potassium Bromide, when irritability and 
excitement (B.) ; indicated in all cases (Gross). Lead, injections of Goulard's 
extract, Z) to E x °f water » night and morning, for 10 minutes at a time (Gross). 
Ergot, when relaxation exists (B.). Bougie, methodically introduced, is one of 
the best local measures (Gross). Hydrastis, locally applied, a useful medicine 
(B.). [Compare Prostatitis.] 

Prurigo. 

Antipyrine, as a symptomatic remedy, is efficient in true prurigo. Alkaline 
Baths, followed by a carbolized ointment, and carbolic acid internally, are of 
value in the papular eruption, known as prurigo (Bulkley). Sulphides, Potassa 
Sulphurata, with tar and benzoated lard, as ointment in genuine prurigo (R.). 
Arsenic, in doses of n\,v of liquor arsenicalis thrice daily and gradually in- 
creased, has exercised a more or less powerful influence (Wa.) ; has only a 
moderate effect (Bulkley). Belladonna, controls cases which have resisted 
ordinary treatment (B.). Carbolic Acid, locally and internally, is especially 
serviceable in prurigo senilis (B.). Mercury, the bichloride, gr. xx with 
Ammonii Chloridi, gr. xxx, in Oj of pure water, as lotion in prurigo con- 
tagiosa, " army-itch ;" nothing equal to it (White). Borax, a saturated solution 
in rose-water locally (R .); gr. v-x to ^j of hot water for pruriginous eruptions 
on mucous membrane of vulva and vagina (R.). Galvanism, when prurigo is 
referable to alterations in the cutaneous nerves (B.). Tonics, are required, 
nerve-tonics as well as general ones, Cod-liver Oil, Quinine, Strychnine and 
Phosphorus (E. Wilson). Quinine, in large doses, gr. v-x, will control violent 
exacerbations (Wilson). Baths, the Turkish, frequently repeated, with inunc- 
tion of the skin, may be regarded as curative in most cases (Wilson). [Com- 
pare Pruritus.] 

Pruritus. 

Antipyrine, internally, as a symptomatic remedy against itching, is promptly 
efficient in nervous pruritus, true prurigo, urticaria, erythema, pemphigus vul- 
garis and lichen ruber. Alkaline Baths, locally, followed by the application of 
Carbolic Acid Ointment, give great comfort in all forms of pruritus (Bulkley). 
Sodium or Potassium Carbonate preferred (Tr.) ; in solution locally, 3iij ad 
^iv (B.). Carbolic Acid, as lotion with glycerin, to the itching surface, gives 
great relief (Bulkley) ; internally and locally in pruritus senilis (B.) ; a one per 
cent, solution as lotion in pruritus ani (R.). Mercury, strong solutions of the 
Bichloride, black wash, yellow wash or mercurial ointment, in itching of skin 
affections (R.). Yellow Wash is one of the most efficient applications for pru- 
ritus ani. Solutions of the Bichloride are very useful applications in pruritus 
vulvas et ani (Tr.) ; for pruritus vulvae a lotion of the Bichloride 1 to 2500 parts 
of water, with alum and starch, is recommended (B.). Calomel Z] to %] of 
lard, as ointment, is the best application, except in the pruritus of urticaria ; 
very useful in pruritus ani, less so in pruritus pudendi (R.). The Oleate, a 5 
per cent, solution in oleic acid with one-eighth part of ether, applied by a camel's- 
hair brush, in pruritus ani et pudendi (Marshall). Alum, a strong solution is 
very useful for pruritus vulvae (Tr.). Hydrocyanic Acid, diluted as lotion, often 
very serviceable ; may be prescribed in solution with borax (B.) ; or laurel- 
water as lotion, especially in pruritus senilis (P.). Potassium Cyanide, Z) toOj 
of water, as lotion for pruritus of various kinds when the skin is unbroken (R.) ; 
as ointment or solution, if strong enough, relieves greatly, but must be used 
with caution (B.) ; or rr^xxx of the dilute acid of the Br. Pharmacopoeia in 3J of 
water or glycerin, may be used instead (R.). Silver Nitrate, a solution, gr. xx 
ad 3J, painted over the affected parts in pruritus vulvas, is very effective (B.). 
Tobacco, is an effective but dangerous application (B.). Iodoform, as ointment, 



66o 



PRURITUS — PSORIASIS. 



3j ad 5J adipis (R.). Iodine, for itching of the nose or inner canthus, sneezing, 
etc., iodine inhalations have a marked effect (R.). Arsenic, for itching of the 
nose, accompanying asthmatic symptoms (R ). Benzoin, the compound tinc- 
ture painted on the skin, for the itching of eczema, urticaria, etc. (R.). Boracic 
Acid makes an excellent lotion in pruritus pudendi, a teasp. to the pint of hot 
water (R.). Borax, gr. v-x ad £} hot water (R.). See Prurigo. Balsam of Peru, 
is a very good application in pruritus ani, scabies, and many other forms of 
itching (Auerbach). Camphor, with Chloral, rubbed together, makes a liquid 
which, added to vaseline, makes an ointment which is powerfully antipruritic 
(Bulkley) ; added to dusting powders, allays heat and itching of eczema and 
intertrigo (R.). Chloroform, as ointment to allay itching of skin diseases. Gel- 
semium, nixv of the tincture every half hour, up to 3}, for itching which is out 
of proportion to the cutaneous lesion (Pelcher). Lead Lotions, to ease the 
itching of urticaria, pruritus pudendi, etc., especially when the mucous mem- 
brane is red and excoriated (R.). Piperazine, gives immediate relief in the pru- 
ritus of the uric acid diathesis. Salicylic Acid, as ointment, in pruritus ani et 
vulvae (R.). Sodium Salicylate, in 15-grain doses by mouth every four hours, 
will greatly relieve pruritus vulvae, when due to diabetes (Goodell). Tar, as 
ointment, is strongly recommended (Tr.) ; for general pruritus, if no cause can 
be found, the two best remedies are Tar and Sulphur, as lotion or bath (Sparks); 
ointments containing Tar give relief in many instances (Bulkley). Sulphur, may 
be employed as a bath, Potassa Sulphurata, ^ij ad C xv of hot water (Sparks) ; 
or the alkaline sulphites locally (Wa.) ; the iodine of sulphur externally and 
internally, in pruritus senilis (Wa.). Chlorine, the liquor Sodae Chloratae, diluted, 
a useful application in pruritus ani (Wa.). Cocaine, in 5 per cent, solution or 
oleate, is by far the most efficient of all antipruritics ; relieves the itching of 
scrotal eczema, pruritus ani et pudendi, and especially in lesions of the epider- 
mis where the oleate or solution can penetrate at once to the true skin. [Com- 
pare Eczema, Erythema, Lice, Pediculi, Prurigo, Scabies, Urticaria.] 






Prescriptions. 



R. Ac. Carbolici, 

Glycerini, 

Aquae Rosae, . . q. s. ad 
M. Sig. — Lotion for pruritus. 



&. 



Ac. Hydrocyanici Dil. 
Infusi Aliheae, . . . 
M. Sig.— Lotion. 



R 



. Potassii Cyanidi, . 

Aquae Laurocerasi, 
M. Sig.— Lotion. 



3SS-J. 

^V-Vlij. 

{Fox.) 



.. gr- xv. 

. ^viij. 
{Anderson.) 



R. Acidi Benzoici, gr. ex. 

01. Caryophylli, gtt. xl. 

Alcoholis, 3iJ ss - 

Solve et adde — 

Cerati Simplicis, 3 vn J. 

Balsami Peruviani, . . . . ^j. 
M. ft. unguentum. Especially good for 
scabies, but may be used for any pruritus. 



R. Ac. Hydrocyan. Dil., . . . gij. 

Sodii Boratis, gj. 

Aquae Rosae, E vll h 

M. Sig. — Lotion. [Fox.) 



R. 



Potassii Cyanidi, . 

Pulv. Cocci, . . 

Ung. Aquae Rosae, 

M. Sig. — Ointment. 



. gr. vj. 

• gr.j- 

• El 

[Anderson.) 



R 



Gummi Camphorae, 
Chloralis Hydratis, . . aa gj-ij. 
Rub together until liquefied, 
then add slowly, with friction, — 

Unguenti Aquae Rosae, . . ^j. 
Sig. — Ointment for itching. 

{Bulkley.) 



R. Hydrarg. Chlor. Corr., 
Pulv. Aluminis, . . . 

Amyli, 

Aquae, 

M. Sig. — Apply locally. 



g r -J- 
gr. xx. 
gjss, 

3 V J- 
( Goodell.) 



Psoriasis. 

Aristol is an excellent application. Arsenic, at first apparently aggravates, 
but soon heals the disease (R., B.) ; in lepra must be persistently used for a 



PTERYGIUM PTOSIS — PTYALISM. 66 1 

long time (B.); exercises a powerful influence (Wa.) ; maximum dose tt^v liquor 
arsenicalis ter die, never on empty stomach (R.). Mercury, in patches of 
obstinate psoriasis, especially of hands, even when not syphilitic. Calomel and 
mercuric nitrate ointment may be mixed and tar ointment added (R.). Lappa 
Major, a tincture of the seeds in whiskey, used by tablespoonful doses, cura- 
tive of psoriasis of long standing (Reiter). Carbolic Acid, I to 4 of lard, as 
ointment (Wa.). Mezereon, a useful adjunct (Wa.). Sulphur, internally (R.) ; 
a solution of potassa sulphurata in water, is excellent in chronic psoriasis (B.) ; 
not in acute (R.). Sulphur Iodide, externally and internally, in doses of gr. j-vj 
used with great advantage (Wa.). Silver Nitrate, in psoriasis of tongue and 
buccal mucous membrane occasionally; if syphilitic, mercurials best (R.). 
Chrysarobin, has the most decided effect on psoriasis, gss-ij ad gj of ung. 
aquae rosse ; often irritates, and should be employed at first with caution 
(Bulkley). Nitric and Nitro-Hydrochloric Acids, when symptomatic of imper- 
fect digestion and assimilation (B.). Phosphorus, as substitute for arsenic (B.). 
Coptis, has reputation in New England (B.). Copper Sulphate, applied solid 
to spots (R.). Lead, the ointment of the iodide (B ). Tar, painted on, in 
obstinate cases (R.). Oils, Cod-liver Oil internally and locally, is the 
sheet-anchor, especially when of strumous origin (B.) ; oils and fats to lubri- 
cate skin, with warm baths (R.). Diet and Hygiene, nourishing diet, frequent 
small quantities of raw vegetables. Cod-liver oil for growing persons, espe- 
cially when stale fish the cause. Rest and change for overworked subjects. 
Daily baths and cold sponging. Free, open-air exercise is also most useful. 
Warm or tepid soft-water baths at night, with use of pure soap. 

Pterygium. 

Silver Nitrate, locally, especially when pterygium with catarrhal conjunc- 
tivitis (Wa.). Treatment unavailing. Benefit seldom derived from any opera- 
tion (C). Arlt's Operation, the most satisfactory ; cut away as little tissue as 
possible, dissect cleanly, close with suture (Green). 

Ptosis. 

Veratrine, gr. x in 3ij of sulphuric ether and %} of alcohol, brushed over 
the eyelids, brows and temples every morning, till a slight burning sensation 
is produced ; conjoined with the use of electricity (W.). Ergot, aqueous 
infusion as collyrium (Wa.). Electricity, the constant current may often relieve 
recent cases (C). Operation for shortening the lid, by removing an elliptical 
piece of skin and subjacent muscle (C.) ; is not advisable unless the ptosis is 
nearly or quite complete, and of great inconvenience. 

Ptyalism. 

Iodine, as gargle, 3ij of tinct. ad gviij aquae (R.) ; is worthy of trial (Wa.). 
Acids, as astringents, small medicinal doses (R.). Sulphuric, int. and as a 
gargle with decoctum cinchonas, of great benefit in mercurial ptyalism (Wa.). 
Potassium Chlorate, in simple or mercurial ptyalism (R.) ; in the latter form 
3j ad :f vj aquas as mouth-wash, and internally in teasp. doses, 4 or 5 times 
daily (St.). Belladonna, very effective in mercurial ptyalism, and that of preg- 
nancy. Gtt. v-x, or Atropine gr. yi^ to yi^ every 4 to 6 hours (B.). Atropine 
hypodermically (R.) ; should be useful (W.). Tannic Acid, in mercurial ptyal- 
ism is an excellent gargle, Z] of tannin to ^ij of mel rosse, and ^vj of water 
(B.). Alcohol, diluted, as a gargle (R.). Potassium Iodide, sometimes bene- 
ficial in mercurial ptyalism, but often aggravates it (R.). 

Prescriptions. 



R. Tinct. My rrhae, 7,). 

Aquae, J vj. 

M. Sig. — Mouth- wash. 



R • Sodii Boratis, 3 ij. 

Pulv. Myrrhse, %'). 

Aquae, gvj. 

M. Sig. — Mouth wash or gargle. 



662 PUERPERAL CONVULSIONS PUERPERAL FEVER. 

Puerperal Convulsions. 

Aconite, one of the best agents (P.) ; gtt. j-ij of tinct. every 10 or 15 minutes 
for the first hour, then at longer intervals (B.). Belladonna, the tincture in- 
ternally with atropine hypoder., of verified utility (P.). Veratrum Viride, in 
5ss doses of fluid extract every 15 minutes, to nausea, invaluable (R.) ; the 
fl. extract, in doses of rr\,viij-x hypodermically, may be repeated in half-hour 
with Morphine, or vr^x by enema, promptly efficient in the worst cases (Elmer) ; 
a very bad case cured by 20-minim doses every hour for 5 days (Dunn) ; the 
worst case seen in my 30 years' experience, after 14 seizures was promptly 
cured by a hypodermic injection of ttjJv of Norwood's tincture in a little water 
(Etheridge). Pilocarpine Nitrate, gr. -|- hypodermically every 2 hours, very suc- 
cessfully used in several cases (Finniss). Potassium Bitartrate, administered 
for a month prior to confinement, in quantity sufficient to bring about free 
action of kidneys and bowels, will certainly prevent puerperal convulsions 
(Anderson). Opium is apt to induce eclampsia, unless its use be preceded by 
free purgation or venesection (Idem) ; as morphine hypodermically ; the most 
important agent for cure of ursemic convulsions (B.) ; with the lancet, some- 
times required (P.). Anaesthetics, especially chloroform (R.) ; utility unques- 
tionable, when not due to cerebral hemorrhage (B.). Chloral, full doses (gr. 
xx-xxx) every 2 hours, may arrest (B.) ; a remedy of the greatest value, a full 
dose, gr. xx-xxx, before proceeding to one of the bromides (Playfair, Barnes, 
etc.). Amyl Nitrite, by inhalation (B.) ; may cause alarming hemorrhage (W.). 
Ice, to the head (R.) ; and mustard poultices at same time to the feet (Wa.). 
Venesection, by far the most efficient measure (Wallace) ; when great cerebral 
congestion and vascular tension, shown by a livid face, a full and bounding 
pulse, and strong pulsation in the carotids (Playfair). 

Puerperal Disorders. 

Cimicifuga, in puerperal hypochondriasis, and depression (Wa., P.). Opium, 
either alone or with alteratives, highly serviceable in puerperal intestinal irri- 
tation ; a few drops of tincture effectually arrests the diarrhoea (Wa.) ; when 
shock and marked exhaustion, a moderate dose is of benefit (L.). Castor Oil, 
undoubtedly the best .laxative (L.) ; purgatives generally are not required. 
Castor oil the very worst (Fordyce Barker) ; action uncertain (Parry). Rhu- 
barb, or enemas, best means of stimulating bowels after fourth day (L.) ; gr. 
xx-xxx in some aromatic water a good aperient (Wa.). Aliment, in puerperal 
state should be easy of digestion and sustaining (L.). Catheter, necessary often 
for several days when bladder paralyzed, if warm water lavements fail to excite 
(L.). Water, tepid sponging of external parts, vaginal washings daily with warm 
water, with y^ part carbolic acid (L.). [See After-pains, Hemorrhage, 
Labor, Lactation, Mastitis, Nipples, Phlegmasia Alba-Dolens, etc.] 

Puerperal Fever. 

Aconite, drop doses every one'or two hours steadily, with an occasional dose 
of castor oil, and repeated hot poultices or laudanum fomentations, the most 
successful treatment, even in the worst cases, but is useless if not promptly 
efficient (P.). Veratrum Viride, is used with great benefit in most cases (F. 
Barker). Opium, for wakefulness and delirium (B.) ; a very valuable remedy, 
tending to allay pain, and reduce excitement of the nervous and vascular 
systems (Wa.). Alkaline Sulphites, especially valuable in early stages, inter- 
nally and locally ; gr. xv-xxx of magnesium or calcium sulphite every 2 or 3 
hours, with injections every day (Wa.). Stramonium, when cerebral excite- 
ment (P.). Potass. Permang., gr. j^-j ter die, has been given with benefit (B.). 
Alcohol, freely used, until all evidence of sepsis subsided, caused recovery in 
one of the most desperate cases of puerperal septicaemia, of three weeks' stand- 
ing, with temp, falling to 95 and rising to 107 (Hills). Calumba, preferable 
to cinchona (P.), Quinine, only large doses are useful : gr. v-xx every 4 hours 



PUERPERAL MANIA PUERPERAL PERITONITIS. 663 

(B.) ; reduces temperature (P.). Turpentine, when depression of vaso-motor 
nervous system, cardiac weakness, and tympanitic distention of abdomen 
(P., R.). Resorcin, is much used in Vienna by Braun ; gr. xl repeated p. r. n. 
Antiseptic Injections into uterus, opposed very strenuously by many of our best 
men. See N. Y. Med. Rec, 1884, p. 14. For antiseptic treatment by Hydrarg. 
Bichlor., see Dr. Garrigues in N. Y. Med. Rec, of December 9, 1883, and N. Y. 
Med. Jour, of March 1, 1884, and the discussion in the N. Y. Academy of Medi- 
cine, reported in the N. Y. Med. Record of January 5 and February 16, 1884, 
et seq. Water, hot fomentations frequently to parts, a valuable preventive. 
Rest, and quiet but attentive nursing; frequent liquid nourishment. Warburg's 
Tincture, is more efficient than the largest doses of quinine in cases of puerperal 
malarial fever, ^ss every four hours until fever abates, then in diminishing 
doses to 3j-ij, until convalescence is established {Fordyce Barker). [Compare 
Puerperal Peritonitis.] 



Puerperal Mania and Melancholia. 

Stramonium, will allay cerebral excitement, and soothe nervous system ; 
when delirium wild and furious, but intermittent ; tendency to suicide or to 
destroy the child, rr^x-xx of tinct. every 3-4 hours (P.). Hyoscyamus, in 
milder cases ; nervous system greatly excited (P.). Aconite, in puerperal 
mania, with high fever, restlessness; speedy and marked success if given soon 
after chill (P.). Cimicifuga, has cured (B.) ; its effects are truly remarkable in 
mania, and hypochondriasis of puerperal state (P.). Chloral, often alleviates 
symptoms (B.) ; to produce sleep (Wa.). Potassium Bromide, in sthenic cases 
(R.) ; its effects are very variable (Wa.). Anaesthetics, ether inhaled in violent 
paroxysms of mania (B.). Tartar Emetic, in frequently repeated doses (Wa.). 
Quinine, when much weakness ; skin cold and sweating (B.). Chalybeates, 
tinct. ferri chlor. (rr^v-xx) in anaemic form (B.). Opium, cautiously (B.) ; gives 
the best results in such doses as may be necessary to allay irritation and procure 
sleep (Wa.). Poultices, hot fomentations, enemas, or gentle laxatives ; nutri- 
tious and stimulating diet. Lochia should be watched (P.). Weaning, impera- 
tive in melancholia ; not so in acute mania. 



Puerperal Peritonitis. 

Aconite, has cured cases of the usual type (P.). [See Puerperal Fever.] 
Cimicifuga, in rheumatic form especially, has remarkable effects (P.). Opium, 
its curative power in this, one of the best established facts in therapeutics (B.) ; 
is good, but aconite often better (P.) ; especially valuable in adynamic cases 
(Wa.) ; the drug of all others to be relied on (Godson). Turpentine, as stimu- 
lant, rtvx frequently repeated; better than alcohol (B.); enemas, also hot tur- 
pentine epithems, may be used with advantage (Wa.). Quinine, in consider- 
able doses, with or without opium (B.) ; gr. x-xx twice daily as an antipyretic 
(Wa.). Antimony, as Tartar Emetic, gr. -^ to ^ every hour to shorten attack 
and render it more mild (R.). Cathartics, advised by many, prohibited by as 
many ; evidence is in favor of mild aperients combined with Dover's powder or 
Hyoscyamus (Wa.). Poultices, hot, of very great value (B.). Water, ice in 
mouth or swallowed, hot fomentations to abdomen. In some cases cold com- 
presses best. [Compare Puerperal Fever.] 



Pulse. 

Aconite, for a quick, resisting pulse (P.) ; a moderate dose, while it makes the 
pulse less frequent, renders it fuller, stronger and less compressible (R.). 
Veratrum Viride, reduces febrile heat with abnormal rapidity of pulse (P.). 
Veratrine, pulse at first quick and strong, then slowed ; afterward quick, weak 
and irregular (R.). [Compare Vascular Stimulants, etc., ante, page 34.] 



1 



664 PURPURA — PYROSIS. 

Purpura. 

Sulphuric Acid, often acts happily (B.). Ergot, has been strongly urged 
(R.) ; is most useful in removing purpura (P.) ; many cases are recorded as 
cured by hypodermic injections of Ergotin (Wa.). Turpentine, has been used 
(R.) ; with invariable benefit (Wa.). [See Hematemesis.] Nux Vomica, no 
prescription more generally useful than the Syrup of Iron, Quinine, and Strych- 
nine (B.). Iron, when due to anaemia ; the tincture of the chloride (B.) ; is 
preeminently the curative remedy for purpura hemorrhagica, arresting the 
hemorrhagic tendency in 24 to 48 hours (Pize). Vinegar, and water, is an 
excellent application by sponging over the body (E. Wilson). Quinine, or Hux- 
ham's tincture of bark, are much used (H.). Potassium Nitrate, gr. x thrice 
daily in purpura simplex, used successfully (Wa.). Styptics, as the ammonio- 
ferric alum, tinct. of ferric chloride (Tr.) ; tannic and gallic acids, used in some 
cases (H.). Alum, and brandy, or whiskey and water at such temperature as 
is not chilling, applied by sponging the body, is the best local measure (H.). 
Wines are generally indicated (B.). [Compare Hemorrhage, Scurvy.] 

Pustule, Malignant. 

Nitric Acid, strong, applied steadily (after thorough cleansing and drying) to 
destroy the diseased mass (D.). Bromine, to saturate the surface (D.). Car- 
bolic Acid, undiluted, as caustic, or with oil, the favorite (D.). Nitric Acid, 
fuming, is the most preferable caustic (Greenfield). Quinine and Carbolic Acid, 
internally, are indicated in all forms, also stimulants, as Ammonia, Ether, and 
Alcohol (Greenfield). Eschar should be promptly destroyed, to avoid con- 
tagion (R.). Excision and cauterization demanded, when from direct inocula- 
tion ; the two most successful remedies (Greenfield). 

Pyaemia and Septicaemia. 

Quinine, large doses only (gr. xv-xx) are useful (B.) ; supposed to diminish 
the temperature (R.) ; to cinchonism, in childhood the best remedy (Wa.) ; is 
probably the most useful medicine, given in full and frequently repeated doses 
(Haward). Salicin, to reduce the temperature in septicaemia and to relieve the 
cerebral symptoms (R.). Salicylic Acid, has decided value (B.). Potassium 
Permanganate, given with advantage, gr. %-gr. j thrice daily in distilled water 
(B.). Boracic Acid, a saturated solution to wounds, ulcers, etc. Also Chlorine, 
as disinfectant (B.). Oleum Caryophylli, locally. Also olei gaultheriae, thymi, 
etc. (B.) ; as antiseptics. Water, cold, as dressing. Hot better, 95°-ioo° F. 
Hamilton's immersion plan for wounds (B.). Stumps to be immersed in a 
warm bath, to avert pyaemia (R.). Sulphites, may do some good in chronic 
cases, but the use of sulphurous acid has not given the results in man which 
Polli obtained from its use on animals (Haward). Turpentine, is a better stim- 
ulant than alcohol (B.). Ice, dissolved in the mouth (Wa.). Aliment. Plentiful 
nourishment, with wine and good ventilation, are not to be neglected (Wa.). 
Malt liquors are justly esteemed (B.). Stimulants necessary ; brandy the best 
(Wa.). Abscesses, must be opened early, especially when in joints. 

Pyrosis and Cardialgia. 

Capsicum, in atonic dyspepsia, with heartburn and diarrhoea (P.). Nux 
Vomica, of the highest possible value in atonic dyspepsia with heartburn, hic- 
cough, regurgitation, etc. An excellent combination is rr\,v-x of the tincture 
with rti^xv of dilute nitric acid for one dose (P.). Pulsatilla, a good medicine 
in heartburn of dyspepsia in phlegmatic subjects (P.). Podophyllin, gr. ^ night 
and morning in obstinate heartburn, with liver derangement (P.). Almonds, 
six or eight blanched, said to relieve heartburn (P.). Diet, lemon-juice, aerated 
bread, plain biscuit, etc. ; but avoid new bread, much vegetable food, and 
pastry. [Compare Acidity, Dyspepsia.] 



RACHITIS RELAPSING FEVER. 665 

Rachitis. 

Lime, as lime-water, or the carbonate, or the syrupus calcii lacto-phosphatis 
(B.) ; in small doses (R.) ; the phosphate may be advantageously combined 
with cod-liver oil (Wa.). Iron, the syrup of the iodide preferred ; calcium and 
ferric phosphates excellent in combination (B.) ; must be continued a longtime 
(R.). Nitro-hydrochloric Acid, as baths, gives excellent results (Wa.). Qui- 
nine, often very valuable (P.). Aliment, food rich in phosphate of lime and 
other phosphatic salts ; oatmeal, Graham bread, etc. (B.). Cod-liver oil, the 
best constructive agent (B.). A full animal diet (Wa.). Cold sponging (R.). 

Rectum, Diseases of. 

Podophyllum, in doses of gr. ^ to ^ night and morning, for a child, may 
relieve prolapsus of the rectum (P.). Belladonna, the extract locally in fissure 
(R.) ; and irritable ulcers (P.) ; internally and locally to remove ulcers, also 
excellent in burning pain following defecation, or with mercurial ointment in 
equal parts, for fissures and ulcers (P.). Phosphorus, in chronic inflammation 
of the rectum, has been highly recommended (R.). Cocaine, gr. xl to 3J of 
Glycerite of Starch, applied by Seeley's Pile-pipe, very efficient in controlling 
spasm of the rectum. Potassium Bromide, in 5 parts of glycerin, locally, fis- 
sures and painful growths (R.). Iodoform, as suppository in painful diseases, 
relieves greatly (R.). Pepper, the confection, as gentle stimulant in fistula, 
ulcers, hemorrhoids (P.). Castor Oil, in fissure and hemorrhoids, is commonly 
used as purgative (R., P.). Sulphur, with confectio sennse, in irritable rectum, 
is very soothing (Wa.). Stramonium, ointment from fresh leaves to alleviate 
pain (P.). Conium, the extract in doses of gr. x to allay pain and irritability in 
cancer (Wa.). Purgatives, best for proctalgia (D.). Surgical, in ulcer or fissure, 
an incision through mucous membrane, and in severe cases to divide part of 
the sphincter. A flake of cotton should be laid in the wound, so that it may 
heal by granulation (D.). [See Anus, Diarrhoea, Dysentery, Rectum, Ul- 
ceration of, Hemorrhage Intestinal, Hemorrhoids, Prolapsus.] 

Rectum, Ulceration of. 

Mercury, the red oxide, Z] to the ^ of unguentum, as ointment in flat ulcers 
of rectum existing just within the anus (Coulson). Belladonna, locally the 
extract for rectal ulcers, is very efficient (P.). Carbonic Acid, the gas, per anum, 
is strongly advised (Wa.). Chloroform, as ointment, in irritable ulcer of rectum 
(Curling). Iodoform, in suppository, extremely useful in painful ulceration (R.) ; 
used in many cases with very satisfactory results, but in some instances poison- 
ing occurs ; hence it should be used with caution (Wa.). Phosphorus, as an 
internal remedy, is highly recommended in chronic inflammation of the rectum 
(R.). Copper Sulphate, with opium, may often be used internally with advan- 
tage, and a weak solution of the same, or of Silver Nitrate, locally (Curling) ; 
the writer had a case which resisted treatment for 3 years, and in which a cure 
was effected by a persevering use of a pill of Cuprum Sulphate, Extract of 
Opium, and Quinine Sulphate. Silver Nitrate, gr. %-] combined in pill with 
Opium, gr. ss ; and a solution, gr. x-xx to the pint, by enema (B.). 

Prescriptions. 
U . Cupri Sulphat., R. Chloroformi, 25 j — xj. 

Morphinae Sulphat., . . aa gr. ij. Zinci Oxidi, Z ss - 

Quininae Sulphat., . . . . gr. xxiv. Olei Olivae, gj. 

M. ft. pil. no. xxiv. Sig. — One pill Cerati Cetacei, ^iv. 

thrice daily. [Potter.) M. ft. unguentum. [Curling.) 

Relapsing Fever. 

Cathartic, mild at beginning (H.) ; if jaundice or other hepatic derange- 
ment, a calomel purgative, cautiously, lest irritation (Wa.). Potassium Citrate, 



666 REMITTENT FEVER RHEUMATIC ARTHRITIS. 

as cooling diaphoretic. Quinine, in moderate doses after the crisis, at least 
until the relapse, which will not be prevented by any amount of quinine (Wa.). 
Leeches or Cupping, best for headache (A.). Alcohol, required by some pa- 
tients. Diet, supporting, especially in third week, beef-tea, etc. Urine, should 
be watched carefully (A.). [Compare Typhus Fever.] 

Remittent Fever. 

Aconite, in hot stage, if any febrifuge is required, frequently repeated doses 
(B.) ; is next in value to quinine for high fever and headache, gtt. j of a good 
tincture every hour (Da Costa). Quinine, 20 to 30 grs. in single dose once 
or twice daily till temperature is reduced, with other appropriate remedies 
(B.) ; 15 to 20 grs. at most (Maclean); 30 to 50 or 60 grs. in severe cases of 
pernicious remittents several times a day without regard to exacerbation (P., 
B.). Warburg's Tincture, has achieved a very high reputation, but must be 
used in less dosage than directed, and supporting treatment given when its 
sudorific action commences (Wa.). Gelsemium, exercises a really beneficial 
influence; depresses temperature (B.) ; valuable in bilious remittents of the 
South (Pf). Morphine, gr. % hypodermically to abort pernicious remittent 
fever (B.). Purgation, by calomel with jalap or salines afterward, is very 
necessary during course of the disease (Da Costa). Quassia, an excellent tonic 
in convalescence, combined with mineral acids (Wa.). Packing, by wet sheet, 
is resorted to with advantage, except when hepatic or splenic congestion 
(Wa.). 

Retina, Affections of. 

Mercury, in syphilitic retinitis is of great value ; calomel gr. j-ij with opium 
gr. %-Yz every 4 or 6 hours ; also mercurial inunction till the gums are affected 
or the disease yields (Wa.). Potassium Iodide and Bromide, in combination, 
in retinal hemorrhage, to promote absorption of the effused blood, and benefit 
congestion (C). Eserine, locally to contract pupil, and diminish the amount of 
light admitted to the eye (Wa.). Iron, in full doses, generally the tinct. of 
the perchloride, in pigmentary retinitis ; seems to have a tendency to arrest the 
malady (C). Leeches, to the temple better than general bloodletting (Wa.). 
When much local congestion present, depletion by artificial leech is almost 
always indicated (C). Pilocarpus, in detached retina and optic neuritis ; has 
been found a very useful remedy in retinal affections generally. [Compare 
Amaurosis.] 

Rheumatic Arthritis. 

Aconite, highly spoken of; as liniment, conjoined with internal use (Wa.). 
Cimicifuga, when joints enlarged and much stiffened, and when traceable to 
uterine derangement, is very useful (R.) ; when pains worse at night (Wa.). 
Iodine, tinct. internally, said to be better than potassium iodide (R.)- Iodoform, 
10 parts to 20 of Ether and 20 of Alcohol, as liniment to the joint, applied by 
a pencil, and covered with oiled silk (Gubler). Iodides, often signally benefit, 
especially when due to syphilitic, mercurial, or mineral poisoning (B.). Large 
doses of potassium iodide sometimes required (R.) ; combined with guaiacum, 
or corrosive sublimate, often curative in cases resisting these remedies given 
separately (Wa.) ; Potassium Iodide should always be fairly tried (Da Costa). 
Guaiac, the ammoniated tincture, in doses of 3j-ij in milk, often gives excel- 
lent results (Da C). Colchicum, with alkalies, extremely useful (B.). [See 
Gout, for formulae.] Arsenic, when referable to nervous affections (B.) ; as a 
bath containing %W washing soda and gr. xx arseniate of sodium; in large 
doses, continued for some time, sometimes of great benefit, but action is capri- 
cious (R.) ; in small doses is of great benefit (Da Costa). Lithium Salicylate, 
very efficient in acute and progressive subacute articular rheumatism, and has 
some effect also in chronic cases, where some of the joints are deformed, swollen 
and painful ; 3j may be given daily, in doses of gr. vij to x, in water (Vulpian). 
Lithium Bromide, of great value in acute and chronic (B.). Piperazine, should 



RHEUMATISM, ACUTE. 



667 



be used in all cases of difficult diagnostic differentiation, from its remarkable 
power over uric acid and urate concretions. Potassium Bromide, sometimes 
allays the severe pain (R.). Arnica, the tincture and infusion are said to be of 
great value (P.). Cod-liver Oil, internally and locally, of much value (R.). Baths, 
Turkish or sulphur. The cold douche, which may be slightly warmed in winter ; 
use for one or two minutes and rub dry (R.). Adhesions may be broken up 
under the anaesthetics (DaC). Massage may be used with benefit to ameliorate 
the condition in chronic cases, where a cure cannot be obtained (Da C). 

Prescriptions. 



R. Vini Colchici Sem., . „• . giij. 
Spt. Ammon. Aromat., . . ^xiij. 
M. Sig. — A teasp. every 3 hours, until 
some physiological effect is produced. (B.) 



R . Lithii Bromidi, .^i'j- 

Syr. Zingiberis, |j ss. 

Aquse, . jfjss. 

M. Sig. — A teasp. thrice daily, con- 
jointly with a lotion of the same. (B.). 



Rheumatism, Acute. 

Aconite, very serviceable when much heat and dry skin (B.) ; subdues pain 
in inflamed joints and perhaps shortens the fever (R.) ; small closes frequently 
repeated of the greatest value, and if used from the start prevent permanent 
organic disease (P.) ; is not reliable as a cure, but a valuable adjunct to other 
remedies (Wa.). Veratrum Viride, tinct. said to be useful (R.) ; as antipy- 
retic, small doses ; may be combined with opium (P.). Bryonia, has proved 
useful, especially for painful and stiff rheumatic joints (P.). Salicin, gr. x-xxx 
every 2, 3, or 4 hours. Gr. xv every 3 hours in powder mixed with water (Mac- 
lagan), or same dose of Salicylic Acid, is of great benefit; good effect gener- 
ally experienced within 48 hours (R.) ; the acid is better than the salicylates, 
but must be abandoned if not effective after 3 or 4 days (Da Costa). Salol, the 
great remedy, none superior (B.). Antipyrine, has a high place as a remedy 
for the hyperpyrexia. Salipyrin, has been employed with excellent results, in 
15-grain doses every yi hour or hour, until about %\] have been taken, continu- 
ing with smaller doses for a long time after convalescence, to prevent relapses. 
Phenacetine, an efficient and safe antipyretic in poly-arthritis. Sodium Salicy- 
late, behaves as Salicin (R.). Oil of Gaultheria, as a substitute for salicylic 
acid, used very successfully in form of emulsion (B.). Rhus Toxicodendron, 
positively invaluable in after-stage, also in subacute forms, muscular or ten- 
dinous, worse at night (P., Pf.). Hydriodic Acid, the syrup, in dessertsp. doses 
every 2 or 3 hours, the best remedy for acute and subacute rheumatism, reliev- 
ing pain and swelling in 18 to 24 hours (Craig). Cimicifuga, excellent reports 
from (B.) ; has been much used, said to quell the pain speedily (R.) ; found 
very serviceable (P.). Dulcamara, recommended especially in persons who 
are subject to catarrhal affections in cold and damp weather (P.). Ammonium 
Bromide, a very excellent treatment, followed by quinine ; gives a very low 
proportion of cardiac complications, gr. xv-xx every 4 hours (Da C.) ; dis- 
agreeable but strongly recommended (B.). Arnica, lowers pulse and tempera- 
ture, relieves articular pain and swelling, diminishes urea (P.). Trimethyl- 
amine, rr\jv-viij in peppermint water, often has remarkable power in acute 
rheumatism and gout (B.). Spigelia Anthelmia, rheumatic pericarditis and 
endocarditis ; rheumatic fever with pain shifting from joint to joint (P.) ; seems 
to fix the disease in certain joints, and prevent its shifting around (P.). Sul- 
phurous Acid, fumigation, and patient covered with blankets exposed to strong 
fumes, produces perspiration, sleep and relief (R.). Colchicum, alleviates the 
symptoms, and shortens their duration (Wa.). Laville's Mixture, is said to be 
a tincture of quinine and colocynthine, -but it is more than probable that col- 
chicine is the active agent therein. (See N. Y. Med. Record, Dec. 5, 1885, page 
642.) Quinine, as antipyretic ; not so useful as wet pack or cold bath ; gr. ij-v 
after the more acute symptoms have subsided (B.) ; is best for the head symp- 
toms (Da C). Opium, strongly recommended as anti-rheumatic; gr.j every 
2 or 3 hours, increased to gr. xij in 24 hours ; tolerance remarkable in this 



66S 



RHEUMATISM, ACUTE. 



disease. Also, in rheumatic carditis it is indispensable (Wa.) ; a very good 
remedy in moderate doses (Da C). Lithium Bromide, equally good in all 
forms, especially for insomnia, delirium, etc. (B.). Digitalis, in powder, gr. ij 
every 4 hours, usually effective after 2 to 7 days ; especially useful in cardiac 
complications with cyanosis and oedema. Iron, tincture of chloride very ser- 
viceable in pale, delicate subjects, tt\,xx-xxx every 4 hours; also as prophy- 
lactic where tendency ^Anstie) ; harmful to the plethoric and overfed (B.). 
Alkalies. The alkaline treatment is now seriously questioned; an injurious 
dyscrasia results from their use (B.). Potassium Bicarbonate, gr. xxx every 4 
hours, in a dilute solution, until joint-symptoms and fever disappear (Wa.). 
Lime-juice, ^viij daily, lemon-juice inferior (R). , Blisters, are a very effec- 
tive method ; a number of small blisters applied to vesication around a joint 
(B.) ; large flying blisters around a joint (R.). Water, cold baths for the hyper- 
pyrexia (Da C.) ; the wet pack very efficacious in rheumatism, also a vinegar 
vapor bath (B.) ; the wet pack, 20 or 30 minutes, and tepid (70°) shallow bath 
1 or 2 minutes. Cold applications only when skin hot and dry, and tempera- 
ture high. Warm baths, or hot compresses very useful. Spongiopiline an 
excellent substance for applications. Diet, low during the fever, water, barley- 
water, milk-and-water, gruel, etc. All through use liquid food. Avoid malt 
liquors, port wine, and sugar. Lemon-juice may be used freely. Blankets, 
instead of sheets to sleep in, and flannel underclothing are useful adjuncts. 
Pack the joints with cotton covered with rubber cloth or oiled silk. 

Plans of Treatment, may be resolved into three, viz., — (1) that by Salicin, 
(2) that by Alkalies, (3) that by Iron. Salicylic Acid and the Salicylates, in 
20-grain doses, to not less than gij in 24 hours, in solution with excess of 
alkali, is especially suited to vigorous, sthenic subjects, whose stomachs will 
bear it, in whom it often effects a cure in 3 or 4 days. Alkalies, for flabby, 
fat subjects; alkaline carbonates, as the Potas. Carb., ^jss, every 24 hours, 
alone or with a vegetable acid, until the urine becomes neutral or alkaline, 
when it may be reduced one-half, and so maintained for some days, when 
quinine or iron may be used. If successful, this treatment brings about a cure 
in two weeks. Tincture of the Chloride of Iron, for the feeble, anaemic, and 
nervous subjects, tt\,xxx every 4 hours, with an occasional saline laxative, 
blisters around joints, and Atropine as an anodyne rather than Opium, used 
hypodermically in the vicinity of the affected joint (B.). Iron and Salicylic 
Acid in combination, should be most valuable, but as heretofore prescribed 
has always made an insoluble precipitate. This is overcome by Dr. Peabody 
in the formula given below, which makes a ruby-red mixture, and has the 
advantage of preventing the anaemia which results from Salicylic Acid given 
alone. 

Cardiac Complications require Ammonium Carbonate, in 5-grain doses fre- 
quently, also Infusion of Digitalis witji hypodermics of Morphine, and a blister 
over the praecordium, followed by Iron and Quinine after the acute symptoms 
have subsided (B.). 



Prescriptions. 



R . Olei Gaultheriae, gj. 

Acidi Salicylici, gr. lxxx. 

Sodii Boratis, gj. 

Syr. Picis Liquidae, . . . % ij. 

Aquae Anisi, ^ij. 

M. Sig. — A dessertsp. every two hours. 



&. Propylamine Chlorid., . . gr. xxiv. 
Aquae Menthae Pip., . . . Jvj. 
M. Sig. — A tablesp. every two or three 
hours. (Tyson.) 



R . Potassii Iodidi, 3 ij. 

Vini Colchici Sem., 
Syr. Simplicis, . . . aa ^iv. 
Aquae Menthae Pip., . . . |j v. 
M. Sig. — Tablesp. every 4 hours. 

(New Orleans Charity Hosp.) 



R. Ammonii Phosphatis, . . . .^jss. 

Tinct. Colchici Seminis, . ^j. 

Tinct. Aconiti, gij. 

Syr. Simplicis, §iij. 

M. Sig. — A teasp. every three or four 
hours. (Corson.) 



RHEUMATISM, CHRONIC. 



66 9 



K- Acidi Salicylici, ^ij. 

Ferri Pyrophosphate . . . £j. 
Sodii Phosphatis, , . . . gr. xij. 

Aquse, Sjjvj. 

M. Sig. — A tablesp. every 2 hours. 

{Peabody.} 



&. Sodii Salicylatis, Jfss. 

Tinct. Lavand. Co., . 3 iij . 

Glycerini, . 3 vj. 

Aquas, q. s. a^ ,^vj. 

M. Sig. — A tablesp. every three hours, 
well diluted. 



Rheumatism, Chronic. 

Arsenic, is very good in most cases, given in small doses steadily (Da C.) ; 
with Guaiac instead of Sulphur in the Chelsea Pensioner (see ante, page 478), 
the latter is more efficient (Fothergill). Bryonia, is useful, especially for pain- 
ful and stiff joints (P.). Rhus Toxicodendron, a very powerful agent in sub- 
acute muscular or tendinous rheumatism, worse at night (Pf.) ; the tendons, 
ligaments, and fascia? are most benefited ; externally, as lotion on compresses ; 
also, internally, small doses every two hours (P.). Potassium Iodide, especially 
when pains are worse at night, or of syphilitic origin (R.) ; should always be 
fairly tried in chronic rheumatism (Da C.) ; was Sir Astley Cooper's remedy for 
rheumatism. Cimicifuga, sometimes has wonderful success, yet often fails ; 
no indications (B.) ; in rheumatic neuralgias and headaches, and rheumatism of 
uterus (P.) ; signally beneficial in many forms (R.). Mercury, and Morphine, 
the oleate locally, for joint affections (R.). Colchicum, is of decided advantage 
in neuralgia of chronic rheumatism (B.). Mezereon, strongly recommended 
(P., R.). Phytolacca, has been useful (B.). Iodides often prove very satisfac- 
tory, especially in strumous or syphilitic subjects (B.). Aconite, the extract as 
plaster to joints is unquestionably very useful (P.) ; is more useful in chronic 
than acute rheumatism (Wa.) ; the liniment of the B. P. locally over the 
sciatic nerve when affected (Fothergill). Dulcamara, has been employed with 
advantage (P.) ; Sulphur, locally, also sulphides as baths (R.) ; is certainly of 
benefit (B.) ; sulphur waters are undoubtedly efficient (Da C.) ; sulphur is an 
ingredient of the Chelsea Pensioner (see ante, p. 478), an old English remedy 
for rheumatism. Iodine, for pain around joints (R.). Lithium Bromide, gives 
excellent results, when smaller joints swollen, tender (B.). Lithium Salicylate, 
in 15 to 20 grain doses every four hours, gives good results in lingering, sub- 
acute cases after acute attacks (Da C). Quinine, in rheumatism with debility, 
shown by night sweats, or sweats during sleep, and only then (Wa.). Arnica, 
the tincture and infusion are useful (P.). Cajeput Oil, internally and externally 
in muscular rheumatism (P.). Turpentine, benefits and relieves the pains ; in- 
ternally and externally as liniment (P.). Guaiac, used with varying success 
(B.) ; often gives excellent results; the, ammoniated tincture, 3J-ij in milk 
(Da C.) ; is vile to the taste. Eucalyptus, the leaves wrapped around the 
affected part, renewing them daily for a week or more, often very efficient as 
a local stimulant, and will produce vesication if too long continued (Gibbons). 
Xanthoxylum, has long had deserved reputation, TtLxv-^ij fluid extract (B.). 
Thuja Occidentalis, is useful for rheumatic pains (P.). Manganese Sulphate, 
is one of the remedies (B.). Belladonna, the extract locally very valuable for 
pains (P.). Cod-liver Oil, internally and externally, exercises some influence 
(B.). Chimaphila, may prove useful, especially when lithiasis (P.). Lupulin, 
as an anodyne (P.). Burgundy Pitch, as plaster locally (P.). Aliment, avoid 
alcoholic and malt liquors, coffee, also starchy, animal and saccharine food. 
The farinaceous vegetables and acid fruits suitable (B.). Alkaline mineral 
waters have deserved reputation (B.). Turkish Baths, in chronic muscular 
rheumatism (B.) ; steam bath daily of great benefit, may be obtained at home 
by pouring water on hot bricks in a tub, the patient sitting on a board or chair 
above, enveloped in a blanket (Brick). Red Flannel, next skin, very popular, 
but white better, as the red gives rise often to eruptions (Da C). [Compare 
Lumbago, Myalgia, Pleurodynia, Rheumatic Arthritis, Sciatica.] 



670 



RHEUMATISM ROSEOLA. 



R. Pulv. Resin. Guaiaci, 
Potassii Iodidi, . . . 
Tinct. Colchici Seminis, 
Aquce Cinnamomi, 
Syrupi, . . . . aa q. s. 
M. Sig. — A dessertsp. 

thrice daily. 



Prescriptions 



aa 3J. 

ad gvj. 
to a tablesp. 
{Pepper.) 



R. Tinct. Guaiaci ./Ether., . . t ^j. 

Tinct. Colchici ^Ether., . . t ^vj. 

Tinct. Cann. Ind. yEther., . sjij. 
M. Sig. — 25 to 30 drops on sugar, every 
4 hours, for rheumatic and neuralgic symp- 
toms. {Atlee.) 

R. Ac. Arseniosi, gr. iij. 

Pulv. Guaiaci, 3 iij. 

Pulv. Capsici, gss. 

Pil. Aloes et Myrrh., . . . 5 iij. 
Ft. pil. no. cxx. Sig. — One thrice daily. 
The modified Chelsea Pensioner. 

{Foihergill.) 



M 
pain, 

R. 



M 
•rheu 



Linim. Aconiti (B. P.), 
Linim. Belladon., . . aa ^ij. 
Glycerini, ... q. s. ad ^ij. 
. Sig. — Apply locally over the seat of 
{Fothergill.) 

Olei Sinapis, 3 SS - 

Olei Terebinth., 3 iij. 

Camphors, ^iv. 

Liq. Ammon. Fort., . . . 3 iij. 

Tinct. Capsici, £iv. 

Alcoholis, . . . q. s. ad J vj. 

. Sig. — Russian Spirit, a liniment for 

matism. 



R. Potassii Iodidi, ..... gj. 

Potassii Nitratis, 3 ss. 

Ext. Cimicif. Fl., 

Glycerini, aa ^ ss. 

Vini Colchici Sem., . ad !|ij. 
M. Sig. — A teasp. after each meal. 

{Potter.) 



Rheumatism, Gonorrhceal. 

Opium, as Dover's powder, in the acute stage, full doses (Wa.). Potassium 
Iodide, with tonics and stimulants, after the acute stage has passed, followed by 
friction, shampooing, and passive movements of the joints (Wa.). Ammonium 
Chloride, in free doses, especially when the muscles are affected (Fuller). 
Potassium Chlorate, internally, and as urethral injection, until urethral dis- 
charge is entirely stopped, then rr^xx of tinct. ferri. chlor. 4 times daily, with gr. 
x of quinine daily, and good food (Da Costa). Aspirate, when pus is dis- 
covered around the joints, as the case will be one of pyaemic rheumatism, and 
may involve more joints than one (Da C). 

Rheumatism, Muscular. 

Diaphoretics, as Dover's powder, with Potassium Nitrate, or Salts of Ammo- 
nium, with dry heat to the part involved and rest in bed (Da C). Morphine 
and Atropine, gr. \ and gr. ¥ x g , together hypodermically, are of great service 
in most forms (R.)- Lithium Bromide, is almost specific (B.). Jaborandi, or 
Pilocarpine hypodermically, to get the skin acting freely, a great desideratum 
(Da C). Potassium Iodide and Colchicum, or Quinine, gr. xij-xvj in 24 hours, 
if case lingers over a week (Da C). Liniments are of little use except to 
amuse the patient, but Chloral ^j in ^vj of Linim. Saponis, makes a good one 
(Da C). Capsicum, powdered, with lard, ^ij ad ^j, rubbed over the part, night 
and morning, with a gloved hand, is very efficient (Macdonald). Cimicifuga, is 
often very efficient in lumbago, myalgia, pleurodynia, and similar conditions 
(Wa.). Xanthoxylum, gives relief in some cases of muscular rheumatism (B.). 
Lithium, and its salts, where there is a uric-acid diathesis (B.). Colchicine, 
5-minim doses of a T \, solution of Merck's, hypodermically into affected muscles, 
thrice daily, very effective in cases resisting other treatment. [Compare Lum- 
bago, Myalgia, Pleurodynia, Torticollis.] 



Roseola. 

Scarcely any treatment called for ; no local application needed, as the rash 
is but slightly irritating. Aconite or Belladonna, according to the symptoms, or 
the Carbonate of Ammonium, answers all the indications. [Compare Measles.] 



SARCIN^£ SCABIES SCARLATINA. 6j I 

Sarcinse. 

Sulphites and Hyposulphites, have been employed to destroy sarcinae and 
torulse in the stomach (R.) ; or Sulphurous Acid, diluted, before each meal 

(Wa.). 

Scabies. 

Sulphur, a solution of potassa sulphurata gss-^j, as local application. An 
extemporaneous sulphide may be made by boiling one part of quicklime and 
two of sulphur in ten of water (B.). Sulphurous acid, as gaseous bath, the 
quickest method. Hebra's mixture of sulphur, chalk, tar, soap and lard, less 
irritating, and equally sure (R.)- Calcium Sulphide, as a bath (W.). Sul- 
phuric Acid, internally, has cured when other remedies failed (Wa.). Storax, 
equally serviceable and not irritating as is sulphur, one part to two of olive oil, 
with a warm bath (R.)- Mercury, the bichloride is very efficient, if used 
strong enough, but caution is required in its employment (B.). See formula 
below. Staphisagria, a certain remedy; 3 parts to 5 of lard, boiled at 21 2° 
F. for 24 hours, when cooled after straining add a little essence ; friction with 
this 4 times daily (Wa.). Balsam of Peru, the best of all applications, killing the 
acarus, relieving the itching and dermatitis, and disinfecting the parts ; rub in 
Z) over the body after a warm bath (Bruce) ; is fatal to the itch-mite (Oldberg). 
Manganese, the oxide, 5ij~5J adipis suilli as ointment (B.). Copper Sulphate, 
as lotion (,fj-Oj) has been used with great success, after crusts are thoroughly 
removed with soap-and-water (B.). Alkalies, as soaps or ointments to remove 
cuticle and break up burrows (R.). Carbolic Acid, locally (B.). [See Tinea 
for formula.] Cocculus Indicus, as ointment, useful (P.). Tar Ointment, 
relieves itching quickly and cures disease in 10 to 12 days (P.). Anise, Ka- 
mala, as ointments, efficient (P.). Benzoic Acid, gr. x-xx ad 0)4 aquae, as 
lotion, effectual for the pruritus (R.). [See last formula on left-hand column, 
under Pruritus.] Linen should be immersed in boiling water ; other gar- 
ments well fumigated with sulphur vapor to destroy insects or their ova, or 
baked in oven (R.). 

Prescriptions. 



R. Styracis Liquidis, . . . . gij. 
Ung. Sulphuris, . . . . . ^iv. 
Ung. Petrolei, .... ad 5J. 
M. Sig.-- Apply after washing. 

{Bulkley.\ 



R. Hydrarg. Chlor. Corr., . . gr. iv. 

Alcoholis, gvj. 

Ammonii Chloridi, . . . . £ss. 

Aquae Rosse, . . q. s. ad ^ vj. 
M. Sig. — Lotion for scabies, phthi- 
riasis, and tinea versicolor. [Fox.) 



& . Sulph. Sublimat., .... ^j. 

Balsam. Peruv., gss. 

Adipis, Sjj. 

M. Sig. — For children. (Dukring.') 



R. Sulph. Sublimat., 

Olei Cadini, aa gij, 

Cretse Preparatas, .... 3 ijss. 
Saponis Viridis, 

Adipis, aa ^j. 

M. ft. unguentum. [Bulkley 



Scarlatina. 

Aconite, of the highest value for all marked increase of temperature (B., R.) ; 
helps the development of eruption when due (P.) ; in the early stage, when 
not decidedly adynamic, is very useful (W.). Belladonna, during the erup- 
tive stage, when depression exists, and rash is imperfectly evolved (B.). As 
prophylactic has been recommended (R.) ; is often efficacious as prophylactic 
(P.) ; the preponderance of evidence is certainly in favor of such use of the 
drug(Pf.); this virtue is claimed by imposing authorities; when so given its 
dose is gr. \ several times a day (Tr.). Mercury, \ of gray powder every 
hour has marked effect ©n inflamed tonsils (R.). Ammonium Carbonate, feeble 
circulation, cyanosis, delirium (B.) ; in all forms, especially if given early (R.) ; 
one of the most reliable remedies ; gr. iij-vij, according to age, in milk or cin- 
namon water, every hour or two (Wa.). Potassium Iodide, in full doses, a very 
satisfactory remedy (Mitchell). Mineral Acids. Muriatic, internally and as 



I 



672 



SCARLATINA SCIATICA. 



gargle ; Nitric, to sloughs in throat (R.)- Carbolic Acid, internally and as 
gargle, successfully used. [See Measles, for formula.] Seems to exercise 
some influence as prophylactic (Wa.) ; is good for the vomiting and for its gen- 
eral effect on the disease; Tr^ss, every 2 or 3 hours (Da Costa). Veratrum 
Viride, in convulsions (R.). Rhus Toxicodendron, of great service, if typhoid 
or rheumatic symptoms (P.). Digitalis, very useful ; lowers temperature and 
maintains kidney action (B.) ; the best antipyretic and diuretic, the infusion 
with dry cups for the renal dropsy in its inception. Later on, milk diet and 
Basham's Mixture (Da C). Potassium Permanganate, locally to throat, and 
internally (gr. %-] ter die) has undoubted benefit (B.). Sulphurous Acid, by 
inhalation, spray, or fumigation, in malignant sore throat (R.). Chlorine Water, 
in sloughing of throat (R.) ; seemingly prophylactic (Wa.). Quinine, small 
doses, in adynamic states, large in hyperpyrexia (B.) ; very successful when 
used systematically from the start (Wa.). Ferrum Perchloride, the tincture in 
doses of tt^x-xv, according to age, in advanced stage, when with albuminuria 
and hematuria, is very valuable (Wa.). Potassium Chlorate, in grain-doses 
every yi hour, will not injure the kidneys, and will give equal results as larger 
doses on the throat inflammation (A. A. Smith). Asclepias, to promote the 
eruption (W.). Zinc Sulphate, gr. Jg every 3 hours, believed to have specific 
influence on the disease (Hoyt). Sodium Benzoate, is highly efficient, having 
slower but more permanent effects on the fever than quinine or the salicylates 
(Klebs). Boric Acid, makes an excellent gargle (Da C). Juniper, as diuretic 
when dropsy (R.). Magnesium Sulphate, as purgative, to prevent sore throat 
and other sequelae (R.). Sodium Sulpho-carbolate, as a means of introducing 
carbolic acid into the system. Has been successfully employed (Wa.). Mustard 
Bath, on recession of rash, to bring it back (R.). Oil Inunctions, very grateful, 
especially useful in desquamative stage. Cocoa-butter the most elegant (B.). 
Ice sucked, in the sore throat (R.). Water, cold baths with oil are all that are 
needed in mild cases. When temperature above 104 , urine scanty and rash 
retroceding, the cold wet-pack renders signal service (B., R.). A cold wet 
compress to neck, through the whole course, renewed every 3 hours (R.). 
Diet, fruit, if ripe, in season, toast, gruel, etc., in simple cases. In malignant, 
extract of beef, stimulants as per pulse. Milk the most suitable aliment, both 
as nutrient and as diuretic. 



Prescriptions. 



R . Ac. Borici ^ss. 

Potassii Chloraiis, . . . . 15 ij. 
Tinct. Ferri Chloridi, . . . 15 ij. 
Glycerini, Syrupi, . . . aa^j. 

A q U3e < 3*j- 

M. Sig. — Tablesp. every 2 hours, 



to a 



child of five years. 



{Smith.) 



R. Acidi Carbol., ."ss-j- 

Vaselini, $iv. 

M. Sig. — By inunction to the entire 
surface. 



R. Acidi Salicylici, . , . . . ^ij. 



K tt. xij. 



Tinct. Aconiti, 

Infusi Digitalis, oJ ss - 

Spt. Ammon. Aromat., . . 3 iij. 
Syr. Aurantii Cort., . . 

Aquae, 

M. Sig. — Teasp. evtry 3 hours, for a 
child of five years. (Brown.) 






R. Acidi Borici, 3 iij. 

Glycerini, 3 iv - 

M. Sig. — For a pint of water as a 
gargle. (Da Costa.) 



Sciatica. 

Aconite, locally (P.) ; as ointment controls in some instances (R.) ; valuable 
and efficient in many obstinate forms (Wa.). Antipyrine, or Acetanilide, are 
efficiently analgesic. Salipyrin, in rheumatic sciatica, has been employed with 
excellent results. Rhus Toxicodendron, a very powerful therapeutic agent in 
various rheumatic affections of the fibrous tissues (P.). Cimicifuga, is highly 
extolled (R.). Turpentine, causes an exquisite sensibility along the track of the 
great nerves (Tr.) ; occasionally of great value in sciatica, yet not a specific, 



SCLERODERMA SCROFULOSIS. 673 

nor have we scientific indications for its use (P.) ; ^ss doses for 4 or 8 succes- 
sive nights (R.). Sulphur, locally, believed to relieve the pain ; effect probably 
due to the flannel surrounding it (R.) ; is worthy of trial after active symptoms 
are subdued (Wa.). Phosphorus, in neuralgic form ; less satisfactory in sciatica 
than in other neuralgias (R.) Nux Vomica, often successful in chronic (Wa.). 
Belladonna, has afforded relief (R.). Atropine, hypodermically, is curative ; 
large doses, gr. -^ to ■£$ in vicinity of nerve (B.). Cocaine, hypodermically 
along the nerve, has afforded instant relief (Wa.). Veratrine, as strong oint- 
ment ; Veratrum Viride, as tincture, is also recommended (R.). Ammonium 
Chloride, in mild forms (R.) ; occurring in the young (Anstie). Ether Spray, 
generally of temporary value (R.) ; Chloroform, on flannel along course of 
nerve, covered with oiled silk (Wa.) ; injected deeply into vicinity of nerve, 
gives the best results in old cases, rrtxv of the spirit hypodermically (B.). Stra- 
monium, gr. %.-Yz every 3 or 4 hours for 4 or 5 doses, often affords decided 
relief. Stop when slightest symptoms of narcotism appear (P.). Opium, inter- 
nally and externally (Wa.) ; Morphine, hypodermically is especially curative in 
sciatica (B.) ; 3 or 4 injections of gr. ye each ; it may almost be regarded as a 
specific (Wa.) ; a single application sometimes cures long-standing cases per- 
manently ; if not it may be repeated every second day or so (R.) ; should be 
injected deeply into the adjacent muscular structure (Pepper). Iodides, in 
syphilitic or metal poisoned subjects (B.) ; often fails (R.). Potassium Iodide 
in doses of 5j daily, dissolved in decoction of sarsaparilla, most efficacious in 
subacute or chronic (Wa.). Salicylic Acid, as paste locally, Z] with Z'w of 
Lanolin and 01. Olivae, q. s., also Rhus Tox., gtt. j. of a 1 per cent, solution of 
the fluid extract every 4 hours, cured one very obstinate case (Aulde.) Salol, 
gr. vij in evening and gr. xv more at midnight, completely cured me after 3 
weeks' suffering in bed, unrelieved by other remedies (Aschenberg). Cold of 
intense degree, produced by refrigeration of limb by Methyl Chloride, extremely 
efficient (Jacoby). Has been found effectual when applied to the sound limb. 
Cantharides, as counter-irritant, to free vesication (R.). Aquapuncture, has 
had extraordinary success (B.). [See under Neuralgia.] Acupuncture, 
occasionally affords instant relief (B.) ; often cures cases of long standing (R.). 
Nerve-stretching, by forcibly flexing the thigh on the abdomen (Lange). Poul- 
tices, applied very hot (R.). Turkish Baths, are often very useful (R.) Elec- 
tricity, produces excellent results (B.) ; does great good, but often aggravates ; 
the continuous current best, when stage of acute inflammation past (W.) ; gal- 
vanism often quickly relieves the pain (Pepper). Cod-liver Oil, should always 
be tried in obstinate cases (W.). [Compare Neuralgia, Rheumatism, 
Chronic] 

Prescriptions. 

R . Tinct. Colchici Sem., 



R- . Tinct. Colchici Seminis, 

Tinct. Belladonnse, 

Tinct. Aconiti, . . . . aa gj. 
M. Sig. — ttlyj every 6 hours. Remark- 
ably efficient. (Metcalf.) 



Tinct. Cimicifugae, 
Tinct. Belladonnae, 
Tinct. Aconiti, . . . . aa rtlxv. 
M. Sig. — ttlnj every 3 to 6 hours. 

{Metcalf.) 



< 



Scleroderma. 

Cod-liver Oil, our sheet-anchor, used internally and locally (B.). Electricity, 
is used successfully (B.) ; with stimulating inunctions offers the best prospect of 
improvement (Bulkley). 

Scrofulosis. 

Iodides, the Iodide of Ammonium when glandular enlargement ; that of Iron 
when debility and emaciation, a powerful and efficacious remedy; also in 
anaemia of scrofula, the syrup tt\,xx-3i, ter die (Wa.) ; disappointing, useful, in 
simple glandular hypertrophy (B.). Iodine, tinct. or oint. applied over scrofu- 
lous glands — take care not to increase inflammation (R.). Iodine and Iron the 
best remedies, but all medicines utterly useless without strict hygiene (A.). 

43 



674 SCURVY SEA-SICKNESS. 

Calcium, the chloride, in doses of gr. x-xx in milk after food, when glandular 
enlargement of neck and chronic diarrhoea. The phosphate of great use for 
sores (R.) ; is of eminent service as a palliative (Wa.) ; see Sulphides below. 
Spongia Usta, formerly held in high repute ; has fallen into perhaps unmerited 
neglect. Contains sodium iodide, magnesium bromide, calcium phosphate, and 
ferric protoxide, in small quantities (Wa.). Iron, ferrum and calcium phosphates 
combined give good results, also chalybeate waters (B.) ; must be long continued 
(R.). Sulphides, for sores, abscesses, suppurating glands ; gr. y 1 ^ or -^ of cal- 
cium sulphide every hour or two (R.). Coniine, gr. }4 to 3j almond oil, 
locally, two or three times a day to conjunctivae in " scrofulous " photophobia ; 
has proved very successful (P.). Cod-liver Oil, the best remedy to promote 
assimilation (B.j ; of great service in the various manifestations of this disease 
(R.). Stillingia. a domestic remedy, used with much success (B.). Capsicum, 
in scrofulous and fistulous ulcerations, a weak infusion becomes a useful stimu- 
lant (P.). Mezereum, strongly recommended (P.). Sarsaparilla, useful by reason 
of its tonic and alterative properties (P.). Hyoscyamus, the bruised leaves as 
cataplasm for scrofulous ulcers (P.). Phosphates, for mal-nutrition (B.). Prunus 
Virginiana, is found very useful in the hectic (P.). Chimaphila, holds a cer- 
tain amount of reputation as a useful remedy (P.). Tussilago, was employed 
by Cullen (P.). Gentian, is valued. As infusion a useful vehicle for chaly- 
beates, etc. (P.). Blisters, for scrofulous glands (R.). Grape-cure, renders 
much service (B.). Alcohol, no doubt as to its great value ; with cod-liver oil, 
or in small amounts at meals (Wa.). Phosphorus, eminently serviceable in 
scrofuloderma, gr. x in Ol. Olivae %}, doses of tr^v-x, thrice daily after meals 
(Broadbent). Aliment, raw or broiled meat, the latter for children. Abun- 
dance of fresh air and sunshine. Sea-air, sunlight, moderate exercise, and 
light digestible food are necessary. [Compare Cachexia, Gland's, Coxal- 
gia, Ophthalmia.] 

Scurvy. 

Citric Acid, used with great advantage, though inferior to lemon-juice (Wa.). 
Lemon- or Lime-juice, of the utmost value, both as preventive and a curative 
agent. Efficacy believed to be due to its potassium salts. Oranges highly 
useful (Wa.). Acids, especially vinegar, to prevent scurvy, in the absence of 
lime-juice or fresh vegetables (R.) ; dilute Muriatic Acid, gtt. v, thrice daily 
with juice of three lemons daily, vegetables and fresh meat (Da Costa). Po- 
tassium Chlorate, is probably a remedy of some value (Wa.) ; is not (W.). 
Cinchona, a decoction, or the dilute tincture with myrrh or the chlorates, a 
very useful gargle. Quinine, internally when much prostration, combined 
with mineral acids (Wa.). Alcohol, diluted, as gargle (R.). Atropine, hypo- 
derm, for salivation (R.). Alum, a solution in water with tinct. myrrhae ^ss, 
several times daily as lotion for ulceration of the gums (W.). Liquor Sodae 
Chloratse, gvj a d ^xij aquae, as a mild application to gums (Wa.). Dietetic 
Treatment alone required. Lemon-juice plays no essential part in the treat- 
ment. The full diet of an hospital, comprising fresh meat, vegetables, and 
milk, is generally sufficient. [Compare Cancrum Oris, Purpura.] 

Sea-sickness. 

Antipyrine, is successfully employed. Chloral, the most effective remedy ; 
gr. xv-xxx every four hours (R.). Staphisagria, has given relief (P.). Crea- 
sote, checks the vomiting (R.)- Chloroform, drop doses pure (R.) ; TTLij-v on 
sugar (B.). Atropine, hypodermically, gr. t ^q in epigastrium, will relieve (B.); 
g r - wo to 200 given with Strychnine, gr. ^ to g 1 ^ hypodermically, is really 
specific in most cases, and in some if given before sailing, will prevent for the 
whole voyage, though but one dose be administered (Giberson). Cocaine, 
quite efficient, the hydrochlorate in water I to ioo, of which ff\,iv-v on a bit of 
ice thrice daily (Otto). Morphine, gr. -^ to ^ hypodermically, will often relieve 
severe cases (B.) ; often fails (Wa.). Amyl Nitrite, by inhalation (B.) ; is 
strongly recommended, but must be cautiously used. Champagne, iced ; 



SEBORRHCEA SPERMATORRHOEA. 675 

tablesp. doses every quarter-hour (B.). Calumba, a few drops of the tincture will 
sometimes relieve (B.). Spinal Ice-bag, often successful (R.). Cocaine, is 
reported quite successful. Bromides, in full doses (Beard). [Compare Nau- 
sea, Vomiting.] 

Seborrhcea. 

Glycerin, especially useful ; with lead acetate, borax, zinc, diminishing secre- 
tion ; also acts efficiently when there is a want of sebaceous secretion (W.). Zinc 
Oxide, 3j, plumbi carbonat. 3j, cetacei ^j, ol. olivse q. s. Ft. unguent (B.). 
Oleate of Arsenic, is of benefit (Wa.). Mercury, an ointment of the white 
precipitate is serviceable on the scalp, with an occasional shampoo with tar soap 
or green soap in solution, followed later by mildly stimulating lotions (Bulkley). 
[Compare Acne, Pityriasis.] 

Sneezing. 

Arsenic, a drop of liquor arsenicalis three times a day in paroxysmal sneez- 
ing, allied to asthma (R.). Potassium Iodide, gr. x, several times a day (R.). 
Iodine, inhalations in paroxysmal sneezing, with itching of nose (R.). Camphor, 
in incessant sneezing, with profuse running from eyes and nose. The powder 
should be snuffed, or the alcoholic solution inhaled (R.). [Compare Catarrh, 
Hay -fever, Influenza.] 

Somnambulism. 

Potassium Bromide, will give decided relief in the somnambulism of children 
allied to epilepsy, often with squinting, which may become permanent ; generally 
the result of deranged digestion. The nightmare of adults will usually yield to 
the same drug (R.). [Compare Nightmare.] 

Spasmodic Affections. 

Aconite, ext. and int. for spasms not of a severe type ; Aconitine, as ointment 
in the most severe, as well as in the milder local spasmodic affections ; in angina 
pectoris, spasmodic asthma, cough, etc. (P.) ; in spasmodic laryngitis of good 
effect (R.). Camphor, in many forms said to relieve, as strangury, etc. (R.). 
Belladonna, of value for spasms of sphincter muscles, especially of pelvic organs 
(P.) ; atropine hypoderm. in local spasm (R.). Strychnine, of great value in 
spasmodic asthma (P.) ; also in tetanus, chorea, and epilepsy (Pf., S.). Vera- 
trine, as solution, brushed over lids once a day in painful spasmodic contraction 
of the orbicularis (Wa.). Opium, very useful as an antispasmodic, especially 
if given with a stimulant, as alcohol, ether, or chloroform (R.)- Ipecacuanha, 
in spasms of respiratory organs, of great value (P.). Chamomile Oil, in spasms 
of hysterical persons, in 4 to 6 tr^ doses, a very excellent remedy ; also useful in 
pseudo angina pectoris (P.). Lobelia, a valuable antispasmodic in cautious 
hands (P.). Lupulin, in gouty spasms (P.). Tobacco, in spasmodic asthma, 
and for relaxation of muscular spasms (P.). Sumbul, in gastric spasms is of 
use (P.). Cardamoms, are usefully employed in gastric spasms (P.). Ammonia, 
useful in children's colic (R.). Chloroform, inhaled for intestinal spasm (R.). 
Sulpho-carbolates, in flatulent " spasm," sometimes phosphorus better (R.). 
Mustard Poultice, an excellent counter-irritant in spasmodic affections (P.). 
[Compare list of Antispasmodics on page 28, and in this section the titles 
Angina Pectoris, Asthma, Chorea, Colic, Cough, Convulsions, Croup, 
Dysuria, Epilepsy, Gastrodynia, Hydrophobia, Hysteria, Laryngismus, 
Pertussis, Tetanus, Torticollis, Trismus.] 

Spermatorrhoea. 

Potassium Bromide, when plethora-erections normal, but persistent and 
teasing ; is harmful in debilitated states, or daily losses (B.) ; with cold sponging 
and use of a hard bed (R.)- Digitalis, 5j or ij of the infusion twice or thrice 
daily ; few remedies are more successful in arresting spermatorrhoea (R., P.) ; 



6/6 



SPINA BIFIDA — SPINAL IRRITATION. 



feeble erections, frequent emissions, cold hands and feet (B.). Cantharis, defi- 
cient tone of seminal vesicles, erections feeble, sexual feeling torpid ; tinct. gtt. 
ij-iij ter die (R.) ; with Iron internally in emissions (R.). Phosphorus, for the 
induced physical and mental debility ; also, hypophosphites of lime and soda 
(R.). Gelsemium, as anaphrodisiac, may be combined with Belladonna or 
Cimicifuga (B.). Nux Vomica, relaxation and atony (B.). Strychnine, in large 
doses, especially when impotence (R.). Quinine, has been recommended (R.). 
Belladonna, gr. % of extract with gr. jss zinci sulphat., three or four times a 
day, often successful in nocturnal emissions (R.). Atropine, relaxed genitalia, 
no dream or orgasm (B.). Camphor Bromide, has been useful (W.). Lupulin, 
is a good anaphrodisiac ; with Camphor, when a genital sedative is required 
(B.). Iron, the iodide, useful in anaemic cases (B.). Ergot, beneficial in relaxed 
state (B.). Hydrastis, is a useful injection, gtt. x of the fluid ext. through a 
urethral tube to the prostatic portion of the urethra (B.). Cimicifuga, useful in 
weak, relaxed conditions (B.) ; with hypochondriasis, very beneficial (P.). Silver 
Nitrate, a vesicating solution applied to perineum generally useful, and without 
danger (B.). Arsenic, when from weak and relaxed seminal vesicles. Kind 
Advice, frequently the best treatment, as this is often the phantasm of a morbid 
imagination. Bladder should be emptied after the first sleep. [Compare 
Emissions, also List of Anaphrodisiacs on page 47.] 



Prfscriptions. 



K . Potassii Bromidi, .... gj. 

Sodii Bicarbonat., . . . . gr. xv. 

Infusi Digitalis Jjss. 

Atropines Sulphat., . . . . gr. -^. 
M. Sig. — One dose, to be taken at bed- 
time. (Gross.) 



$. Tinct. Gelsemii, ^j. 

Tinct. Belladonna?, . . . spj. 
M. Sig. — 15 drops thrice daily. 



(B.) 



R- . Lupulini, gr. x. 

Pulv. Camphorge, . . . . gr. vj. 
Ext. Belladonnas, . . . . gr. ij. 
M. ft. pil. no. xij. Sig. — One pill thrice 
daily. (B.) 



R. Tinct. Cantharidis, . . . . gij. 
Tinct. Ferri Chlor., . . . ^vj. 
M. Sig. — 20 drops in water thrice daily. 
In impotence with spermatorrhoea, of great 
utility. {J/. C. Wood.) 



Spina Bifida. 

Iodine, injected into the sac, 3ss of tinct., or gr. ss, with potassium iodide gr. 
v, aquae 3j» nas cured numerous cases (B.) ; iod. gr. #, pot. iod. gr. ]/ 2 ad aq. 
3j (Wa.). Collodion, as a means of compression (B.). 

Spinal Concussion. 

Lead Water and Opium, as lotion over the seat of injury (A.). Leeches, if 
pain persistent (A.). 

Spinal Congestion. 

Ergot, gives excellent results (Brown-Sequard). Turpentine, hot epithems, 
useful (Wa.). Antiphlogistic measures, with rest and absolute diet ; wet cups 
or leeches to the column ; cool affusions to the spine while patient in a warm 
half-bath (Ros.). [Compare Meningitis.] 



Spinal Irritation. 

Aconite, as ointment locally (R.). Belladonna preparations, locally, gen- 
erally are better than Aconite (B.). Ignatia, in small doses diminishes irrit- 
ability of cerebro-spinal axis (Pf.). Strychnine, persistently, will ameliorate 
wandering neuralgic pains due to irritability of nervous system (B.). Ergot, 
large doses for congestion (Hammond). Conium, in functional derangement 
of the cord, with excessive irritability of the reflex function (Wa.). Firing, 



SPINAL PARALYSIS — STAMMERING. 6JJ 

sometimes very beneficial (B.). Electricity. An inverse galvanic current 
gives much relief (Hammond). Blisters, with hot-water bag to spine, large 
doses of strychnine, phosphorus, phosphoric acid, and opium, are the methods 
based upon the ansemic theory of the disease. Out of 156 cases 133 were 
thoroughly cured (Hammond). [Compare Meningitis, Myelitis.] 

Spinal Paralysis and Softening. 

Ergot, to starve the inflammation by occluding the spinal arteries (Ham- 
mond). Electricity, best; galvanic current from spine to nerves and muscles 
(Ros.). Treatment must be palliative and supporting only, in softening (H.). 

Splenic Affections. 

Mercury Biniodide, gr. j ad unguent. 5j> rubbed in before a hot fire, has 
given excellent results in chronic malarial enlargements of spleen (Wa.). 
Quinine, in simple malarial enlargement (B.) ; gr. xv or xx or more daily, one 
of the most effectual remedies (Wa.). Ergot, the most effective remedy for 
enlarged spleen (Da Costa). Ammonium Iodide, effective in chronic splenitis, 
with unguent, hydrarg. iod. rubri externally; also small doses frequently re- 
peated in all splenic derangements from malaria (B.). Iodine, locally in chronic 
forms (B.). [Compare Leucocyth^emia.] 

Sprains. 

Arnica, is very useful ; the infusion internally and externally (P.) ; the tinct. 
diluted as lotion is very effectual (Wa,). Aconite, the liniment to painful 
sprains often affords speedy relief (Wa.). Turpentine, the oil as a liniment 
(P.). Ammonium Chloride, in solution, as lotion, or with bread as poultice, 
to remove discoloration from sprains (W.). Rhus Toxicodendron, the tinct. 
3ss to Oj of water a good external application to sprains. Oil of Bay as 
stimulating liniment (P.). Cold Douche, salt may be added. The force must 
be regulated by the condition of the tissues (R.). Rest, the most essential 
measure, should be perfect. Warm fomentations, or cold affusion, opiates, 
and plain diet (D.). A roller bandage with splints, often required to secure 
rest of the part. 

Stains. 

Nitrate-of-silver Stains maybe removed by washing with Potassium Cyanide 
^ijss ; Iodine, gr. xv ; Water, ^iij ; or, after moistening the spots, drop on 
them a few drops of Tinct. Iodine, and wash out with a solution of Sodium 
Hyposulphite, 3ss-^j (B.). Blood-stains, if on dark-colored materials are 
best seen by an artificial light. After a few hours they become of a rusty, 
reddish-brown color, which they maintain for years. The microscope shows 
the characteristic corpuscles. These stains when on iron are difficult to dis- 
tinguish from rust ; the latter is not soluble in water, while blood is extremely 
so. Heat applied to the metal will cause the blood to peel off, unless the stain 
has been exposed long enough to have rust mingled with the blood. A solu- 
tion of blood in water, heated, forms a coagulum which is soluble in hot caustic 
potash, the solution thus formed is green by transmitted light, and red by 
reflected light. Menstrual blood cannot be distinguished from that resulting 
from a wound (Husband). 

Stammering. 

Vocal Training. The rhythmical method, the most successful ; the chief 
end in view is to regulate the precipitate, irregular form of respiration. Long 
continuance necessary, six months, a year, or more, in special institutions 
(Ros.). The patient mu$t be taught the use of language anew, treated with 
especial kindness, and never subjected to mockery or punishment. [See Potter 
on Defects of Speech, Lea Prize Essay, Philadelphia, 1882.] 



6/8 



STERILITY — STINGS AND BITES — STOMATITIS. 



Sterility. 

Aurum, cures sterility when dependent on chronic metritis or amenorrhcea 
or coldness, more certainly than any other remedy. Auri chlor. gr. -g 1 ^ (B.). 
Potassium Iodide, when due to syphilis (R.). Dilation of os and cervix care- 
fully when sterility depending on obstruction, with dysmenorrhcea (H.). Ster- 
ility is frequently associated with uterine displacement (Meadows) ; less often 
with atresia. In persons of good health may be caused by an acid discharge 
from the uterus, which kills the spermatozoa ; for this Vichy water internally 
and per vaginam, and alkaline baths (Charrier). Is due to aspermatism of the 
husband in more cases than generally believed (Gross). Many cases are due 
to blocking of the cervical canal with a morbid discharge from the cervical 
glands, and such may be relieved simply by repeated cleansing thereof with a 
cotton-wrapped probe or forceps. 



Stings and Bites. 

Ammonia or Alkalies, a weak solution, in stings of insects, to neutralize the 
formic acid (R.). Ammonia, as nervine stimulant in snake-bites, more useful 
than brandy or any other stimulant ; rr\,x-xx of liquor ammonias in water or 
wine, every half-hour or oftener ; also externally or hypodermically, i part to 
2 aquae into a vein (Wa.). Ammonium Carbonate, gr. v hypodermically, as for 
wounds by poisoned arrows. [See under Wounds.] Carbolic Acid, a weak solu- 
tion sponged over the body, to keep off mosquitoes (R.). Salicylic Acid, I to 19 
of Flexible Collodion, locally for bites of insects, allays pain at once, and only 
in rare cases is the neighboring tissue swollen. Mercury. The Bichloride, 1 to 
1000 of Flexible Collodion, is equally effective. Potassium Permanganate, in 
strong solution, 1 to 6, locally, is promptly efficient for all reptile-bites and 
insect-stings. If wound is small, make incision to enlarge it, and insert lint 
soaked in the solution. If a rattlesnake-bite, inject the solution hypodermically 
above the wound (Dupon). Viola Cucullata, the common violet, is used as an 
internal remedy in Pennsylvania for rattlesnake-bite, and is successful in a 
remarkable degree. The leaves are eaten, and a poultice of indigo and salt is 
at the same time applied to the wound. Arsenic, 1 part to 5 of black pepper, 
is the "Tanjore Pill," highly esteemed in India for bites of venomous snakes 
(Wa.). Chloride of Lime, a filtered solution injected into wound from snake- 
bite, successful in seventeen cases (Binz). Silver Nitrate, the sharpened stick 
applied to every sinuosity of the wound. Excision safer (Wa.). Sugar, applied 
to stings of wasps, said to relieve almost instantly (Wa.). Ipecacuanha, as poul- 
tice or paste, allays pain and irritation ; is regarded by some as almost specific 
(Wa.). Stimulants, in snake-bites, freely ; most important. Liquor ammoniae 
the best (Wa.) ; stimulants are indicated in snake-bites, but there is no remedy 
of any value (Gross). Sting, should always be removed if left in the wound ; 
pressing upon it with the barrel of a small key will expose it. [Compare 
Wounds.] 

Prescriptions. 

$. Carbo Vegetab., ft)j. 

Potassii Nitratis, 5 ij. 

Ac. Carbolici, ,1J SS - 

Persian Insect Powder, . . ^viij. 

Mucil. Tragacanth., q. s. 
To make fumigating pastilles for use 
against mosquitoes. 



R . 01. Picis Liquidse, 
01. Olivse, 
Ol. Hedeomse, . . 
Spt. Camphorse, 

Glycerini 

Ac. Carbolici, . . . 


. aa 3J. 

aa fy ss. 
. . . J?ij. 


M. Sig.— Shake well, 
mosquitoes, for fishermen 


T . ° J 

Lotion against 
and hunters. 



Stomatitis. 

Potassium Chlorate, locally and internally. Large (joses necessary (gr. x-xx) ; 
in ulcerative stomatitis of nursing women, and aphthae ; of no value in mercu- 
rial form (R.). Hydrastis, fluid extract locally in mercurial and aphthous 



STRABISMUS — SYCOSIS. 679 

stomatitis (B.). Carbolic Acid, concentrated, in glycerin, carefully, as a mild 
caustic in aphthous stomatitis (Wa.). Alcohol, Brandy-and-water an excellent 
lotion (B.). Acids, Mineral, pure Hydrochloric on pine wood to ulcers (B.). 
Eucalyptus, a decoction of the leaves an efficient local application (B.). Gly- 
cerin of Tannin, in ulcerative stomatitis (R.). Copper Sulphate, solution painted 
over edges of gums in ulcerative stomatitis ; generally dry alum better (R.). 
Alum, in ulcerative, applied dry with the finger several times a day, especially 
when disease affects one-half the jaw (R.). Salicylic Acid, to ease the pain of 
catarrhal stomatitis. One part (dissolved in sufficient alcohol) to 250 parts of 
water (R.). [Compare Aphtha, Cancrum Oris.] 

Strabismus. 

Belladonna, for the strabismus of encephalitis (P.). Atropine, with strong 
convex glasses, to suspend accommodation for months, or years if necessary ; 
may cure convergent strabismus in its earlier stages, in children of 3 years of 
age or younger (Green in C). Operation, required in most cases, especially 
when of congenital origin. Glasses, properly adjusted to sight, serve to 
strengthen the weak muscles in children, and to pull the axes right (Gould). 

Strophulus. 

Glycerin, locally, combined with bismuth, and digitalis (Wa.). Lancing the 
gums is proper (H.). 

Sunstroke. 

Water. Cold affusion when patient is stricken down unconscious (R.) ; abso- 
lute rest and quiet, free air, loose clothes. Potassium Bromide, in cold water 
enemata. Stimulants when frequent and feeble pulse. Chloroform, if convul- 
sions. Leeching, in stage of reaction (Wa.). Veratrum Viride, and Gelsemium, 
as sedatives, instead of stimulants, when pulse full and strong (Ely). 

Suppuration. 

Sulphides, small doses (gr. ss-j), frequently repeated, are very serviceable 
(B.). Calcium Sulphide, when ichor secreted instead of pus ; also arrests sup- 
puration, or if that is impossible will hasten maturation (R.). Quinine, recom- 
mended in profuse suppuration (R.) ; to sustain system when suppuration pro- 
longed (B.). Sarsaparilla, is very useful (P.). Phosphates, Parrish's to repair 
waste from suppuration (B.). Iodide of Manganese and Iron, the. syrup in 
cachectic states resulting from suppuration (B.). Alcohol, an excellent anti- 
septic dressing (B.). [Compare Abscess, Boils, Carbuncle, Pyaemia.] 

Surgical Fever. 

Aconite, quickly and repeatedly in early stages, during chill or soon after, 
the safest treatment (P.). Salicylic Acid, or Salicylate of Sodium, especially 
useful as an antipyretic (B.). Chloral, gr. xx-xxx of the hydrate every 2 hours, 
no better treatment (Wa.). 

Sycosis. 

Nitric Acid, ^j to Oj aquae, as wash, used frequently (R.). Boracic Acid, 
3jss finely powdered and incorporated with ^j of vaseline, is found most use- 
ful (Wa.). Mercury, citrine ointment has been extensively employed, also the 
oleate of mercury, both with good results (Wa.). Arsenic, the oleate is found 
beneficial, and the Solution of Arsenic and Mercury, Donovan's solution, inter- 
nally is highly useful. Mercurial Ointments are extensively employed (Wa.). 
Sodium Sulphite, Z] \ glycerini, ^j ; aquae, 3'uj ; locally, when of parasitic 
origin (Wa.). [Compare Condylomata, Mentagra.] 



i 



1 



680 SYNCOPE — SYNOVITIS — SYPHILIS. 

Syncope. 

Cinnamon, the oil, as a powerful stimulant, sometimes employed (P.). Alco- 
hol, as brandy, or wine, when heart suddenly enfeebled from fright, etc. (R.). 
Amyl Nitrite, in some forms, especially in anaemic subjects, its inhalation 
speedily restores consciousness (O'Neill). Atropine, gr. xjyo - !^ subcutaneously, 
the best means of resuscitation, there being no medicine which so promptly exalts 
the force and rapidity of the heart's action (Harley). Ammonia, internally, or 
breathed into the air-passages (R.) ; the carbonate as " smelling salts " (Wa.). 
Lavandula, the compound tincture (Wa.). Chloroform, internally, for hysteri- 
cal people, as cardiac stimulant (R.). Position, leaning forward, with head as 
low as possible (R.). Galvanization of pneumogastric (B.). Cold Water over 
the face, and volatile substances to the nose (B.). Cold affusion always (Wa.). 

Synovitis. 

Potassium Iodide, with iron and quinine, in syphilitic patients with consti- 
tution broken down (D.). Iodide, in chronic, painted around joint; the solu- 
tion injected into white swelling (R.). Quinine, and free stimulation in all 
cases of pysemic synovitis, such as occurs in acute rheumatism of gonorrhceal 
causation, occasionally in typhoid fever, and may from a trifling injury in 
strumous subjects. Mercury, and Morphine, the oleate locally (R.) ; an ele- 
gant and efficient application (B.) ; in syphilitic cases Mercury internally when 
acute symptoms have subsided (D.). Aconite, for pains in inflamed joints (R.). 
Silver Nitrate, locally, to vesication almost, often very beneficial (Wa,). Car- 
bolic Acid, injected into joint (B.). Alcohol, and water, equal parts, an excel- 
lent evaporating lotion (B.). Blisters, a flying blister every night in chronic 
synovitis (R.). Cod-liver Oil, in strumous cases (B.). Surgical Treatment. 
Splints to keep limb motionless in all cases arising from injury ; during acute 
stage splint should be fastened at some distance above and below joint, and 
not touch joint itself. Straight position, leeches to joint, or cupping near it; 
ice, evaporating lotions or hot fomentations. Blisters inapplicable until acute 
stage subsides (D.). If suppuration occurs the joint must be dealt with as any 
other abscess cavity (MacCormac). Heat, as fomentations or poultices in the 
acute form. Bandage, or Strapping, to cause absorption of fluid ; bandages 
(cold water) after alternate bathing with hot and cold water, in chronic. [Com- 
pare Coxalgia, Joint Affections.] 

Syphilis. 

Mercury, the mainstay in earlier and later stages ; the Protiodide in pills of 
gr. )/e each, one after each meal increased by one every third day, until teeth 
sore or bowels disordered, then drop two pills from each dose (Keyes). The 
best remedy for primary and secondary, not so in tertiary, or in chancroid; 
small doses are best, to stop short of ptyalism (B.). Blackwash, calomel or 
citrine oint. very useful in mucous sores, tubercles, and elevated indurations ; 
in syphilitic ozsena, psoriasis, rashes, condylomata, etc., the bichloride, gr. ij-v 
in ^j alcoholis, painted over syphilitic mouth lesions daily (Keyes). Mercury 
believed to be a true vital antidote against the virus (R.) ; used for at least two 
years can eradicate it (Keyes). Internal administration best because practical ; 
the two great preparations are the Bichloride and the Protiodide — of the former, 
the curative dose for a man is about }4. grain daily, for a woman ^ grain, below 
which the drug has no active effect on the disease ; — dose of the Protiodide is 
larger, — for a man about 2 grains, for a woman gr. 1^3 daily (Fournier). Nitric 
Acid, in secondary forms (R.) ; holds a high place as an internal remedy 
(Wa.) ; when sponginess of gums excessive, 3iv-^ij aq., teasp. 4 times daily ; 
also use locally (St.) ; as cautery for the initial lesion, the fuming acid, if done 
at all, should be early and thoroughly, followed by Blackwash locally on lint 
(Bulkley). Potassium Iodide, approached by no remedy in constitutional syph- 
ilis; also for mercurial cachexia, syphiloma of nervous system, and many dis- 
orders of syphilitic origin. Will certainly arrest ulceration of nares, palate, etc., 



SYPHILIS. 



68 1 



if given in large doses, gr. xx-3j every 4 hours (R.) ; is of little value in early 
stages ; in later should be combined with mercury (St.). Iodine, as gargle for 
ptyalism ; the tincture applied to syphilitic sores of the throat (R.); or gss of 
tincture to 3iv syr. fusci ; a teaspoonful well diluted ter die, after meals, when 
Pot. Iod. cannot be borne (St.). Iodoform, powdered and dusted over ulcers 
(B.). Aurum, after mercury and the iodides, in old cases of secondary and 
tertiary, ulceration of the throat, ozaena, phthisis, syphilitic bone-diseases (B.); 
its beneficial action incontestable (Tr.). Stillingia, with nitric acid in chronic 
cases of broken-down constitutions from mercury and iodides has been most 
satisfactory (B.). Cascara Amarga, is said to have remarkable powers as an 
alterative in syphilis, but to be useless if alcohol and tobacco are used at the 
same time. Sanguinaria, in secondary and tertiary, is held to be very useful 
(P.). Sarsaparilla, a most important remedy, as adjunct to, and in abuse of 
mercury (P.); with guaiac and mezereon, as the compound decoction of sarsa- 
parilla, in tertiary form (B.). See Guaiac, below. Belladonna, with mercurial 
ointment, for secondary ulcerations of rectum (P.) ; tincture Z'w ad ^ij aquae, a 
teaspoonful 4 times a day in water, instead of mercurials (St.). Iron, the 
iodide in constitutional syphilis, to promote constructive metamorphosis (B.) ; 
where anaemia exists (R.) ; the potassio-tartrate, gr. xv-xx, every 4 hours, 
especially in the gangrenous form (Otis). Guaiacum, in tertiary only ; or as 
vehicle for potassium iodide and mercuric chloride (B.). Carbolic and Salicylic 
Acids, locally to syphilitic abscesses, carbolic best (B.). Zinc Chloride, Iodide, 
Nitrate, locally to syphilitic ulcers (R.). Denutrition. The Arabic "hunger- 
cure" efficient, but unpopular (B.). Turkish Baths, or wet packing, amelio- 
rate and aid cure of constitutional syphilis (B.). Hygiene, is of the greatest 
importance in syphilis (Bulkley). Cod-liver Oil, remarkably improves condi- 
tion resulting from prolonged use of mercury and iodides, the syphilodermata, 
and squamae ; internally and by inunction (R.). [Compare Chancre, Con- 
dylomata, Ulcers, Ptyalism.] 

Prescriptions. 

R • Hydrarg. Chlor. Corr., 



R. Massae Hydrargyri, . 
Ferri Sulph. Exsiccat 
Extr. Opii Aquosi, . 
In pill, thrice daily. 



. gr. ij. 

• gr-j- 

• g r - %• 

{ Otis ) 



R . Hydrargyri Bichloridi, 

Ammonii Chloridi, . . aa gr. iij. 
Tinct. Cinchonae Comp., . ^ iij. 

Aquae, ^iij. 

M. Sig. — A teasp. thrice daily. Each 
5 contains gr. -^ of corrosive sublimate. 

(Bumstead.) 



R . Potassii Iodidi, g ij. 

Ammonii Carb., gss. 

Tinct. Cinchonae Comp., . . 3 iv. 

Glycerini, Jj. 

Syr. Aurantii Cort., . . . sjjss. 

M. Sig. — A teasp. in plenty of water 
after each meal. (Keyes.) 



R. Hydrarg. Chlor. Mitis., . . gij. 

Lycopodii, ^ij. 

M. Sig. — Use as snuff thrice daily, in 
lesions of the nostrils. (Diday.) 



Potassii Iodidi, 

Syr. Sarsaparillae Co., . . . 
M. Sig.—" The Three Eights, 
a. teasp. thrice daily. 



gr. viij. 
^viij. 

3 vii j- 
."—Dose, 



R . Hydrarg. Iodidi Rubri, . . gr. ij. 

Ammonii Carbonatis, . . . gr. xx. 

Potassii Iodidi 3 iij. 

Tinct. Gent. Comp., . . ad £ iv. 
M. Sig. — A teasp. in water alter each 
meal. (Fox, for the Mixed Treatment.') 



R. Hydrarg. Iodidi Rubri, . . gr. iij. 

Potassii Iodidi, ^ iij — vj. 

Tinct. Aurantii Cort., 

Syrup. Aurantii Cort., . aa ^j. 

Aquae, ^ viij. 

M. Sig. — A teasp. thrice daily after 
meals. ( Otis, for the same.) 



R . Hydrarg. Bichloridi, . . . gr. iv. 

Tinct. Benzoini, J|ss. 

Aquae Cologniensis, . . . %]. 

Aquae Rosae, ^ivss. 

M. Sig. — Apply locally with sponge to 
skin for 20 minutes. For squamous syphil- 
ides. (S. W. Gross.) 



682 TABES MESENTERICA TETANUS. 

Tabes Mesenterica. 

Lime, the chloride and phosphate (R.); the chloride is a powerful remedy if 
kept up (Wa.). [See Scrofulosis.] Iodine, by inunction with cod-liver oil 
(El.) ; locally over glands ; carefully, lest inflammation be increased (R.). Potas- 
sium Iodide in small repeated doses, valuable (Wa.). Mercury. Corrosive 
Sublimate with bark (gr. j ad gij tinct. cinchonas) after meals, for chronic gland- 
ular disease (D.). Phosphates, for malnutrition (B.). The hypophosphites act 
slowly but surely (Wa.). Iron and Iodine, in various forms are the most useful 
remedies in scrofulosis, but medicine is powerless without strict hygienic meas- 
ures (A.) ; the Iodide or Phosphate of Iron and Cod-liver oil," as for tubercle 
elsewhere (El.). Fel Bovinum, is worthy of trial, though at best a palliative 
(Wa.). Cod-liver Oil, is the best remedy to promote assimilation (B.) ; of great 
service (R.). Chaulmoogra Oil, is of benefit, used by inunction (Wa.). Aliment. 
Raw meat, cream, chocolate, and cocoa, are valuable nutriments in these cases 
(El.). Peptonized foods are of inestimable value (Wa.). Hygiene. Change of 
air, especially to sea-air, is all-important (El.). [Compare Scrofulosis.] 



Taste, Disordered, 

Mercury or Podophyllin, as purgative for cankery taste unconnected with 
alcoholism ; or half-glass of pure cold water daily half an hour before break- 
fast (R.). 

Teeth. 

Potassium Iodide, in doses of gr. x, thrice daily, often cures looseness of 
teeth from periostitis of alveolar processes (Wa.). Iodine, tincture painted over 
gums close to the teeth when the gums begin to recede ; also to remove tartar 
(R.). Cinchona, powdered bark often used in tooth-powders (R.). Collodion, 
on cotton, as stopping for carious teeth (P.). Liquor Sodse Chloratae, gvj ad 
^xij aquae, a highly useful application in fetid discharges from carious teeth 
(Wa.). [Compare Dentition, Odontalgia.] 

Testicles. 

Mercury, the ointment, locally in indurations and enlargements of testes 
(Wa.). Corrosive Sublimate, with cinchona or sarsaparilla in sarcocele (D.). 
Water, cold applications in neuralgia of testes, with tonics and neuralgic treat- 
ment generally (D.). Suspensory Bandage, with rest, in many affections of 
the testes (D.). [Compare Hydrocele, Orchitis, Varicocele.] 

Tetanus. 

Strychnine, of decided service (P.); cured 8 cases of traumatic form, in 
doses of gr. -^ to % (S.) ; is conclusively curative, especially in chronic and 
spontaneous, rather than in traumatic. Strychninae Sulphat., gr. -£$ to -^ (B.). 
Aconite, has benefited many cases (P.) ; its success warrants further trial (W.). 
Belladonna, successfully used in many cases ; the extract, internally, and 
locally to wound (Wa.) ; gr. T ^ atropine injected into muscle (B.) ; bleeding, 
vapor-baths, and large doses of belladonna have cured tetanus (Tr.). Nico- 
tine, by rectum or hypodermically, appears to be useful in many cases (R.) ; 
much evidence for it as the best remedy (P.) ; effective but dangerous (B.). 
Physostigma better (Wa.). Potassium Bromide, not less than ^ss during the 
day, with chloral at night as a hypnotic ; out of 21 cases but 3 died. Its physio- 
logical action indicates it to be the best remedy known (W.). Chloral, in 
large doses (gr. xx) no remedy more effectual (B.) ; has sometimes cured (R ) ; 
best used in combination with potassium bromide (W.). Gelsemium, cured 
several cases (P.). Hyoscyamine, gr. -^ gradually up to gr. -^ s , ameliorates 



THIRST THROAT, SORE. 683 

(B.). Cocaine. A mixed solution of Cocaine and Morphine, of each 5 per 
cent., 3 syringefuls hyyodermically, immediately relieved and finally cured 
a bad case of idiopathic tetanus unrelieved for 3 days by chloral, morphine, 
etc. (Lopez). Physostigma, has been used with excellent results (P.) ; the fluid 
extract by mouth if possible, at very beginning, and must be pushed until just 
short of arresting breathing (B.) ; evidence is discrepant (W.). Apomorphine, 
may prove antagonistic (P.). Curare, hypodermically, has much 3 evidence for 
its power (P.). Cannabis Indica, used with marked success in traumatic form 
(P.). Difficult to obtain an active extract (W.). Anaesthetics. Ether, to relieve 
pain (B.). Chloroform, in small and frequently repeated doses, also by fric- 
tion, has been useful in many instances (Wa.), Amyl Nitrite, used in 3 cases 
with marked benefit as spinal sedative (W.) ; has been used with success (R.). 
Morphine, hypodermically, deeply into tetanized muscles (B.) ; of no value 
(Wa.). Conium, is indicated, but has not been successful (B.). Water. 
Warm baths, and cold, or ice, afford only temporary amelioration (B.). Spinal 
Ice Bag, extremely useful (R.). Division, or stretching of any nerve-trunk 
connecting wound with spinal cord. [Compare Spasms.] 

Thirst. 

Acid Drinks, promote secretion of saliva in fevers (R.). Tepid Drinks, are 
useful in the thirst of diabetes (R.)- I ce > sucked, allays thirst (R.). 

Throat, Sore. 

Aconite, when temperature high, half-drop doses of tincture, every % hour 
for 2 hours, then every hour, will almost certainly prove efficacious (R.) ; valu- 
able in ordinary sore throat (P.). Belladonna, is very admirably adapted to 
the treatment of ordinary sore throat. When much fever, combine with Aco- 
nite (R., P.) [See Catarrh, Acute.] Mercury, in acute tonsillitis, which 
see (R.). Nitre, dissolved in mouth, to abort a sore throat (Wa.). Tannic 
Acid, as powder, gargle, spray (P.). Glycerin of Tannin, after acute inflamma- 
tion ; in ulceration of aphthous sore throat daily when tendency to catarrh (R.). 
Ipecacuanha, the wine as spray, in non-inflammatory sore throats and hoarse- 
ness from congestion of vocal cords (R.). Capsicum, 3»j of tincture to 0% 
aquae as gargle, in some sore and malignant sore throats (R., P.). Potassium 
Chlorate, in grain doses every half-hour (A. A. Smith). Alum, dry, or in solu- 
tion (R.). Myrrh, as gargle in ulcerated sore throat (P.). Cimicifuga, in 
simple (R., P.), and malignant forms when mucous membrane dry and spotted 
with inspissated mucus (R.). Arsenic, in medicinal doses, in sloughing of 
throat or malignant sores (R.). Iodine, tincture, locally to sores, whether 
syphilitic or not (R.). Rhus Glabra, a very efficient gargle, a decoction, gj- 
ad Oj, boiled to Oj(, with Potassium Chlorate, ^ss (W.). Nitric Acid, undi- 
luted to sloughs (R.). Silver Nitrate, locally, in early stage of inflammation 
may cut it short (R.). Sulphurous Acid, by inhalation, spray, or fumigations 
for malignant sore throat, scarlatinal or otherwise (R.). Water, cold compress 
nightly, to harden the throat when tendency to catarrh (R.). Ice, constantly 
sucked (R.). [Compare Tonsillitis, Pharyngitis, and formulas for Gargles, 
on page 468.] 

Prescriptions. 

R . Hydrarg. Bichlor., . . . . gr. iv. 
Alcoholis, !| ij. 

Solve, et adde — 
Decocti Cinchonse, 
Mellis Rosse, 



Tinct. Myrrhse, ... aa ^ ij. 

M. ft. gargarysma. Gargle, to be diluted 

if too severe. For ulcerated forms of 

syphilitic sore throat. [Sir Ckas. Bell.) 



R . Tinct. Guaiaci Ammon., 

Liq. Potassse, .... aa Sjiij. 
Tinct. Opii, 5?ij. 

Aq. Cinnamomi, ... ad ^viij. 
M. ft. gargarysma. Sig. — To be used 
every hour, as a gargle, in clergyman's 
sore throat. [Garner.) 



684 TIC DOULOUREUX — TINEA FAVOSA. 

Tic Douloureux. 

Arsenic, cures, influences nutrition (B.). Phosphorus useful ; gr. yi^ to ^ 
every 3 hours (R.). Belladonna, Aconite, Spigelia, Iodides, Morphine, Cimici- 
fuga, Gelsemium, Turpentine, Galvanism (B.). [See under Neuralgia.] 
Croton- Chloral, palliative in doses of gr. v every ]/ z hour till gr. xxx taken 
(W.). Salicylates, in large doses, cured a case of 12 years' standing. Stramo- 
nium, gr. % to Yz every 3 or 4 hours for 4 or 5 doses, often affords decided 
relief; stop if narcotic symptoms appear (P.). Laurocerasus, sometimes 
removes (P.). [Compare Hemicrania, Neuralgia.] 



Tinea Circinata — (Ringworm of the Body). 

Mercury, the bichloride, 1 part to 250 of water, as parasiticide solution, after 
depilation (A.). [See also T. Tonsurans.] Carbolic Acid, a very efficient 
application ; gj ad ^j glycerini, locally (B.) ; or equal parts of Carbolic Acid 
and Glycerin, is a very efficient application. Sulphurous Acid, better and 
safer (A.) ; must be fresh to be of use (Bulkley). Cocculus Indicus, the decoc- 
tion locally, after washing the skin well (P.). Oil of Cade, the best depilatory 
known (A.). Arsenic will not cure, but may do service as a nerve tonic or an 
improver of nutrition, in connection with other remedies (Bulkley). Cuprum 
Acetate, gr. x ad ^j adipis, as ointment, is very effective (B.). Sodium Hypo- 
sulphite, %} ad ^xij aquae, locally, used by Dr. Tilbury Fox. Mercury. Calo- 
mel ointment (gj ad ^j) useful (B.). Hydrarg. nitrate as strong citrine oint- 
ment, rubbed in twice daily, often effectual. Hydrarg. oxid. rubrum, as oint- 
ment, often cures ringworm on body or limbs, when other remedies fail (Wa.). 
Cocculus, ointment from kernels, or decoction (P.). Iodine, liniment once 
applied (R.) ; with oil of tar (1 to 4 of latter) locally, is excellent (Wa.). 
Kamala, used locally by the Hindoos (P.). Tar Ointment, is used with good 
effect (P.). Acetic Acid, applied to cut it short (R.). Cod-liver Oil, a power- 
ful auxiliary in weakly and cachectic subjects (Wa.). Diet and Hygiene, are 
important. Food should be nutritive and abundant, especially animal fats. 
Daily baths, out-of-door exercise. Fungus, is the Tricophyton tonsurans (A.). 



Tinea Decalvans — (Alopecia Areata). 

Parasiticide Lotions, must be used after epilation, and washing of head 
daily with soft or black soap. Stimulants (as Collodium with Ether Cantha- 
ridalis, equal parts), after fungus is destroyed (A.). Tonics are necessary 
especially to the nervous system (Bulkley). Fungus — Microsporon Audouini 
(A.) ; but I have- never seen it, though having made repeated and thorough 
searches (Bulkley). 

Tinea Favosa — (Favus). 

Mercury. Hydrarg. chlor. corr. gr. xx ; cerat. simplicis gj ; efficient when 
used early (B.) ; or gr. ij ad ^j aquae after each epilation (R.)- Sulphurous 
Acid, Sulphites, and Hyposulphites, as parasiticides. R. Sodii hyposulphitis 
^iij ; ac. sulphurosi dil. ^ss; aquae q. s. ad ^xvj (Startin). Carbolic Acid, Cod- 
liver oil, locally (B.). Oils, to facilitate removal of scabs ; head to be greased 
freely to prevent spreading. A mild mercurial pomade, or quinine in glycerin 
best (R.). Cleanliness, and free use of soap and water, is a sine qua non, 
and in some cases of tinea may be alone sufficient to produce curative results. 
Isolation of person, and brushes, towels, etc., necessary to prevent infection. 
Fungus — Achorion Schonleinii (A.) ; a very rare affection in this country 
(Bulkley). 



TINEA TONSURANS TONSILLITIS. 685 

Tinea Tonsurans — (Ringworm of the Scalp). 

Mercury. Hydrarg. chlor. corr. gr. xx ad ^j unguent, simplicis, an effective 
application when used early (B.) ; must be employed with great caution. 
Sulphurous Acid, with glycerin (R.). Carbolic Acid, 3j ad ^j glycerini (B.). 
Viola Tricolor, the leaves are employed in Italy for tinea capitis (P.). Cocculus 
Indicus (P.)'. [See T. Circinata.] Potassium Sulpho-cyanide, ^ss with ^ j 
glycerini, ^viij aquae, as lotion (R.). Iodine, 5ij ad gj of oil of wood tar (R.). 
Arsenic Iodide, the best constitutional remedy ; gr. ^ increased to gr. %. for an 
adult: gr. ^q to ^ for children, with alkaline lotions locally (Wa.). Lead, in 
chronic porrigo capitis ; the ointment of the iodide (B.) ; will complete a cure 
after alkaline lotions (Wa.). Fungus — Tricophyton tonsurans (A.). [Compare 
Tinea Circinata.] 

Tongue. 

Potassium Chlorate, gr. v internally and 3j-ij ad Oj aquae locally ; in ulcers 
of tongue (Wa.) ; also in rawness of tongue in advanced phthisis. Potassium 
Iodide, in syphilitic ulcers of tongue (D.) ; and in hypertrophy (A.). Potas- 
sium Bromide, Z) to ^vj water as wash, may soothe morbid sensibility of the 
tongue (A.). Borax, gr. xl ; glycerini £j ; aquas %'w. As application in 
cracked tongue (Wa.). Iodine, the tincture locally by a fine brush, or as a 
gargle with 7 or 10 parts of water and some honey, has given uniform success 
in malignant ulcers (Wa.). Conium, thought to act specifically with benefit 
in ulcer of the tongue (Wa.). Cinnamon, the oil as a powerful stimulant in 
paralysis of tongue (P.). Ginger, Cochlearia, Pyrethrum, as gargle ; Cloves, 
Mezereon, Pepper, as masticatories, in paralysis (P.). Fraenum, should be 
divided in tongue-tie ; use blunt-pointed scissors, directing the points down, 
close to the jaw, so as to avoid wounding the ranine artery (D.) ; better to 
cut as little as possible, and that directly backwards, as the artery of the frae- 
num may proceed from the sublingual (Holmes). [Compare Glossitis, Ran- 
ula.| 

Tonsillitis. 

Aconite, when accompanied by fever and elevated arterial tension, relieves 
greatly ; gtt. ss-j every ^-hour or hour (B.) ; every X" nour f° r 2 hours, 
then every hour, will almost certainly prove efficacious (R.). Belladonna, of 
surprising efficacy ; gtt. v of tinct. every 3 hours in ^ss aquae (P.). Mercury, 
often speedily removes. Calomel, gr. -^V. or hydr. cum creta, gr. \ every 2 
hours ; not in chronic forms (B.); gr. x / z of gray powder every hour when ton- 
sils almost meet, has marked effect. The oleate of mercury and morphine in 
obstinate and painful tonsillitis (R.). Silver Nitrate, locally may abort, if 
applied early (R.) ; the solid stick, once thoroughly applied in first stage, rarely 
fails to prevent suppuration (Howard). Guaiac, disagreeable, but very effec- 
tive (P.) ; ^ss doses of tincture every 4 hours has remarkable power ; should 
be given in emulsion with mucilage or yolk of an egg (B.) ; makes an excel- 
lent gargle, see page 468 for formula. Tinctura Guaiaci and Glycerin, equal 
parts, in teaspoonful doses every hour or two, gives excellent results in acute 
tonsillitis. Opium, gr. v-x of Dover's powder at bedtime, is in many cases 
curative (Shoemaker). Cocaine, in 10 per cent, solution, locally, at intervals of 
15 minutes, removes pain at once and promotes resolution. A very efficient 
application in 5 or 10 per cent, solution, but causes temporary paralysis of pala- 
tal muscles, so that liquids regurgitate through nose (Boeckel). Alum, dry or 
in solution (R.). Potassium Iodide, locally (gr. j-v-^), is useful (B.). Potas- 
sium Chlorate, in grain doses every half-hour, very efficient (A. A. Smith). 
Capsicum, the dilute tincture in a gargle, or in powder applied on a swab, is 
useful in severe tonsillitis, especially in that accompanying scarlatina (W.). 
Quinine, gr. x-xv will sometimes abort (B.). Tannic Acid, is useful (P.) ; as 
gargle, see page 468. Ice and wet pack, extremely grateful (B.). Cold Wet 



686 TONSILS — TORTICOLLIS — TRISMUS. 

Compress, nightly, useful (R.). Incision, of the tonsils gives immediate and 
marked relief in all cases, especially those which are not amenable to ordinary 
treatment. Sodium Bicarbonate, locally by wetted finger to surface of tonsils 
every five minutes for ^-hour, then every hour during the same day, will pre- 
vent necessity for lancing (Lyon Medical). 



Prescription. 



\}c . Tinct. Aconiti % ss. 

Tinct. Guaiaci, . . . *. . *ss. 

Syr. Zingiberis, Jjss. 

Syr. Simplicis, ^ij. 



M. Sig. — 3 ss— ij , every 2 hours accord- 
ing to age. In severe cases, with high 
fever, bounding pulse, severe headache. 

(Shoemaker.) 



Tonsils, Enlarged. 

Ammonium Iodide, gss in ^j glycerin, applied every night by a camel's-hair 
brush, very efficacious (Wa.). Baryta Iodide, in hypertrophy of the tonsils, 
effects a rapid diminution in their size, even when indurated for years (Hale). 
Liquor Ferri Perchloridi, 3j-ij ad §j, painted over tonsils twice daily, is one 
of the most effective astringents (Mackenzie). Aluminium Sulphate, a satu- 
rated solution applied daily by a brush, as a mild caustic (W.). Ergot or Ergo- 
tine, injections into tonsils (Meigs). Zinc Chloride, as caustic, the most efficient 
and least annoying method ; a saturated solution applied on a wire cotton- 
holder to each crypt and held there a few seconds ; a few applications will 
shrink the gland in a week. Tannin, a strong solution touched daily to tonsils 
(H.) ; a few r sips of a saturated solution (^ss in giij aquae) slowly sipped, will 
stop bleeding, if profuse (A.) ; gr. xx to ^j aquas, hypodermically, as in nasal 
polypus. Silver Nitrate, touched daily to tonsils, will sometimes make them 
shrink (H.). Catechu, a serviceable astringent gargle; the infusion %vj with 
tincture of kino %\), as gargle (Wa.). Oxgall, locally, is praised (Wa.) ; is of 
real utility (W.). Citric Acid, rubbed daily to tonsils, is highly praised in 
enlargement thereof. Excision of a part of tonsil (H.). Mackenzie's double 
guillotine removes both tonsils at once. Hemorrhage seldom happens; ice 
will generally check it (A.). Surgical measures should receive unprejudiced 
consideration, as the medical treatment is tedious in the extreme. 

Tonsils, Ulcerated. 

Coptis, the infusion as a gargle (B.). Sulphurous Acid, dilute, locally by 
spray, or a solution of sulphite of sodium in water (3j-^j) (B,). Potassium 
Iodide, will arrest syphilitic ulcerations at once (B.). Carbolic Acid, a 5 per 
cent, wash with tincture of myrrh, a good application by sponge to throat (Wa.). 
Cimicifuga, a decoction of the root as a gargle (Wa.). 

Torticollis. 

Cimicifuga, has curative efficacy (P.). Capsicum, a handful of the crushed 
pods infused for 36 hours in a pint of hot or cold water, and applied on lint 
covered with gutta-percha (R.) gives striking results (Wa.). Opium, as lini- 
ment with friction, or an opium plaster, is often serviceable (Wa.). Galvaniza- 
tion of affected muscles, and faradization of opposed ones quickly relieves (B.). 

Trismus. 

Aconite (A.), Atropine (R.), hypodermically. Cannabis Indica, has been used 
successfully in trismus neonatorum (B.). Opium, rti^ doses of laudanum, with 
castor oil and warm bath, in trismus infantum. 'Treatment of any kind seldom 
effectual (D.), never (El.). Ether, Chloral, Gelsemium, Physostigma (B.). [See 

Tetanus.] 



TUMORS TYPHOID' FEVER. 68? 

Tumors. 

Mercuric Bromide, in }4 gr. doses, has benefited abdominal tumors (Wa.). 
Chloroform, in diagnosis of abdominal tumors when deep-seated, and when 
walls of the belly are hard and rigid ; also in phantom tumors (R.). Pepsin, 
hypodermically, to dissolve. Hyoscyamus, the leaves as cataplasm or fomenta- 
tions to painful tumors, afford great relief (Wa.). Electrolysis, employed with 
more or less benefit in sebaceous, lipoma, bronchocele, enlarged glands, etc. 
(Wa.). Iron, the liquor ferri perchloridi is found to be valuable as a curative 
application to fungous or hemorrhoidal tumors (Wa.). Galbanum, as plaster to 
indolent, non-malignant tumors, to diminish or cause their absorption (Wa.). 
[Compare Cancer, Cysts, Glandular Enlargement, Goitre, Polypus, 
Uterine Tumors, Wen.] 

Tympanites. 

Turpentine, often greatly benefits (P., Wa.) ; £>j every 6 hours in tympanites 
of typhoid, with prostration but without diarrhcea (R.). Asafcetida, in hysteri- 
cal, internally or as enema, beneficial (P.) ; also in that of fever (Wa.). Capsi- 
cum, gr. ss-ij, every 4 hours (P.). Cocculus Indicus, a few doses of tincture will 
often succeed in the tympanites of peritonitis and enteric fever (P.). Ginger, 
with drastic purgatives (P.). Aspiration, in extreme cases and as a last resort. 
[Compare Typhoid Fever, Peritonitis.] 



Typhlitis. 

Opium, of undoubted curative power (B.). Purgatives, are inadmissible; 
Epsom salts may be used, but no drastics (B.). Leeches, should never be 
omitted when tenderness and fever begin (B.). Ice-bag, over the swelling (B.). 



Typhoid Fever. 

Baptisia, is very useful in the early stage (W.). Mineral Acids, are very 
useful generally, especially HC1 acid (Wa.). Nitro-hydrochloric Acid, is to be 
preferred over all other plans of treatment, 20-drop doses in simple elixir; Sul- 
phuric is useful for intestinal hemorrhage (Da Costa). Sulphurous Acid, is 
highly praised by Dewar, and has real antidotal power ; TVLijss-rt\xx every 4 
hours according to age, continued for a week or ten days, until the patient's 
complaints show him to be saturated. If diarrhcea be present, add Sulphuric 
Acid and Opium (Wilks). [See formulae below.] Opium, small doses at night, 
for insomnia with delirium ; also as injection for the diarrhcea (R.) ; in one case 
when vital powers seemed hopelessly depressed, gr. }4 opii caused, improve- 
ment (Wa.) ; for spreading tenderness (peritonitis), give 10-minim doses of the 
deodorized tincture, also gr. j in suppository every four hours (Da C). Vera- 
trum Viride, to reduce temperature (R.) ; delirium ferox (B.) ; strongly recom- 
mended (Wa.) ; its efficacy difficult to believe (S.). Cinnamon, efficiently 
used to abort the disease. [See ante, page 188.] Potassium Bromide, is as 
much a specific for typhoid fever as quinine sulphate is for ague, aborting the 
fever in 8 or 10 days (Hawkins). Carbolic Acid, 3j, with Tincture of Iodine 
3ij, of which tt\J-iij every 2 or 3 hours is a very good plan of treatment (Da C). 
Turpentine, invaluable, when hemorrhage and extreme tympanites (P., R.) ; 
rr\,xxx-lx in starch mucilage, tt\,x of liquor opii (P.) ; tt\,v-x frequently for hemor- 
rhage or tt^x every 2 hours in advanced stage, with dry tongue (R.) ; coma, 
stupor, etc. ; often arouses the vital powers (Wa.) ; n\,vij with gr. ^g of morphine ; 
of especial value when marked fever and congested lungs, as well as for the 
tympany (Da C). Chloral, is the best drug for nervous symptoms, but must 
not be used when the heart is weak (Da C). Arnica, highly extolled : its 
"picture" shows definite powers in this disease (P.) ; small doses in asthenic 



688 



TYPHOID FEVER. 



conditions (B.) ; when vital powers greatly depressed (Wa.). Belladonna, con- 
tracted pupils ; low, muttering delirium (B.); thought to counteract the poison 
of typhoid ( Wa.). Mercury, corrosive sublimate gr. T ^ every 2 or 3 hours for 
the diarrhoea. Calomel in small doses at onset (R.) ; gr. x in one dose the first 
day, gr. iij per diem for 3 or 4 days, the German "specific treatment" (B.). 
Bismuth, gr. x-xxv of the subnitrate with gr. %-] of Opium every 3 hours for 
the severe diarrhoea (Da C). Ergotin, gr. ij-vj hypodermically, or Z] of the 
fluid extract of Ergot, for intestinal hemorrhage (Da C). Tartar Emetic, with 
opium, when wakefulness and delirium. Minute doses (gr. ^), frequently, are 
of great service (B.). Antimony cuts the disease short with such certainty that 
it is almost doubtful whether the lesion of typhoid is specific or is not rather 
incidental or adventitious (Surgeon-Major Lawrie) ; should be given with 
cardiac tonics. Digitalis, of value in many cases as a sustainer of heart 
power, but may be dangerous in the later stages (Anstie, Murrell) ; used by the 
Germans when there is no cardiac weakness. Gr. xj-xxij, as antipyretic, over 
a period of 36 hours (P.). Quinine, may have efficacy in typho-malarial ; is 
less effective as the typhoid element predominates ; useless in purely continued 
fevers (B.) ; is justly abandoned, but may be used to maintain thfe circulation, 
in tonic doses, gr. vj-x in the 24 hours (Da C). Antipyrine, for hyperpyrexia, 
also Thymol, gr. ss-ij in solution (Da Costa). Phenacetine, extensively used 
for the pyrexia. Serpentaria, useful when much depression exists. Cautiously, 
if intestines at all irritable (B.). Hydrastine, when copious sweats (P.). Lead 
Acetate, with opium for the purging (R.). Also Alum (R.). Ergot, for intes- 
tinal hemorrhage, hypodermically, if symptoms urgent (R.). Sodium Chloride, 
should not be withdrawn from the food (Wa.). Aromatic Spirit of Ammonia, 
for great accumulation of mucus in the throat (Da C). Copper Sulphate, gr. 
-^2, with Opium, gr. ^, for the diarrhoea (Da C). Strychnine, is the remedy for 
the functional palsies (Da C). Purgatives, only the very mildest, and they 
with the greatest caution (Wa.). Water, a most important agent. Cold baths 
when temperature above 102 (B.) ; in mild cases, cold wet compresses or wet 
sheets, or washing with cold water; in severe cases, affusion, shower, or general 
cold bath, 50 to 55 Fah., or better 95 cooled gradually to 6o° (R.). Medicine 
will never abort a case of true typhoid; its natural duration is from* 28 to 30 
days (Sir William Jenner). Stimulants, freely, with quinine, for pysemic cases, 
showing joint complications. See under Synovitis. Aliment. Milk alone, 
or alcohol with milk, eggs, broth (B.). Coffee, a better stimulant than alcohol 
(P.). Alcohol is needed to sustain the heart's action (Da C). Milk must be 
used with great caution, if the curd be undigested great evils arise ; give essence 
of meat alone (Sir William Jenner). Avoid the extremes; an absolute milk 
diet required if intestinal symptoms are grave ; no solid food until health is 
restored fully ; a scalded-milk diet exclusively maybe depended on. Adju- 
vants, water, especially 'the abdominal compress, cleanliness, ventilation, 
absolute rest and quiet. Discharges should be received in vessels containing 
carbolic acid or a solution of corrosive sublimate, and buried instantly. [Com- 
pare Hemorrhage, Intestinal, Rectal Ulceration, Tympanites.] 



Prescriptions. 



R . Ac. Sulphurosi, 3 ij . 

Syr. Aurantii, 3 iij. 

Aquse, ad ^vj. 

M. Sig. — One-sixth every 4 hours. 

(miks.) 



& . Ac. Sulphurosi, rnjcv. 

Syr. Aurantii, £iij. 

Aquoe, ad %]. 

M. Sig. — For infants, one sixth every 4 
hours. ( Wilks.) 



R. Tinct. Iodi, 

Ac. Carbolici, . . . . aa p. aeq. 
M. Sig. — gtt. j-ij every 4 or 6 hours. 
In typho-malarial fever. 

(Bartholow.) 



R. Ant. et Potassii Tartrat., .gr. j-ij. 

Morphinse Sulphat., . . . gr.jss. 

Aquae Laurocerasi, .... j;j. 
M. Sig. — A teasp. every 2, 3 or 4 
hours. (Bartholotv.) 



TYPHUS FEVER ULCERS AND SORES. 



689 



R. Ac. Sulphurosi 5jij. 

Ac. Sulphur. Dil., . . . . ^ij. 
Tinct. Opii Deodor., . . . rr^xx. 

Syr. Auiantii, J^iij. 

Aquae, ad % vj. 

M. Sig. — One-sixth to be taken every 
4 hours. ( Wilks.) 



R . Ac. Sulphurosi, TT\, XV - 

Ac. Sulphur. Dil., .... TT\,xv. 

Tinct. Opii Deodor., . . . mjj. 

Syr. Aurantii, giv. 

Aquae ad 3J. 

M. Sig. — For infants, one-sixth to be 
taken every 4 hours. ( Wi/ks.) 



U. Quininae Sulphatis, . . gr. x. 

Ac. Hydrochlor. Dil, . . . 3 ss. 

Vel Ac. Sulphur. Dil., . . . . % ss. 

Syr. Aurantii, ^j. 

Aquae Carui, ad Jvj. 

M. Sig. — A tablesp. in an equal quan- 
tity of water, every 3 or 4 hours. 

{Mure hi son.) 

Typhus Fever. 

Phenacetine, extensively used for the pyrexia. Baptisia, is said to have 
proved very useful (W.). Belladonna, to cleanse and moisten the tongue; 
controls the delirium, slows and strengthens the pulse, reduces the tempera- 
ture, shortens course of disease (R., P.). In the early stages, relieves severity 
of symptoms (P.) ; contracted pupils (B., Wa.). Arnica, very highly extolled 
(P., Wa.). Hyoscyamus, mild brain symptoms (PT). Opium, fulfils many 
important indications ; never when contracted pupil (Wa.). Mineral Acids. 
Hydrochloric, nitric, sulphuric ; their use recommended in all countries (Wa.). 
Tartar Emetic, with opium in the delirium with insomnia (R.). [See Typhoid.] 
Chloral, to produce sleep, and allay violent delirium (R., Wa.) ; its use has often 
been followed by amelioration of the symptoms (Wa.). Antipyrine or Quinine, 
as antipyretics, it being more necessary than in typhoid to keep the tempera- 
ture wfthin safe limits (B.). Podophyllin, gr. Ye-% as mild laxative at onset, 
when constipation, congestive headache, biliary derangement (P.). Digitalis, 
in large doses, a favorite remedy in Germany (P.). Rhatany, as tonic, in ad- 
vanced stages (P.). Serpentaria, in low stages, delirium, watchfulness ; tongue 
dry and brown, or black. Combine with ammonium, sesquicarbonate (P.) ; 
given occasionally to excite diaphoresis, and support the vital powers (Wa.). 
Camphor, a remedy of considerable value ; contraindicated when flesh-red 
tongue, tender abdomen, diarrhoea (Wa.). Purgatives. [See Typhoid Fever.] 
Coffee, better than alcohol for the adynamia (P.). Stimulants, are not needed 
under the use of mineral acids and a supporting diet, in many cases (Wa.) ; 
are needed sooner than in typhoid, as the adynamia is more profound and 
appears sooner (B.). Diet, nutritious persistently. Beef-tea, egg-nog ; nutrient 
enemata. Isolation, imperative, as the disease is eminently contagious (B.). 
[Compare Delirium, Typhoid Fever.] 



Ulcers and Sores. 

Arsenic, improves rodent ulcer (B.). Belladonna, has a remarkable influ- 
ence over various ulcerative processes (P.). Mercury, Calomel ointment or 
black wash in scrofulous or tuberculous lupus, and in open scrofulous sores 
(R.) ; corrosive sublimate, 1 per cent, solution, as application to syphilitic ulcers 
(Fox) ; the Ung. Hydrarg. Nitratis, for serpiginous ulcerations, diluted one half, 
or the iodide, gr. xx-xl ad gj Vaselini, in syphilitic ulcerations (Keyes). Lime, 
as carbonate or lime-water to check discharge; the sulphide when thin ichorous 
discharge ; the phosphate has influence on scrofulous sores (R.). Phytolacca, 
as a local application (B.). Hamamelis, employed with satisfaction in varicose 
ulcers (Pf.). Opium or Morphine, with glycerin, as an application to relieve 
pain (R.) ; gr. j-ij, daily, also locally, has a decidedly curative value in phage- 
denic and indolent ulcers ; not so useful in so-called " irritable " ulcers (Pf., P.). 

44 



690 



ULCERS AND SORES. 



Tannin, or glycerite of Tannin, to coat over wounds, or discharging sores (R.). 
Potassium Chlorate, in solution as a wash to clean and stimulate foul ulcers 
(R.) ; in impalpable powder, a better application than is Iodoform (B.). Cin- 
chona, powdered bark dusted over foul, indolent, sloughing, and gangrenous 
ulcers, promotes healing (R.). Conium, locally, by means of a poultice, will 
ease pain and improve the sore (R.). Chlorine Solution, as a wash for slough- 
ing and indolent sores (R.). Iodide of Starch, cold as a poultice (R.). Lead, 
the soluble salts as lotions to unhealthy, over-secreting sores (R.). Pyrogallic 
Acid, an excellent application in venereal ulcers (Vidal). Chloral, in lotion, 
gr. v-xx ad 3J aquae, for sluggish sores (Keyes). Nitric Acid, as escharotic, 
applied with a glass rod ; oil to protect surrounding tissues ; arrest by alkaline 
wash. 3j-0j is a good acid lotion for washing (B.) ; the lotion to indolent and 
painful ulcers (R.). Hydrastis, internally and externally, employed with excel- 
lent results in rodent ulcer, and ulcers of legs, rectum, and uterus (R.). San- 
guinaria, locally, to repress fungous granulations of indolent ulcers, 1 to 80 
parts glycerini (P.). Carbolic Acid, and Salicylic, locally (B.). The glycerin 
of carbolic acid a good application to fetid sores (R.). Balsams of Peru and 
Tolu, excellent (P.). Camphor, dusted over indolent sores (R.). Charcoal, 
locally to sloughing sores (R.). Alcohol, to cover sores with thin protecting 
layer of coagulated albumen (R.). Alum, dry or in solution to relaxed and 
abundantly-secreting sores (R.). Turpentine, internally for ulceration of 
bowels (P.). Collodion, as protective covering (P.). Capsicum, a weak solution 
useful as a stimulant in scrofulous or fistulous sores (P.). Savine, as acrid (not 
chemical) caustic (P.). Potassa Fusa, or the milder Vienna paste, as escharotic ; 
to arrest, dilute acid (B.)! Zinc Chloride, the most efficient escharotic consistent 
with safety (B.). Zinc Sulphate, dried, dusted over (R.). Iodoform, dusted 
over surface (B.) ; prevents granulation in all ulcers, and does no good except 
to relieve pain (Gross). Aristol, is highly praised ; an excellent substitute for 
Iodoform, being quite as efficient, and odorless. Has given excellent results 
in treatment of indolent s"oft ulcers, syphilitic ulcerative processes, etc. See 
Potassium Chlorate above. Silver Nitrate, as caustic, quickly rubbed over 
(B.). Applied to unhealthy ulcers, also ulcers of the mouth (R.). Copper 
Sulphate, to indolent ulcers. Touch with a crystal, or frequently apply a solu- 
tion, gr. lj-x ad Sjj (B., R.). Coptis, the infusion has high reputation (B.). 
Chimaphila, Copaiba, Catechu, Myrrh, Rhatany, Rhubarb, Storax, Benzoin, 
Tar water, locally, are useful (P.). Oxygen, to atonic, painful ulcers (R.). 
Galvanic Couplet (B.). [See Bedsores. J Yeast, as poultices (R.). Section 
of exposed nerve-filament, in irritable ulcer, by bistoury passed beneath the 
sore (Hilton on Rest and Pain). Cod-liver Oil, especially for ulcerations of the 
glands, or indolent ulcers with excoriated edges, lupus, etc. Water, is sufficient 
as dressing in the majority of cases. Rest and support of great value. Clean- 
liness, bandaging and recumbent position in ulcer of legs facilitate recovery; 
also daily washing to restore the lost vitality of parts ; elastic stockings, and 
the Esmarch bandage in chronic cases. [Compare Chancre, Chancroid, 
Bedsores, Throat, Gastric, Intestinal, and Uterine Ulceration, 
Syphilis.] 

Prescriptions. 

&. Iodoformi, gij. R. Hydrarg. Chlor. Corr., . . gr. xv. 

Ac. Carbolici, rr^xxv. 

Aquae, q. s. ad £ iv. 

M. Sig. — For syphilitic ulcers, pack on 



. Iodoformi, % ij. 

Mucil. Acacias, l^xv. 

Ol. Menthae Pip , .... Tr\^ij. 

Glycerini, trrxx. 

M. Sig. — For unhealthy ulcers. 

(Bronson.) 



R . Emplas. Plumbi, 25 ij. 

Ung. Hydrargyri, . . . . J ss. 

Olei Cadini, 5pj. 

M. Sig. — Spread on linen, and apply to 
inflamed patches on palms from syphilis 

{Biimstead and Taylor?) 



cotton, and renew daily. 



(Fox.) 



R. 



Ung. Petrolei, 2; ij. 

Ung. Hydrargyri, . . . . 3 iv. 

Olei Cadini, 3 ij. 

M. Sig. — Apply after removing scales 
to chronic palmar and plantar lesions. 

(Bumstead and Taylor.) 



URAEMIA URINARY DISORDERS. 69I 

Uraemia. 

Digitalis, the infusion, or a poultice of leaves to abdomen and back (B.). 
Jaborandi, diaphoretic; eliminates urea (B.) ; or Pilocarpine hypodermically. 
Opium. Scanzoni and Loomis urge morphine, hypodermically, as the most 
efficacious agent (B.) ; in acute, not in chronic uraemia (Pf.). Colchicum, as 
diuretic (B.). [See Dropsy.] Saline Cathartics, active are required (B.), 
Hydragogue Cathartics. 01. tighi (gtt. j-ij), or elaterium (gr. ^ to l), to 
procure tree watery evacuations. Cautiously (B.). Transfusion, in uraemic 
eclampsia (B.). Water, the vapor bath, or hot wet-pack to induce powerful 
diaphoresis (B.). [Compare Bright's Disease, Puerperal Convulsions, 
Scarlatina and the list of Diuretics and Diaphoretics, on pages 43 and 46.] . 

Urethritis. 

Aconite, is used to advantage in urethral fever; also for prevention of chill 
after passage of sound (Pf., W.). Strophanthus, efficient in preventing rigors 
after instrumentation on the urethra ; the tincture in doses of 5 minims (Fen- 
wick). Silver Nitrate, locally, very efficient in chronic urethritis in females 
(Wa.). Tannin, on bougies, once a week for 15 minutes, most efficient for 
urethritis in the female (Wa.). Zinc Sulphate, cast in sticks, for indroduction 
into the urethra (Wa.). Potassium Bicarbonate, with Potassium Acetate, aa 
gr. x in a large cup of flaxseed tea or a glass of Vichy water, every 4 to 6 
hours; with absolute rest in bed, a calomel purge, and urination under hot 
water, sufficient for most cases of urethritis, which may arise from lithiasis, 
leucorrhcea in females, etc. Many cases of aborted gonorrhoea (so-called) 
were really simple urethritis (Otis). [Compare Gonorrhoea.] 

Urethral Stricture. 

Aconite, is of great service in spasmodic stricture (P.). Cocaine, locally by 
catheter (Smith). Buchu, in irritable urethra, spasmodic stricture, and gleet 
(P.). Opium, in full dose or an opiate suppository, with fomentations and a 
warm bath, will often suffice in spasmodic stricture (CI.). Catheterization, 
under an anaesthetic in spasmodic stricture if other measures fail to relieve.-. 
Also for gradual dilatation in organic stricture, the safest and most generally 
applicable treatment (CI.). Oil, injected before dilatation (Wa.). Thorough 
Division, by a dilating urethrotome the best operation for a radical cure ; 600 
cases thus treated without a death or permanent disability (Otis). ; 

Urinary Disorders. 

Aconite, of great service in retention from chill, sub-inflammatory (P.). Tur- 
pentine, in hematuria and chronic catarrh of the bladder, incontinence from 
atony, etc. (B.). Strychnine, sometimes employed with marked benefit in 
retention or incontinence of the old (P.). Cantharis, frequent or involuntary 
micturition, especially when coughing, in women from weakness of sphincter ; 
one or two drop doses (R.). Cannabis Indica, in retention from spinal dis- 
eases (R.). Diuretin, a remarkably efficient diuretic in cardiac and renal 
dropsy, 15 grains several times daily will increase the urine three and fourfold* 
Digitalis, holds high as a diuretic, £j or ij of the infusion night and morning, 
or oftener if necessary ; in sudden suppression from cold or damp or after scarr 
latina, if danger threatens (P.). Benzoic Acid, or the Benzoate of Sodium, in 
10- 15-grain doses, to render alkaline urine acid, and check the formation of 
phosphates (B.). Thymol in chyluria, due to the presence of filiaria in the 
blood ; doses of one grain, gradually increased to five grains, every four hours, 
cured two cases (Lavvrie). Nitro-hydrochloric Acid, dilute, gtt. x-xv thrice 
daily in water, for phosphatic deposits (Mears). Ammonium Carbonate, in 
6-grain doses, 3 or 4 times a day, to make acid urine alkaline. Triticum- 
Repens, a favorite remedy with Sir Henry Thompson, in pint doses daily of its 



692 



URTICARIA. 



infusion or decoction (^ij-iv ad Oj), for strangury, cystitis, and many other 
complaints, connected with the urinary apparatus. Alkalies, to neutralize acid 
urine, and control chronic cystitis; the liquor potassae preferable to the bicar- 
bonates, tartrates, and citrates, which all have diuretic action and increase the 
frequency of micturition ; Liquor Potassae mixed with the tinctures of Hyoscy- 
amus or Belladonna, may undergo chemical changes, but it materially controls 
painful and frequent micturition in bladder troubles (Thompson). Buchu, 
renders mOre help than any drug known in incontinence or retention from 
catarrh of bladder implicating the ureters, and even the kidneys (P.). "Water, 
copious injections are beneficial in some cases of suppression (R.). [Compare 
the list of diuretics on page 43 ; — and in this section see Bladder Irrita- 
ble, and Paralysis of ; Cystitis, Diabetes Insipidus, Dysuria, Dropsy, 
Enuresis, Hematuria, Lithiasis, Nephritis, Oxaluria, Uremia, Ure- 
thral Stricture.] 



R . Pulv. Scillae, 

Pulv. Digitalis, 

Hydrarg Chlor. Mitis, 
M. ft. pil. no. xij. Sig. 
diuretic twice daily. 



Prescriptions. 

R. Potassii Bicarb., , ^iijss. 



aa gr. xij. 
-One pill as a 
{A. Clark.) 



R. Acidi Benzoici, ^ij. 

Sodii Boratis, ...... 3HJ. 

Aquae, % xij. 

M. Sig. — A teasp. in water, thrice 
daily, to keep urine acid. (Emniett.) 



R. Ext. Belladon. Fl, . . . .• ^ss-j. 

Ext. Buchu Fl., . . . . . %]. 

Spt. yEtheris Nitrosi, . . . 3j ij. 
M. Sig. — A teasp. 3 or 4 times daily, 
for dysuria in women. 



Acidi Acetici, p;vj. 

Aquae, Sjiij. 

M. Sig. — Teasp. doses as required, as 
a diuretic. Each contains about gr. x of 
Potassium Acetate. 



R. Potassii Citratis £). 

Sodii Bicarbonat, . . . 3 v. 
Syr. Limonis, jf j. 

Aquae, . . . , . q. s. ad £ iv. 
M. Sig. — A teasp. every 2 hours, to 
render the urine alkaline. 

{Roberts.) 



R . Tinct. Digitalis 3 es-j 

Spt. ^Etheris Nitrosi, . . . 5J iij. 
Liq. Ammon. Acetat., . . ^ss. 

Aquae, q. s. ad. % vj. 

M. Sig.— One-sixth every 3 hours, 
re-establish the renal secretion. 

{Goodeve.) 



to 



Urticaria. 

Antipyrine, internally, is promptly efficient in urticaria, also in the urticaria- 
like eruptions of children. Chloroform, as ointment to allay itching (R.). Potas- 
sium Cyanide, or Hydrocyanic Acid (R.). [See Prurigo.] Nitric Acid, a 
dilute wash, controls itching and prevents wheals (R.). Benzoin, the compound 
tincture painted on the skin for itching (R.). Sodium Salicylate, gr. ij every 
x / 2 hour, is remarkably efficient (A. A. Smith) ; gr. xx thrice daily is effective. 
Copaiba, in full doses will produce urticaria, but drop-doses every x / z hour will 
sometimes control it (A. A. Smith). Strychnine, with emetics and purgatives, 
when the affection is chronic (Guibout). Colchicum, in gouty persons (R.). Lead, 
lotions to ease itching (R.). Alkalies (R.). [See Prurigo.] Warm Baths, 
may be employed with benefit. 



R. Acidi Benzoici, ..... gr. viij. 

Aquae, Jiv. 

M. Sig. — Lotion for urticaria. 

{Squire 



Prescriptions. 

R. Atropinae Sulphat., . 
Aq. Destil., Glycerini, 
Pulv. Tragacanthae, q. 



. gr. y 6 . 
aa^ss. 



Ft. pil. no. x. Sig. — One bis die. 



UTERINE CANCER UTERINE CONGESTION. 693 

Uterine Cancer. 

Conium, useful as a palliative, 3iij— iv ad Oj aquae, as injection for extreme 
pain of uterine cancer (Wa.). Arsenic, small doses for a long time, with a 
strong iodine solution and glycerin locally (Atlee). Opium, stands first in the 
list of palliatives, quieting irritation, allaying pain (Wa.). Morphine, the spe- 
cific action of morphine upon the uterine circulation should be utilized in hope- 
less cases of this disease (Lutaud). Carbolic Acid, a weak solution as injection, 
an excellent cleanser, healer, disinfector and allayer of pain (R.). Bromine, 
the best escharotic for destruction of the mass(E.). Glycerite of Tannin, checks 
discharge and stench. Better still if mixed with glycerite of carbolic acid (R.). 
Iodoform, with cocoa fat as bolus inserted into excavation produced by cancer 
(R.) ; gr. v-x in each bolus (W.). Iodine, the saturated tincture thoroughly 
applied to the entire surface of the mass, is frequently of great use in checking 
hemorrhage, and seems to temporarily check the extension of the disease (E.). 
Chloral, as anodyne, will agree with most persons (E.) ; relieves the pains 
(W.). Chloroform Spray, for some minutes (R.). Cannabis Indica, to allay the 
pain (Wa.). Surgical Measures, advisable; medicine can only palliate. 

Uterine Congestion and Hypertrophy. 

Aurum, salts of, often beneficial in chronic metritis with scanty menstruation 
(B.). Ergotine, long continued, successful in chronic metritis ; lessens con- 
gestion (B.) ; long continued has produced remarkable results in fibroids and 
polypi and chronic metritis; large, spongy, subinvoluted uterus (P.) ; by inter- 
stitial injection into the cervix, has been of great benefit (Goodell). Carbolic 
Acid, undiluted, on cotton-wrapped probe. No better treatment for uterine 
catarrh (B.). Iodine, has proved the most valuable of all remedies as local 
stimulant, and a reliable alterative (Thos., E.) ; and excitant of uterine con- 
traction. Use a saturated tincture to any part not exposed to the air (E.) ; 
may be injected into cervix (G.). Iodo-tannin, or Iodoformi gj, Ac. Tannici 
^j ; a serviceable application in many inflammatory and hypertrophic condi- 
tions. Iodoform suppositories in chronic metritis (P.). Potassium Bromide, 
our main stand-by in uterine troubles; apart from its soothing properties it 
seems to divert the blood from the womb, and to lessen uterine congestion 
(Goodell) ; a specific cure for simple subinvolution, the benefit being derived 
from the potash (Tait). Digitalis, in subinvolution (B.). Glycerin, on cotton 
tampon to cervix as local hydragogue (Thos.). v Caustic Potash, and Potassa 
cum Cake, said to be effective in chronic metritis ; must be used cautiously 
(B.). Chromic Acid, a strong solution to interior of uterus, a very useful ap- 
plication. Ipecacuanha, in subacute metritis of the puerperal state (Tr.). 
Iron, locally in uterine catarrh (R.); as tonic, Iron and other restoratives, a 
cardinal rule in the treatment of all uterine disorders, with Ergot, Quinine, 
Arsenic or Potassium Bromide, whenever the womb as a whole is congested 
or hypertrophied. Syr. Ferri Iodidi, with Cod-liver Oil, wins half the battle 
(G.). Zinc Valerianate, in 2- to 4-grain doses thrice daily, is one of the best 
nervines in these cases (G.). Scarification, after dry cupping, ^in chronic metritis 
(Thos.). Electricity, in chronic congestive enlargement, a galvanic current of 
moderate intensity, slowly interrupted (B.). Water, hot injections or douche, 
also cold alternately; one of the most effective measures ; a gallon very hot, ter 
die (R.) ; — especially valuable in congestion, which is generally venous; — ele- 
vated hips a necessary part of treatment (E.). Cold water is often better than 
hot (G.). Rest, to the patient and the organ, is of prime importance. Abdomi- 
nal bandage, skirt-supporters, pessary if anteversion or retroversion, abstinence 
from sexual intercourse (Thos.). 

Prescriptions. 



R. Ext. Humuli, §j. 

Elix. Ammon. Valerianat., 
Syr. Lactucarii, ... aa % ss. 
M. Sig. — A dessertsp. at bedtime, or 
during the day when needed, as an anti- 
spasmodic. [Goodell.) 



R. Iodi, 

Potass. Bromidi, . . . aa gr. xx. 

Tincr. Todi, 7,]. 

Aq. Deslillat., . . . . ad 3 iv. 
M. Sig. — TTi^xxx t:> be injected into cer- 
vix by 3-5 punctures. {Goodell) 



694 UTERINE DISEASES UTERINE TUMORS. 

Uterine Diseases. 

Cimicifuga, to prevent miscarriage in irritable uterus and prolapsus (R.) ; 
promises to be a valuable remedy in uterine affections (Wa.) ; is remarkably 
efficient in neuralgia and sympathetic pains arising from an irritable uterus, no 
matter what their precise character (P.). Belladonna, with tannin, as supposi- 
tory in uterine neuralgia (R.) ; as vaginal or rectal injections, in neuralgic or 
inflammatory pains (Tr.). Arsenic, in irritable uterus, of decided benefit; gr. 
$y ter die, after meals (Wa.). Carbonic Acid, injection up vagina for neuralgia 
(R., Wa.). Opium, with starch as injection into the rectum will subdue the 
pain of uterine diseases (R.) ; gives more speedy relief than any other remedy 
in irritable uterus, but long-continued is one of the worst (Wa.). Iodized Phenol, 
has proved the most generally efficient agent for intra-uterine use during eight 
years' experience, applied by hard-rubber probes wound with cotton-wool. It 
removes cervical mucus, gives freedom from pain, softens and dilates the cervix, 
heals abrasions, removes induration, removes villosities, regulates the menses, 
improves appetite and digestion, acts as a general alterative, overcomes barren- 
ness, etc., if used long enough, but rapid results are not attainable by any 
method of treatment (Battey). Lead, as plaster for pain in the back due to 
uterine disease (R.) Chloroform, spray, in neuralgia (R.). Aqua-puncture, 
has had extraordinary success in uterine colic (B.). Baths of warm salt water 
remarkably useful in nervous or inflammatory hysteralgia (Tr.). [See Abor- 
tion, Amenorrhcea, Climacteric, Dysmenorrhcea, Endometritis, Hem- 
orrhage POST-PARTUM, LEUCORRHCEA, MENORRHAGIA, MENSTRUAL DIS- 
ORDERS, Metritis, Metrorrhagia, Prolapsus Uteri, etc.] 



Uterine Displacements. 

; Anteversion without prolapsus, not a mal-position (E.). Ice, locally when 
paits inflamed (R.). Hot-water injections, to give tone to the vessels, essential. 
Also valuable after reduction of mal-positions (E.). Mechanical Means, only 
reliable or safe in retroversion and prolapse ; the sound, as a means to restore 
a retroverted uterus to position, cannot beregarded as free from risk, even in 
skillful hands (E.). Pessaries, harmful unless expertly fitted ; should be adj usted 
so as to restore the uterus to the normal line, where the circulation will be least 
obstructed ; not too high. Should never be employed while cellulitis exists (E.). 
Cotton Roll, as a substitute for the orthodox pessary, is far superior. Use the 
Borated cotton in flat sheets, rolling it into a roll 2 inches long by 1 inch 
diameter, and saturating it in Boroglyceride ^j. Aluminii Acetatis ^j, Glycerini 
Pur. q. s. ad Oj. If an astringent is required, the Acetate is replaced by Alum- 
inii Sulphas (Wylie). [Compare Prolapsus Uteri.] . 



; Uterine Tumors. 

! Mercury, the bichloride in small doses, long continued, of undoubted value 
in treatment of fibrous or polypoid growths ; gr. -^ every 6 hours, sometimes 
restrains the hemorrhage, when other remedies fail (Wa.). Calcium Chloride, 
in 30-gr. doses thrice daily, has by prolonged use cured uterine fibroids 
(Hewitt) ; calcifies uterine arteries, also those of the body generally, and is 
dangerous thereby (Tilt, Wells). Ergotin, hypodermically for fibrous tumor 
(R.) ; gr. ij-vj, on alternate days, give excellent results (B.) ; nine cases of 
fibroid treated by Hildebrandt with good results (P.) ; this method often causes 
great pain and severe local inflammation (W.) ; one grain each of Ergotin and 
Ferri Sulphas Exsiccat., in pill thrice daily, persistently, for uterine fibroids, 
using for the hemorrhages a tampon saturated with Tincture of Iodine or Monsel's 
Solution (Parvin). Opium, has specific action upon the uterine circulation, and 
in bleeding from hopeless cases of cancer or from fibroid tumors, should be used 
freely, regardless of danger of opium habit. (Editorial, N. Y. Med. Rec, Dec. 



UTERINE ULCERATION VAGINITIS. 695 

10, 1887.) Ammonium Chloride, in fibrous tumors, gives more benefit than 
any other remedy, gr. x, twice or thrice daily, for weeks and months consecu- 
tively (Atiee). Ferric Subsulphate, injected to restrain bleeding. Cautiously ! 
(B.). Saline Mineral Waters, especially those at St. Catherine's Canada, are 
useful (B.). Aliment, carefully regulated, chiefly of animal food ; with recum- 
bent posture while flowing, and long-continued use of Ergot in small doses, may 
accomplish something (E.). [Compare Cysts.] 



Uterine Ulceration. 

Hydrastis, quickly improves ; the fluid extract undiluted as topical application 
in uterine and vaginal leucorrhcea, ulcerations and erosion of cervix (B.). 
Carbolic Acid, pure, over the surface twice a week in simple ulceration (R.). 
Silver Nitrate, a serviceabl-e application, but is often abused (B.). The solid 
stick applied to surface, after cleansing, and drying with cotton-wool (Wa.). 
Alum, as hip-bath, flb j ad Cj, and vaginal injection is of great utility in 
ulcerations of the os uteri, or of the uterine cavity (Recamier). Glycerin 25, 
Alcohol \iy 2t and pure Creasote 1 part, an excellent application to ulcers of 
the neck. Bismuth Subnitrate, with enough Glycerin to make a thick cream, 
is the best of all applications for ulceration of the os and cervix uteri (Suesse- 
rott). Vegetable Astringents, Infusions or decoctions of galls, oak-bark, 
hamamelis, geranium, alum-root, etc. The glycerite of tannin, tannin and 
iodoform, packed around cervix (B.). 



Uvula. 

Tannin, Rhatany or Zinc, as astringent lozenges, for relaxed uvula (A.). 
Amputation, of elongated part (A.). 



Vaccination. 

Aconite, with Belladonna ointment for erysipelatous redness after vaccination 
(R.). Zinc Oxide, dusted over, to allay the subsequent local irritation (Wa.) ; 
with Pulv. Amyli, equal parts, over the surface. Lead Acetate, Z) to Oj water, 
as lotion for irritable pock (Foster). Carbolic Acid, 3j to Oj water, as lotion 
for excessive redness, with burning and itching. 



Vaginismus. 

Ether, to ascertain cause ; usually a displacement, fissure, or cellulitis (E.). 
Hygiene, sun-baths, hot-water injections, fresh air, removal from husband, etc. 
(E.). Operation (Sims'), removal of hymen with scissors and insertion of glass 
plug till parts are healed, when the cicatrix is to be divided, etc. (E.). Tents to 
gradually dilate vagina, may be impregnated with various sedatives (Gallard). 
Iodoform in a suppository, when redness and excoriation. Belladonna, the 
extract, 1 part with 8 or 9 of fresh lard, if only pain (Gallard). 



Vaginitis. 

Tannin, the glycerin of tannin in chronic vaginitis of children (R.). Silver 
Nitrate, gr. xl-Jjj aquae, applied within cervical canal, and oyer the vaginal 
mucous membrane (E.). Emollient Injections, with Opium (Goodsell). [Com- 
pare Gonorrhoea, Leucorrhosa.] Pinus Canadensis. The concentrated 
extract (colorless), locally, has a very soothing influence in acute vaginitis. 



696 VARICELLA VARIOLA. 

Varicella. 

Diet, no animal food, milk best ; which, with careful attention to the bowels, 
patient to be kept cool with light covering-, and use of a mattress rather than a 
feather bed, is all the treatment required (A.). Saline Mixture, if high fever. 
Quinine, during convalescence. Complications to be treated symptomatically. 



Varicocele. 

Hamamelis, appears to have permanently cured one case (R.). Ergot, gr. 
ij-vj of Ergotin hypodermically, the needle to be inserted among the affected 
veins, care being taken not to puncture a vein, is effective ; severe pain follows 
for a few hours (R.). Water, cold douche to the perineum and buttocks, with 
suspension of testicles in cold water (R.). Radical Cure, consists in obliterat- 
ing the veins by wire ligatures, etc. (CI.). 



Varicosis. 

Hamamelis, is employed with satisfaction in varicose veins and ulcers (Pf.). 
Digitalis, by fomentation, in acute inflammation from varicose ulcers (R.). 
Ergotin, injected along side of vein, but not within it, has cured (B.). Bandage, 
or elastic stocking ; with cold sponging, and rubbing upwards, as palliatives 
(CI.). [Compare Hemorrhoids, Ulcers.] 



Variola. 

Cimicifuga, is given internally by some, who assert that it prevents pitting 
(R.). Mercury, in ointment or plaster, to prevent pitting in semi-confluent, or 
barely confluent cases (Wa.) ; formerly used (R.). Camphor, is said to restore 
the eruption, if retrocedent ; in confluent malignant smallpox, camphor 
alone, or with Opium, may be used for great depression of the vital powers 
(Wa.). Belladonna, successfully used both as prophylactic and curative agent 
(Erasmus Wilson). Gr. %-] every 3, 4 or 6 hours, to dilatation of pupil and 
some stupor ; found effectual (Wa.). Carbolic Acid, is used with decided ad- 
vantage (Wa.). [See Measles.] Has been much used on theoretical grounds, 
but not with success (B.). Ammonium Carbonate, has had cheering success 
(Wa.). [See Scarlatina.] Quinine, small doses in adynamic states, larger 
in hyperpyrexia (B.). Chloral, temperature high, much delirium, and restless- 
ness (B.). Opium, low, muttering delirium ; not so much used now as formerly 
(B.) ; morphine in the insomnia of the advanced stage, once or twice only, but 
not when copious salivation or mucous expectoration (Wa.). Silver Nitrate, 
on a sharp-pointed stick, inserted into each vesicle after rupture, to prevent 
pitting (B.) ; or simply paint skin with a solution of gr. xx to the ^ (R.). Iodine, 
the tincture to prevent pitting, is painted ten times over face if on first day of 
eruption, 12 if on the second day, 12-16 times if on third day (B.). Collodion, 
or solutions of India rubber or gutta percha in chloroform, to prevent pitting; 
or cotton-wool dipped into lime liniment, applied to face or neck(R.). Water. 
Cold baths and cold pack of great utility (B.). Packing especially on retro- 
cession of rash (R.). External Applications, as powdered starch, flour; zinc 
carbonate, 3 parts to 1 of zinc oxide with olive oil ; cold or tepid water with 
vinegar, sponged over body twice or thrice daily (Wa.). Diet. Tea and dry 
toast, raw eggs beaten in cold milk, beef-tea, grapes, roasted apples, ripe fruits 
in season. Cold water may be drunk freely. Fats. Bacon-fat smeared over 
the face, to allay itching and prevent pitting. [Compare Vaccination.] 



VERTIGO VOMITING. 697 

Vertigo. 

Digitalis, in small doses, alternately month by month with tincture of larch, 
and with a long course of the citrate of iron and strychnine, in essential ver- 
tigo, without any other head symptoms, and with general depraved nutrition, 
the most effectual treatment ( Wa.). Potassium Bromide, often controls par- 
oxysmal vertigo, without coexistent spasm, or organic Drain-disease (Wa.). 
Ammonium Bromide, in an effervescing form with cascarilla, for vertigo from 
overwork, where there is usually restlessness, insomnia, depression of spirits, 
with a sense of impending evil (Wa.). Alkalies and Bitter Tonics, give the 
best results in vertigo of gastric origin. Sodium Bicarbonate, after meals, 
tonics before meals. Strychnine with Iron, thrice daily, gives good results. 
Corrosive Sublimate, in small doses, with attention to the bowels and diet. 
Cod-liver Oil, giddiness of the aged, when no serious brain-disease (R.). Is 
mostly symptomatic of disorder of the stomach, or of the liver (cholasmia) ; 
sometimes of general debility ; rarely of disease of the brain (H.). Nitro- 
glycerin, gives good results in epileptic vertigo (Br.). 



Vomiting. 

Ipecacuanha, in small doses, will arrest certain kinds — a curious fact; espe- 
cially useful in certain forms ; tt\,j of vinum ipecac, every yi hour or more 
(B., R., P.) ; in sick stomach of nervous origin, minute doses are of undoubted 
value (W.). Arsenic, in many forms of stomach vomiting, especially that of 
alcoholism, and chronic ulcer (B.), and in the vomiting of cholera (R.) ; gtt. ss 
of Fowler's solution, every y 2 hour for 6 or 8 doses, often relieves vomiting 
after a debauch, the a. m. vomiting of drunkards, and that of pregnancy (A. A. 
Smith). Nux Vomica, stands next to arsenic; is useful in many ways (B.) ; 
may be given with Ipecac, especially when tongue coated (R.). Iris, in 
vomiting with blinding right supraorbital pain ; liver deranged (P.). Bismuth, 
in many forms of vomiting in children, especially when from gastric catarrh 
(R.). Carbolic Acid, with or without bismuth (B.) ; in nervous vomiting (W.). 
Creasote, in the vomiting of cancer, gastric ulcer, etc. (R.) ; gtt. j-ij (W.). 
Cocaine, in doses of gr. ^ thrice daily, controlled the vomiting of gastric car- 
cinoma, after all other means failed (Meigs); 10-minim doses of a 4 per cent, 
solution every hour, of inestimable value in the vomiting of yellow fever (Jen- 
nings). Potassium Nitrate, one of the surest remedies against vomiting and 
nausea, gr. %■ in ^ss of cold water every 4 or 5 minutes, until relieved, in all 
cases, except reflex ones, and those due to irritant poisons (Moore). Mercury, 
gr. Ys of gray powder every two hours, especially in children with clayey stools 
(R.) ; Calomel, gr. j to Oj aquae, first dissolved in ^j of lime water — a teasp. 
every ten minutes for the regurgitation of food in nursing children (A. A. 
Smith). Sulphurous Acid, TT\, v- 3j, well diluted, or less effectively, sodium sul- 
phite. Sulphites often curative in vomiting of sarcinae, and acid matter, due to 
acid fermentation of starchy elements (B.). Cocculus Indicus, efficient in 
cephalic vomiting (P.). Opium, will arrest many kinds ; best in that of biliary 
or renal calculi, dysmenorrhea, sea-sickness, pregnancy. Morphine, hypoder., 
gr. y 1 ^ to l /e (P.). Bryonia, bilious vomiting and headache (P.). Veratrum 
Album, in vomiting and purging of summer diarrhoea (R.). Hydrocyanic Acid, 
often very serviceable in nervous vomiting ; acts promptly if at all (R.). Hy- 
drobromic Acid, £ss in ^j of water, four times daily, useful for" the vomiting 
due to gastric ulcer. Chloroform, n^ij-v, on sugar, for non-inflammatory 
vomiting (R.) ; see Yellow Fever for formula. Bromides, in cerebral vomit- 
ing only ; not in the gastric form (B.) ; potassium bromide in that of uterine 
disease (W.). Cinnamon or Cloves, will check vomiting (P.). Calumba, in 
vomiting from kidney disease and renal calculi ; frequently allays that of preg- 
nancy and dentition (P.). Serpentaria, for bilious vomiting (P.). Cerium 
Oxalate, in that of pregnancy and from cancer (B.) ; gr. j every three hours 
(R.). Sodium Bicarbonate, o'ss-j to a pint of milk, for infants especially if 



\ 



698 VOMITING OF PREGNANCY. 

constipated (R.). Ammonium Carbonate, may relieve when vomited matter 
is acid (B.). Milk and Lime Water, often relieves when other methods fail; 
also the effervescing soda powders in the vomiting of acute diseases, and 
the exanthemata (B.). Alcohol. Iced brandy or champagne in spoonful doses 
every y 2 hour in vomiting of cholera, pregnancy, and delir. trem. (B.). 
Counter-Irritation, at epigastrium (R.). Nutrient Enemata (B.). [See Ene- 
mata.] Ice, sucked, with horizontal posture, absolute rest and quiet (Wa.). 
Iced champagne, ^ss every % hour (B.). Pepsin, for vomiting of food after 
meals ; gr. x-xv before or during meals. Kumyss, has proved efficacious when 
no other food would remain on the stomach. [Compare the List of Anti- 
emetics, on page 37, also the articles entitled Hematemesis, Nausea, Sea- 
sickness, Vomiting of Pregnancy.] 



Prescriptions 

R. Ac. Hydrocyan. Dil., . . . %]. 
Aquae Laurocerasi, . . . . ^ ij. 
M. Sig. — A teasp. every 2 hours, for 
nervous vomiting. 



$ . Ac. Hydrobromici Diluti, . 25 ij. 

Sig. — Half a teasp. in a winegl. of 
water, 4 times daily. 



Vomiting of Pregnancy. 

Ipecacuanha, or Nux Vomica, either will generally succeed where the other 
fails (R.) ; no other remedy of equal value to Ipecacuanha (P.). Nux Vomica, 
is useful but often fails ; gtt. ss-j every hour or two in water (R.) ; in very 
minute doses (S.) ; gtt. ij-iij of the tincture every two or three hours, or gtt. x 
before each meal, with very hot water as a drink, is the best treatment (Parvin). 
Arsenic, Fowler's solution, gtt. j before each meal, will often relieve, when 
vomiting of food, retching and straining, with blood and pain (B.). Creasote, 
checks the vomiting (R.). Carbolic Acid, drop-doses of crystals liquefied by 
heat, in mucilage ter die (Wa.). Staphisagria, has subdued when other reme- 
dies failed (P.). Cerium Oxalate, gr. j every three hours (R.); ordinary doses 
far too small, give as high as 10 grains (B). Morphine, hypodermically in 
severe vomiting (R.)- Pepsin, has been used with success. Ingluvin, seems 
almost specific (B.). Potassium Bromide, is often efficacious (W.) ; 3ss doses 
thrice daily, exceedingly effective in the combined diarrhoea and vomiting of 
pregnancy. The first dose should be given an hour before rising. Hydrocy- 
anic Acid, often the best remedy (P.). [See ante, Vomiting.] Copper Sul- 
phate, sometimes effective, not more than gr. -^ ter die (B.). Iodine, Tt^v of 
the tincture in ^ss of sweetened water, repeated in ]/ 2 hour, of magical effect 
in a bad case which had resisted every other treatment. Is often useful (B.). 
Menthol has proven very successful in obstinate cases. (See formula below.) 
Cocaine, locally to cervix, promptly cured a most intractable case of several 
months' duration, though it failed when used internally (Bois). Has given 
excellent results when used internally. See formula below ; or may use tablet 
triturates of gr. ^ each. Calumba, as tincture often useful ; drop-doses every 
hour or two (B.). Bismuth, and Carbolic Acid, are effective (B.). Atropine, 
frequently effective (R.) ; never failed to give relief in many years of using it 
(Boys). Ether, sprayed over the epigastric region and the corresponding part 
of the spinal column, for 3 to 5 minutes every 3 hours, gives immediate relief 
(Lubelsky). Pop-corn, is a god-send in this complaint, having acted marvel- 
ously in several cases in which I have used it (Sweringen). Aconite, in full 
doses, is often very successful (W.). Dilatation of the cervical canal, by the 
index finger, is regarded as extremely efficient, and reasonably safe. It may 
bring on abortion, if too extensive, but from records of several cases since 1875, 
it may be said that it is a safe and sure remedy (Copman). Ice-bag to spine, 
an efficient measure (R.). Vesication, a single blister over the 4th and 5th 
dorsal vertebrae, never failed for many years to put an end at once to the sick- 
ness of pregnancy for the whole remaining period of gestation (Harkin, in 
Lancet). 



VULVA VULVITIS WARTS. 699 

Prescriptions. 

R. Atropinse Sulphatis, . . . gr. j. I R. Cerii Oxalatis, gr. xij. 

Morphinae Sulphatis, . . . gr. iv. . Ipecacuanhse, gr. xv. 



Acidi Sulph. Aromat., . . ^iij. 

Aquae, • . . 3 v. 

M. Sig. — Ten to twenty drops, thrice 
daily. {Boys.) 



R . Cerii Oxalatis, gr. xxiv. 

Ext. Hyoscyami, gr. xxxvj. 

M. ft. pil. no. xij. Sig. — One pill twice 
daily. ( Goodell. ) 



R. Mentholi, gr. xx. 

Alcoholis, 3 vjss. 

Syr. Simplicis, . . . . ad % ij. 

M. Sig. — 3J every hour. {Potter.) 



Creasoti, gr. xxiv. 

M. ft. pil. no. xij. Sig. — One every hour. 
{Goodell.) 

R. Bismuthi Subnitrat., . . . gr. clx. 

Cerii Oxalatis, gr. xl. 

Morphinae Sulphatis, . . . gr. jss. 

Syrupi, et Acaciae, . . . ad |jij. 
M. ft. emulsio. Sig. — A teasp. every 
hour until vomiting ceases. ( Van Valzah.) 

R . Cocainae Muriatis, . . . . gr. xv. 

Acidi Carbolici, rr^x. 

Aq. Cinnamomi, ^ ss. 

Syr. Zingib., . . . q. s. ad * j. 
M. Sig. — 10 drops gradually increased 
to 20, in a little water every hour until re- 
lieved, then every 2 or 3 hours. {Potter?) 



Vulva. 

Sodium Hyposulphite, an unfailing remedy in lotion for aphtha? of the vulva 
(R.). Arsenic, much used for eczema (T.). Lead Acetate, a concentrated solu- 
tion in glycerin, for eczema of vulva (T.). [Compare Pruritus, Prurigo.] 



Vulvitis. 

Alum, as lotion in vulvitis of children ; gr. lx-Oj aquae, or less strong if found 
to increase discharge (R.). Lead, solutions of the acetate or the diacetate as 
wash, after the acute stage has subsided. Lime Water, as wash (R.). [Com- 
pare Vaginitis.] 

Warts. 

Thuja, worthy of recommendation in the highest terms, for the cure of warts 
with a narrow base and pendulous body. A strong tincture locally three times 
a day, for one or two weeks, with 5 drops in a wineglassful of water internally, 
night and morning (P.). Iron, tincture of the chloride and dilute HC1 acid, 
applied night and morning, equal parts, very effective (Bulkley). Nitric Acid, 
3 j — ij of the dilute acid to a pint of water, as wash, to keep small syphilitic warts 
constantly moist (R.). Sabina, as caustic (P.) ; j-ij of alum (Wa.). Rue, the 
oil, with honey, locally (P.). Arsenious Acid, as a caustic ; enough to be used 
to excite active inflammation. Liq. arsenicalis painted over warts (R.) ; may 
be taken internally (B.). Mercurial Ointment, containing 5 per cent, of 
Arsenic, or a plaster having in each 8 square inches 154 grains of Arsenic and 
JJ grains of Mercury (Unna). Tannin, and Burnt Alum, equal parts, pow- 
dered over warts twice daily, gives good results. Chromic Acid, gr. 100 to £) 
aquae, with a glass rod, to saturate diseased growth. Remove any superfluous 
acid; dress with dry lint (R. , Wa.). Mercuric Nitrate, locally (R.). Silver 
Nitrate, as caustic, but is usually too superficial (R.)- Dermal Curette, is much 
used in Vienna to remove warts by enucleation. Strangulation, by tying a 
string tightly around the base, will cause them to drop off in a few days. Heat, 
is a most thorough measure for their radical removal; it may best be applied 
by touching the wart 3 or 4 times daily with the hot end of a cigar ; the first 
few applications only give pain. Caustic Alkalies, locally (R.) ; a saturated 
solution of potassa fusa, carefully applied by a brush or sponge fastened to the 
end of a stick, is to be preferred (E. Wilson). [Compare Condylomata.] 



I 



700 WEN — WORMS. 

Wen. 

Extirpation, the least troublesome and most speedily effective method. Run 
a scalpel through it, seize thecut edge of the cyst, and gently tear it out with a 
touch or two from the knife. ' Dressing of lint and capbolic oil to cause suppu- 
ration and contraction (D.). 

Worms. 

Filix Mas, Brayera (Kousso), Rottlera (Kamala), Pepo, Granati Fructus 
Cortex, as taeniafuges (B.). Filix Mas to be taken on an empty stomach, for 
tape-worm, and followed by a purge (R., P.). Pepo, ^ij as emulsion, taken 
fasting, one of the most efficient remedies against taenia (B.). Santonin, the 
best anthelmintic ; laxative in morning, fasting all day, a dose (gr. ss-v) of 
santonin and calomel, or troches of santonin (j-x), at bedtime, a senna draught 
next morning. For ascarides (B., P.). For round and thread-worms, in 
castor oil by mouth, or as injection (R.). Iron, the Syrup of the Iodide in- 
ternally and a solution of the tincture locally, for ascarides (B.) ; the tincture 
ferri sesquichlor. ^ss ad Oj aquae, a good injection for thread-worms ; coagu- 
lates albumen (R.). Quassia, the infusion an effectual injection, conjoined 
with simple bitters internally, for ascarides (R.)- Pelletierine, the alkaloid 
of Granatum, is by far the best vermifuge for a tape-worm, repeated after a 
week for a second worm, as many as 3 having been found in one patient (Da 
C.) ; gr. xv-xx of the tannate, followed in a few hours by Castor Oil (R.). 
Chloroform, a very efficient taeniafuge, 3j in E) °f mucilage, after 20 hours' 
fasting, followed one hour later by ^j of Castor Oil ; this is an adult dose, 3] 
should never be exceeded (Wilde). Lime Water, as injection for thread- 
worms (R.) ; ^iij-iv repeated, for ascarides (Wa.). Sodium Chloride, in 3ss 
doses on empty stomach, expels ascarides and prevents reproduction (Wa.). 
Quinine, as a tonic ; also cold sponging, out-door exercise and judicious diet. 
Useful probably by preventing the production of the abundant mucus which 
favors the growth of worms (R.) ; especially useful for ascarides ; also as injec- 
tion for thread-worms and taenia (Wa.). Ignatia, for convulsive symptoms 
(P.). Kamala (Rottlera), excellent for taenia, requires no purge (P.) ; gr. cl-clxxx 
for an adult (Wa.). Eucalyptus, as injection, for ascarides (B.). Aloes, are 
efficacious for ascarides (P.). Ailanthus, decoction of fresh bark, for taenia (B.). 
Tonics, as cod-liver oil and iron to restore intestinal canal to healthy condition 
(R.). Turpentine, as poison to tape- and thread-worms (R.) ; also for taenia 
(Wa.). Scammony, for thread-worms in rectum (R.) ; with calomel, effective 
(Wa.). Tannin, as catechu, kino, red-gum, rhatany, haematoxylum, in injec- 
tions to destroy thread-worms (R.). Alum, as solution for injection (R.). Am- 
monium Chloride, to prevent formation of thick mucus which serves as nidus 
for worms (R.). Valerian, especially when convulsions (R.)- [Compare the 
List of Anthelmintics on page 40.] 

Prescriptions. 



R . Chloroformi, 

Ext. Filicis Maris, . . . aa gj. 
Emuls. Ol. Ricini (50 per 

cent.), giij. 

M. Sig. — One dose after 24 hours' fast- 
ing. Does just as well if Male Fern be 
omitted. {Smith.) 

R. Ext.SpigeliseFl., . . . . gj. 

Ext. Sennse Fl., ^ss. 

M. Sig. — A teasp. to a child of 3 to 5 
years. [Smith.) 

R. Ext. Spigeiiae et Sennas Fl., 3; j. 

Santonini, gr. viij. 

M. Sig. — A teasp. to a child of 5 years. 

{Smith.) 



R. Granati Corticis, Jfij. 

Ft. infusum. Sig. — To be taken before 
1 1 A. M.— and followed after 2 hours by — 

R. 01. Ricini, ,^iij. 

01. Terebinth., sjj. 

Ext. Filicis Maris ^Ether., gj. 
M. ft. haustus. 

Fasting unnecessary. ( Wilde.) 



R. Magnesii Sulphat., .... ^ij. 

Sodii Chloridi, ]§ss. 

M. Sig. — A fluid Ounce in halt a glass 
of water, with gtt. v of Carbolic Acid, night 
and morning, for ascarides. Persevere. 

(Barkley.) 



WOUNDS YELLOW FEVER. 



Wounds. 



Arnica, very useful for external bruises and cuts, also for internal injuries ; 
unites surfaces very rapidly after amputations. The infusion or decoction best 
(P.) ; very effectual (Wa.). Aconite, valuable in surgical fever (P.). Carbolic 
Acid, solutions check suppuration, and correct fetor (B.). The " antiseptic " 
treatment of wounds (Lister), especially surgical wounds. See Ag. vol. I, 
page 187. Bismuth Subiodide, dusted into a wound, one of the most effi- 
cient antiseptics, non-irritant, and a prompt stimulant of granulation. An 
excellent dressing for wounds after approximation of the edges, the powder 
to be dusted thickly over the edges, and thoroughly smeared with Flexi- 
ble Collodion (Potter). Ammonium Carbonate, gr. v hypodermically in the 
vicinity of wounds caused by poisoned arrows, repeatedly used with success in 
saving life, by Dr. Parke, the surgeon to Stanley's last expedition in Africa. 
Sulphurous Acid, in solution, diluted or not, constantly applied (R.) ; in solu- 
tion or by fumigation, is regarded by some as superior in efficacy to carbolic 
acid, and less irritant (Wa.). Salicylic Acid, Thiersch prefers to Carbolic ; may 
be applied pure in powder to gangrenous and sloughing wounds (B.). Mer- 
cury, the bichloride, gr. vijss to quart j of hot water, stirred with a stick, makes 
a solution of 1 to 2000 ; the best of all antiseptics, for washing a wound or 
cavity, and for saturating the dressings. See List of Antiseptics on page 51. 
Boracic Acid, also applicable as Carbolic Acid (B.). Balsam of Peru, excel- 
lent for closing recent wounds (P.). Benzoin, the basis of healing " balsams " 
(P.). Aloes, topically as a slight stimulant; often purges (R.). Gum Traga- 
canth, a thick aqueous solution to granulating surfaces, to protect tbem from 
the air (Wa.). Opium, to quiet intestinal movements in wounds of the abdo- 
men (R.) ; forwards the reparative processes (P.). Tannin, or glycerin of tan- 
nin to coat over wounds (R.). Collodion or Liquor Gutta-perchae, to secure 
primary union of incised wounds (B.) ; as protective covering (P.). Iodoform, 
powdered and dusted over sloughing wounds, irritable and ill-conditioned 
ulcers, sores (B.). Iodoform 1, Collodion 9 parts, painted on a superficial 
wound while edges are held together (Gross) ; may be painted over edges when 
stitched together : gives excellent results. Aristol, an excellent substitute for 
Iodoform, and odorless. Galvanic Couplet, to wounds of indolent form (B.). 
[See Bedsores.] Nitric Acid, as escharotic for gangrene (B.). Turpentine, 
one of the most •efficient applications in hospital gangrene (B.). Aloes, pul- 
verized fine, as a dressing for wounds, favoring cicatrization and closing them, 
also relieving the pain at once ; requires removal only at long intervals (Millet). 
Poultices, are often abused. Yeast or Charcoal best for foul wounds (B.). 
Alcohol, an excellent antiseptic dressing when suppurating ; also favors cica- 
trization of open wounds (B.). Water, in universal use as dressing. Cold 
water often abused. Hot-water dressing as advocated by Hamilton, of New 
York, promises better results (B.). Turkish Baths, for pain in the seat of old 
wounds (R.). Ice and Salt, applied to wound prevents inflammation (R.). 
[Compare Hemorrhage, Inflammation, Pyaemia, Surgical Fever, Gan- 
grene, Ulcers.] 

Prescriptions. 



R. Acidi Tannici, f ^ij. 

Alcoholis Absolut., . . . . ^ ss. 

^theris, ,^ij ss - 

Collodii, ;f x ij- 

M. Sig.— Styptic Colloid. 



R. Collodii, sj. 

Olei Ricini, ^ss. 

Acidi Carbolici, t ^ss. 

M. Sig. — Carbolized Collodion, for 
wounds. 



Yellow Fever. 

Treatment must all be done at the beginning, no time to be lost. Cold 
sponging early and frequently repeated. Calomel, Quinine and Salines at the 
start. Potassium Acetate for the kidneys. Morphine for gastric irritation, the 
feet to be in mustard water (Da Costa). Diaphoretics and Diuretics, also Lax- 
atives, are very important throughout the disease (Da Costa). Pilocarpine, in 



702 YELLOW FEVER. 

dose of gr. % hypodermically, in first stage, carried to the induction of emesis 
and catharsis, as well as that of diaphoresis, the most efficient treatment known, 
absolutely jugulating the paroxysrh (Habersmith). Mercury, a calomel purga- 
tive, gr. ss, 2 or 3 times on the first day, followed by a warm-water enema, is 
good treatment (B.) ; has many advocates, and many opponents (Wa.) ; should 
generally be abstained from (S.). Duboisine, gr. -£$, subcutaneously, the most 
efficient hypnotic and calmative (B.). Turpentine, when cardiac weakness, 
depression of vaso-motor system, dissolved state of the blood; TTLx-^ss; small 
doses, with tinctura ferri chloridi, in hemorrhagic form (B.). Quinine, has 
some strong evidence in its favor as an abortive agent, one large dose (gr. 
xxx-xl) with opium at outset (Wa.) ; is not a specific ; may hasten recovery in 
mild cases (S.) ; gr. xx per rectum, to reduce temperature (B.). Liquor Calcis, 
with milk, has been found efficient for the vomiting (Wa.). Capsicum, to obvi- 
ate the black vomit, is highly spoken of (Wa.). Cocaine, for the vomiting, 
nothing equals it in efficiency, it also acting as a diuretic, io-minim doses of a 
4 per cent, solution, by mouth, every hour for 2 or 3 doses, acts like a charm 
(Jennings). Chloroform, for the vomiting, a few drops to prepare the stomach 
for reception and retention of food ; effects transitory, has to be repeated before 
each meal (Wa.) ; the Ammoniated Chloroform in zymotic pyrexia ; its action 
is sedative, analgesic and antipyretic (Richardson). Carbolic Acid, by stomach 
and hypodermically, remarkably efficacious, even after the ominous " coffee- 
grounds " vomit (Lecaille). Chlorodyne, is excellent for restlessness, insomnia, 
irritability of stomach (A.). Veratrum Viride, gtt. j-x hourly, according to 
age, till pulse and temperature subdued ; successfully used in connection with 
mercury, etc. (White and Ford). Stimulants, only in typhus form (B.) ; in 3d 
stage must be bold, prompt and continued (Da C). Diet, of the blandest 
description (A.) ; milk and lime-water, half and half, in small quantities, is the 
best aliment. In convalescence, the utmost care is necessary in giving aliments 
(B.). Rest is very important (Da C). Iced Champagne, in tablespoonful doses 
every % hour, for the vomiting (B.). Purgation, throughout the disease 
(Da C). [Compare Remittent Fever.] 

Prescriptions. 



R • Potassii Carbonat., . . . . gr. xx. 

Tinct. Opii Camphorat., . . zj. 

Aquae, 5 v »j- 

M. Sig. — £] every hour or two, as a 
diaphoretic, (Dicksoiz.) 



R. Chloroformi, 

Tinct. Camphorce, . . . aa Jjss. 
M. Sig. — Two drops as required for the 
vomiting. 



1 



APPENDIX 



LIST OF LATIN WORDS, PHRASES, ETC., USED IN WRITING 
PRESCRIPTIONS; WITH THEIR CONTRACTIONS, AND 
THE CORRESPONDING ENGLISH EQUIVALENTS. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Abdomen 


Abd. 


The belly. 


Absente febre 


Abs. feb. 


Fever being absent. 


Accurate 


Ace. 


Accurately. 


Ad 


Ad 


To, or up to. 


Ad duas vices 


Ad 2 vie. 


At twice taking 


Ad secundum vicem 


Ad sec. vie. 


To the second time. 


Ad tertiam vicem 


Ad 3 tiam vie. 


For the third time. 


Adde 


Add. 


Add. 


Addantur 


Add. 


Let (them) be added. 


Addendus 


Add. 


To be added. 


Addendo 


Add. 


By adding. 


Ad defection em animi 


Ad def. an. 


To fainting. 


Ad gratam aciditatem 


Ad grat. acid. 


To an agreeable sourness. 


Adhibendus 


Admb. 


To be administered. 


Adjacens 


Adjac. 


Adjacent. 


Ad libitum 


Ad lib. 


At pleasure. 


Admove 


Admov. 


Apply. 


Admoveatur 


Admov. 


Let (it) be applied. 


Admoveantur 


Admov. 


Let (them) be applied. 


Adstante febre 


Adst. feb. 


The fever being on. 


Adversum 


Adv. 


Against. 


Aggrediente febre 


Aggr. feb. 


While the fever is coming on. 


Agitato vase 


Agit. vas. 


The vial being shaken. 


Aliquot 


Aliq. 


Some. 


Alter 


Alt. 


The other. 


Alternis horis 


Alt. hor. 


Every other hour. 


Aluta 


Aluta 


Leather. 


Alvo adstricta 


Alv. adst. 


The bowels being confined. 


Alvus 


Alv. 


The belly. 


Amplus 


Amp. 


Large. 


Ampulla 


Ampul. 


A large bottle. 


Ana 


A. or aa 


Of each. 


Aqua 


Aq. 


Water. 


Aqua astricta 


Aq. astr. 


Frozen water. 


Aqua bulliens 


Aq. bull. 


Boiling water. 


Aqua communis 


Aq. com. 


Common water. 


Aqua fervens 


Aq. ferv. 


Hot water. 


Aqua fluviatilis 


Aq. fiuv. 


River water. 


Aqua fontalis 


Aq. font. 


Spring water. 


Aqua fontana or fontis 


Aq. font. 


<< << 


Aqua marina 


Aq. mar. 


Sea water. 


Aqua nivialis or nivalis 


Aq. niv. 


Snow water. 



{ 



703 



704 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Aqua pluvialis, or pluvia- 


Aq. pluv. 


Rain water. 


tilis 






Aqualis 


Aqualis 


Pertaining to water. 


Aut 


Aut. 


Or. 


Balneum arense 


B. A. 


Sand-bath. 


Balneum mariae, or maris 


B. M. 


Salt-water bath. 


Balneum vaporosum, or 


B. V. 


Vapor bath. 


vaporis 






Balsamum 


Bals. 


Balsam. 


Barbadensis" 


B. B. 


Barbadoes. 


Bene 


Bene 


Well. 


Bibe 


Bib. 


Drink (thou). 


Biduum 


Bid. 


Two days. 


Bis 


Bis . 


Twice. 


Bis in die, or dies 


Bis die 


Twice a day. 


Bolus 


Bol. 


A large pill. 


Bulliat or Bulliant 


Bull. 


Let boil." 


Butyrum 


But. 


Butter. 


Caeruleus 


Cserul. 


Blue. 


Calefactus 


Calef. 


Warmed. 


Calomel or Calomelas 


Cal. 


The mild chloride of mercury. 


Cape 


Cap. 


Take (thou). 


Capiat 


Cap. 


Let him take. 


Capsula 


Capsul. 


A capsule. 


Caute 


Caute 


Cautiously. 


Charta 


Chart. 


Paper. 


Chartula 


Chartul. 


A small paper. 


Cibus 


Cib. 


Food. 


Cochlear, or Cochleare, or 


Coch., Cochleat. 


A spoonful, By spoonfuls ( 3 j). 


Cochleatim 






Cochleare amplum 


Coch. amp. 


A dessertspoonful { gij). 


Cochleare magnum 


Coch. mag. 


A tablespoonful ( Js»). 


Cochleare medium, or 


Coch. med. or mod. 


A dessertspoonful (^ij). 


modicum 






Cochleare parvum 


Coch. parv. 


A teaspoon ful ( 3J). 


Coctio 


Coct. 


Boiling. 


Cola 


Col. 


Strain. 


Colaturse 


Colatur. 


To the strained liquor. 


Colatus 


Colat. 


Strained. 


Coletur 


Colet. 


Let it be strained. 


Colentur 


Colent. 


Let them be strained. 


Collutorium 


Collut. 


A mouth wash. 


Colly rium 


Collyr. 


An eye-wash. 


Coloretur 


Coloret. 


Let it be colored. 


Ccmpositus 


Comp. 


Compounded. 


Concisus 


Concis. 


Cut. 


Confectio 


Conf. 


Confection. 


Congius 


Cong. 


A gallon. 


Conserva 


Cons. 


A conserve, also Keep (thou). 


Contineantur remedia 


Cont. rem. 


Let the medicines be continued. 


Contusus 


Contus. 


Bruised. 


Coque, Coquantur 


Coq. 


Boil, let them be boiled. 


Coque ad medietatis con- 


Coq. ad. med. con- 


Boil to the consumption of half. 


sumptionem 


sump. 




Coque secundem artem 


Coq. S. A. 


Boil according to art. 


Coque in sufficiente quan- 


Coq. in S. A. 


Boil in sufficient water. 


titate aquae 






Cor, cordis 


Cor. 


The heart. 


Cortex, corticis 


Cort. 


The bark. 



LIST OF LATIN WORDS, PHRASES, ETC. 



705 



Word or Phrase. 


Contraction. 


English Equivalent. 


Coxa 


Cox. 


The hip. 


Cras, Crastinus 


Crast. 


To-morrow. 


Cras mane sumendus 


Cras mane sumend. 


To be taken to-morrow morning. 


Cras nocte 


Cras nocte 


To-morrow night. 


Cras vespere 


Cras vesp. 


To-morrow evening. 


Crastinus 


Crast. 


For to-morrow, early. 


Cujus, Cujus-libet 


Cuj. 


Of which, of any. 


Cum 


C. 


•With. 


Cyatho theae 


Cyatho these 


In a cup of tea. 


Cyathus, vel Cyathus vina- 


Cyath., C. vinar. 


A wine-glass (§j-ij). 


nus 
Da, detur 


D., det. 


Give, let be given. 


De 


De 


Of, or from. 


Deaurentur pilulae 


Deaur. pil. 


Let the pills be gilded. 


Debita spissitudo 


Deb. spiss. 


A proper consistence. 


Debitus 


Deb. 


Due, proper. 


Decanta 


Dec. 


Pour off. 


Decern, Decimus 


Decern. 


Ten, The tenth. 


Decoctum 


Decoct. 


A decoction. 


Decubitus 


Decub. 


Lying down. 


De die in diem 


De d. in d. 


From day to day. 


Dein vel Deinde 


Dein. 


Thereupon. 


Deglutiatur 


Deglut. 


Let be swallowed. 


Dejectiones alvi 


Dej. alv. 


Stools. 


Detur in duplo 


Det. in dup. 


Let twice as much be given. 


Dexter, Dextra 


Dext. 


The right. 


Diebus alternis 


Dieb. alt. 


Every other day. 


Diebus teriiis 


Dieb. tert. 


Every third day. 


Diluculo 


Diluc. 


At break of day. 


Dilue, Dilutus 


Dil. 


Dilute (thou), Diluted. 


Dimidius 


Dim. 


One-half. 


Directione propria 


D. P., or Direct, prop. 


With a proper direction. 


Dividatur in partes 


D. in p. oeq. 


Let it be divided into equal parts. 


aequales 






Dividendus, -a, -um 


Divid. 


To be divided. 


Dolor 


Dolor 


Pain. 


Donee 


Donee 


Until. 


Donee alvus bis dejicia- 


Donee alv. bis dejic. 


Until the bowels have been twice 


tur 




evacuated. 


Donee alvus soluta fuerit 


Donee alv. sol. ft. 


Until the bowels shall be opened. 


Donee dolor nephriticus 


Donee dolor neph. 


Until the nephritic pain is removed. 


exulaverit 


exulav. 




! Dosis 


D. 


A dose. 


; Drachma 


Dr. or % 


A drachm (60 grains). 


Durante dolore 


Dur. dolor. 


While the pain lasts. 


Eadem (fern.) 


Ead. 


The same. 


Eburneus 


Eburn. 


Made of ivory. 


! Ejusdem 


Ejusd. 


Of the same. 


! Electuarium 


Elect. 


An electuary. 


! Emesis 


Emesis 


Vomiting. 


Enema 


En. 


A clyster or enema. 


Enemata 


Euem. 


Clysters. 


Et 


Et 


And. 


j Evanuerit 


Evan. 


Shall have disappeared. 


Exhibeatur 


Exhib. 


Let it be exhibited. 


I Extende 


Ext. 


Spread. 


Extende super alutem 


Ext. sup. alut. moll. 


Spread upon soft leather. 


mollem 






Extractum 


Extr. 


An extract. 



45 



706 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Extrahe 


Extrahe 


Extract thou. 


Fac 


t. 


Make. 


Fiat 


Ft. 


Let be made (sing.). 


Fiant 


Ft. 


Let be made (pi.). 


Fac pilulasduodecim 


F. pil. xij 


Make 12 pills. 


Farina 


Farina 


Flour. 


Fascia lintea 


Fas. lint. 


A linen bandage. 


Fasciculus 


Fascic. 


A bundle which can be carried 
under the arm. 


Febre durante 


Febr. dur. 


During the fever. 


Febris 


Febr. 


Fever. 


Femoribus internis 


Fern, intern. 


To the inner thighs. 


Fervens 


Ferv. 


Boiling. 


Fac cataplasmatem 


Ft. cataplasm. 


Make a poultice. 


Fiat ceratum 


Ft. cerat. 


Let a cerate be made. 


Fiant chartulae xij 


Ft. chart, xij 


Let 12 powders be made. 


Fiat collyrium 


Ft. collyr. 


Let an eye-wash be made. 


Fiat emplastrum vesica- 


Ft. emp. vesic. 


Let a blister be made. 


torium 






Fiat emulsio 


Ft. emuls. 


Let an emulsion be made. 


Fiat enema 


Ft. en. 


Let an enema (an injection for the 
rectum) be made. 


Fiat injectio 


Ft. inject. 


Let an injection (for the urethra) be 
made. 


Fiat lege artis 


F. L. A. 


Let it be made by the rules of art. 


Fiat massa, et divide in 


Ft. mas. div. in pil. 


Let a mass be made, and divide it 


pilulas xij 


xij 


into 12 pills. 


Fiant pilulse xij 


Ft. pil. xij 


Let 12 pills be made. 


Fiat pulvis 


Ft. pulv. 


Let a powder be made. 


Fiant pulveres xij 


Ft. pulv. xij 


Let 12 powders be made. 


Fiat pulvis in chartulas 


Ft.Dulv. in chart, xij 


Let a powder be made to be divided 


xij dividenda 


div. 


into xij little papers. 


Fiat solutio 


Ft. sol. 


Let a solution be made. 


Fiant suppositoria iv 


Ft. suppos. iv 


Let 4 suppositories be made. 


Fiant trochisci xxiv 


Ft. troch. xxiv 


Let 24 troches be made. 


Fiat unguentum 


Ft. ung. 


Let an ointment be made. 


Fiat venesectio 


Ft. venesec. 


Let a bleeding be done. 


Fictilis 


Fict. 


Earthen. 


Filtra 


Filtra 


Filter (thou). 


Filtram, Fiitrum 


Filt. 


A filter. 


Fistula arrnata 


Fistul. arm. _ 


A syringe ready for use. 


Fluidus 


Fluid., Fl. 


Liquid. 


Formula 


Form. 


A prescription. 


Frustillatim 


Frust. 


In small pieces. 


Fuerit 


Fuerit. 


Shall have been. 


Gargarysma 


Garg. 


A gargle. 


Gelatin a. quavis 


Gelat. quav. 


In any kind of jelly. 


Gingivas incide 


Ging. incid. 


Lance (or cut) the gums. 


Gradatim 


Grad. 


By degrees gradually. 


Grana sex pondere 


Gran, vj pond. 


Six grains, by weight. 


Granum, Grana 


Gr. 


Grain, Grains. 


Gramme 


Grm. 


Gram. 


Gratus 


Grat. 


Pleasant. 


Grumus 


Grum. 


A clot (of blood). 


Gutta, Guttae 


Gtt. 


A drop, Drops. 


Guttatim 


Guttat. 


By drops. 


Guttis quibusdam 


Gtt. quibusd. 


With a few drops. 


Harum pilularum suman- 


Har. pil. sum. iij 


Let three of these pills be taken. 


tur tres 










LIST OF LATIN WORDS, PHRASES, ETC. 



707 



Word or Phrase. 


Contraction. 


English Equivalent. 


Haustus 


Haust. 


A draught. 


Haustus purgans noster 


H. p. n. 


A purgative draught after my own 
(formula). 


Hebdomada 


Hebdom. 


A week. 


Herba 


Herb. 


An herb. 


Herbarum recentium 


Herb, recent. 


Of fresh herbs. 


Heri 


Heri 


Yesterday. 


Hie, Haec, Hoc 


Hie, Hsec, Hoc 


This. 


Hirudo 


Hirudo 


A leech. 


Hirudines appone 


Hirud. app. 


Apply leeches. 


Hora 


H. 


An hour. 


Hora somni 


Hor. som. 


At the hour of sleep. 


Hora undecima matutina 


Hor. xj matut. 


At the eleventh hour of the morning. 


Horae decubitus 


Hor. decub. 


At bedtime. 


Horse unius spatio 


Hor. j spat. 


After one hour. 


Horis intermediis 


Hor. interm. 


In the intermediate hours. 


Idem 


Id. 


The same. 


Idoneus 


Idon. 


Proper. 


Imprimis 


Impr. 


First. 


Incide, Incisus 


Inc. 


Cut (thou), Being cut. 


In dies 


Ind. 


Daily, or From day to day. 


Infunde 


Infun. 


Pour in. 


Infusum 


Infus. 


An infusion. 


Injectio 


Injec. 


An injection. 


Injiciatur enema 


Injic. enem. 


Let a clyster be given. 


In pulmento 


In pulm. 


In gruel. 


Instar 


Instar. 


As big as. 


Inter 


Inter 


Between. 


Internus, -a, -um 


Int. 


Inner, or Internal. 


Intus 


Intus 


Inwardly. 


Jam 


Jam 


Now. 


Julepus, Julepum, Julap- 


Jul. 


A julep. 


ium 






Jusculum 


Juscul. 


A broth. 


Juxta 


Juxta 


Near to. 


Kali prasparatum 


Kal. ppt. 


Prepared Potash, or the Carbonate 
of Potassium. 


Lac, Lactis 


Lac. 


Milk, of Milk. 


Lagena 


Lag. 


A flask, or bottle. 


Lana 


Lana. 


Flannel. 


Languor 


Lang. 


Faintness. 


Lateri dolenti 


Lat. dol. 


To the painful side. 


Lectus 


Lect. 


Abed. 


Libra 


Lb. or ft) 


A pound. 


Ligatura 


Lig. 


A ligature. 


Linimentum 


Linim. 


A liniment. 


Linteum 


Lint. 


Lint. 


Liquor 


Liq. 


A solution. 


Lotio 


Lot. 


A lotion. 


Mac era 


Mac. 


Macerate. 


Magnus 


Mag. 


Large. 


Mane 


Mane 


In the morning. 


Mane primo 


Mane primo 


In the very early morning. 


Manipulus 


M. or Man. 


A handful. 


Manus 


Manus 


The hand. 


Massa 


Mass. 


A mass, or pill mass. 


Matutinus 


Matut. 


In the morning. 


Medius 


Med. 


Middle. 


Mensura 


Mensur. 


By measure. 



7o8 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Mica panis 


Mic. pan. 


Crumb of bread. 


Minimum 


M. or Min. 


A minim. 


Minutum 


Minut. 


A minute. 


Misce 


M. 


Mix. 


Mistura 


Mist. 


A mixture. 


Mitte 


Mit. 


Send. 


Mittatur 


Mit. 


Let (it) be sent. 


Mittantur 


Mit. 


Let (them) be sent. 


Mitte sanguinem ad uncias 


Mit. sang, ad uncias 


Take away blood to 12 ounces at 


duodecim saltern 


xij salt. 


least. 


Modicus 


Modic. 


Middle-sized. 


Modo praescripto 


Mod. praesc. 


In the manner prescribed. 


Mora 


Mora 


Delay. 


More diet u 


Mor. diet. 


In the manner directed. 


More solito 


Mor. sol. 


In the usual manner. 


Morturarium 


Mort. 


A mortar. 


Ne trades sine nummo 


Ne tr. s. num. 


Do not deliver without the money. 


Necnon 


Necn. 


Also. 


' Nisi 


Nisi 


Unless. 


Non 


Non 


Not. . 


Non repetatur 


Non repetat. 


Let it not be repeated. 


: Noc, Noctis 


Noc, Noct. 


The night, of the night. 


Nocte maneque 


Noct. maneq. 


At night, and in the morning. 


Nucha 


Nucha 


The nape of the neck. 


Numero 


No. 


In number. 


Numerus 


No. 


Number. 


Nux Moschata 


Nux Mosch. 


A nutmeg. 


Octarius 


0., Oct. 


Apint(|xvj). 


Octavus 


Octav. 


Eighth. 


Octo 


Octo 


Eight. 


Oleum Lini sine igne 


01. Lini sine ig. 


Cold-drawn Linseed Oil. 


Oleum olivae optimum 


01. 0. opt. 


Best olive oil. 


Omni hora 


Omn. hor. 


Every hour. 


Omni bihorio 


Omn. bih. 


Every two hours. 


Omni quadrante horae 


Omn. quadr. hor. 


Every j^ hour. 


Omni mane 


Omni mane 


Every morning. 


Omni nocte 


Omn. noct. 


Every night. 


1 Opus 


Opus 


Need, or occasion. 


Ovum 


Ov. 


An egg. 


Pannus 


Pan. 


A rag. 


I Pars, Partis 


Par., Pt. 


A part, Of a part. 


: Partes sequales 


Pt. aeq. 


Equal parts. 


I Partitis vicibus 


Part. vie. 


In divided doses. 


j Parvulus 


Parvul. 


An infant, A parvule. 


! Parvus 


Parv. 


Little. 


i Pastillus, Pastillum 


Pastil. 


A Pastille. 


Pediluvium 


Peduliv. 


A foot-bath. 


i Penicillum camelinum 


Penicil. cam. 


A camel'sthair pencil or brush. 


Per 


Per 


Through, By. 


Peracta operatio emetici 


Peract. operat. emet. 


When the action of the emetic is 

finished. 
By deliquescence. 


Per deliquium 


Per deliq. 


Per fistulam vitream 


Per fistul. vit. 


Through a glass tube. 


Pergo, Pergere 


Perg. 


To go on with. 


Phiala prius agitata 


P. P. A. 


The bottle having been first shaken. 


Phiala 


Phil. 


A vial, or bottle. 


Pilula 


Pil. 


A pill. 


Poculum 


Pocul. 


A cup. 


Pocillum 


Pocill. 


A little cup. 






LIST OF LATIN WORDS, PHRASES, ETC. 



7O9 



Word or Phrase. 


Contraction. 


English Equivalent. 


Pond ere 


P. 


By weight. 


Pondus civile 


P. civ. 


Civil weight (avoirdupois). 


Pondus medicinale 


P. med. 


Medicinal weight. 


Pone aurem 


Pone aur. 


Behind the ear. 


Post singulas sedes liquidas 


Post sing. sed. liq. 


After every loose stool. 


Potus 


Potus 


Drink. 


Praeparata 


Praep. 


Prepared. 


Primo mane 


Primo mane 


Very early in the morning. 


Primus 


Primus 


The first. 


Pro 


Pro 


For. 


Pro ratione aetatis 


Pro rat. set. 


According to the age of the patient. 


Pro re nata 


P. r. n. 


Occasionally. According to circum- 
stances. 


Pugillus 


Pug. 


A pinch. 


Pulmento 


Pulm. 


Gruel. 


Pulvis 


Pulv. 


A powder. 


Pulverizatus 


Pulvz. 


Powdered. 


Pyxis 


Pyxis 


A pill box. 


Quadrans, — antis 


Quad. 


A quart. 


Quantum libet 


Q. lib. 


As much as you please. 


Quantum placet 


Q.p. 


a a a a a 


Quantum vis 


Q.v. 


ti M u it i< 


Quantum volueris 


Q. vol. 


it it it <( tc 


Quantum sufficiat 


Q. s. 


As much as is sufficient. 


Quantum satis 


Q.s. 


« it l< (« u 


Quaqua. hora 


Qq. hor. 


Every hour. 


Quaque 


Qq. 


Each, or Every. 


Quartus 


Quart. 


Fourth. 


Quater 


Quater 


Four times. 


Quatuor 


Quat. 


Four. 


Quibus 


Quibus 


From which. 


Quinque 


Quinq. 


Five. 


Quintus 


Quint. 


The fifth. 


Quoque 


Q.q. 


Also. 


Quorum 


Quor. 


Of which. 


Quotidie 


Quotid. 


Daily. 


! Ratio 


Ratio 


Proportion. 


Recens, -entis 


Rec. 


Fresh. 


Recipe 


R 


Take. 


Redactus in pulverem 


Red. in pulv. 


Let it be reduced to powder. 


Redigatur in pulverem 


Redig. in pulv. 


it (i it a 


Regio umbilici 


Reg. umbil. 


The umbilical region. 


Reliquus 


Reliq. 


Remaining. 


Repetatur 


Rept. 


Let it be repeated. 


Repetantur 


Rept. 


Let them be repeated. 


Respondere 


Respond. 


To answer. 


Retmere 


Retin. 


To keep. 


Saltern 


Saltern 


At least. 


Saltim 


Saltim 


By leaps. 


Saturatus, -a, -um 


Sat. 


Saturated. 


Scarificare 


Scarif. 


To scarify. 


Scarificatione explicata 


Scarif. expl. 


Scarification having been effected. 


Scatula 


, Scat. 


A box. 


Scilicet 


' Scil. 


Namely. 


Scrupulum 


Scrup. or ►} 


A scruple (20 grains). 


Secundum artem 


S. A. 


According to art. 


Secundum naturam 


S. N. 


According to nature. 


Secundus 


Secund. 


Second. 


Sedes 


Sed. 


The alvine evacuation. 



yio 



LIST OF LATIN WORDS, PHRASES, ETC. 



Word or Phrase. 


Contraction. 


English Equivalent. 


Semel 


Semel 


Once. 


Semis, or Semissis 


Ss. 


A half. 


Semi-drachma 


Semidr. 


Half a drachm. 


Semi-hora 


Semih. 


Half an hour. 


Sept em 


Sept. 


Seven. 


Septimana 


Septim. 


A week. 


Sesuncia 


Sesunc. 


An ounce and a half. 


Sesquihora 


Sesqh. 


An hour and a half. 


Sex 


Sex 


Six. 


Sextus 


Sext. 


Sixth. 


Si 


Si 


If. 


Signa 


Sig. 


Write, or Mark (thou). 


Signatur nomine proprio 


Sig. nom. prop. 


Let it be written upon with its 
proper name. 


Simul 


Simul 


Together. 


Sine 


Sin. 


Without. 


Sin gul arum 


Sing. 


Of each. 


Singulorum 


Sing. 


Of each. 


Si non valeat 


Si non val. 


If it does not answer. 


Si opus sit 


Si op. sit. 


If necessary. 


Si veres permittant 


Si vir. perm. 


If the strength will bear it. 


Sit 


Sit • 


Let it be. 


Solus 


Sol. 


Alone. 


Solve 


Solv. 


Dissolve. 


Solvo, Solvere 


Solv. 


To dissolve. 


Solutus 


Solut. 


Dissolved. 


Somnus 


Somnus 


Sleep. 


Spiritus, —us 


Spt. 


Spirit. 


Spiritus vini rectificatus 


Spt. vin. rect. 


Rectified spirit of wine (i.e., Alco- 
hol). 


Spiritus vini tenuis 


Spt. vin. ten. 


Proof spirit. 


Spiritus vinosus 


Spt. vinos. 


Ardent spirit (of any strength). 


Statim 


Stat. 


Immediately. 


Stet, or Stent 


St. 


Let it (or them) stand. 


, Stratum superstratum 


S. S. S. 


Layer upon layer. 


Subactus 


Subact. 


Subdued. 


vSub finem coctionis 


Sub fin. coct. 


When the boiling is nearly fin- 
ished. 


Subinde 


Subind. 


Frequently. 


Sumat talem 


Sum. tal. 


Let him take one like this. 


Sume 


Sum. 


Take. 


Sumat 


<< 


Let him take. 


Sumatur 


« 


Let it be taken. 


Sumantur 


<( 


Let them be taken. 


Sumendus 


a 


To be taken. 


Summitates 


Summit. 


The summits. 


Superbibendo haustum 


Sup. bib haust. 


Drinking afterwards this draught. 


Supra 


Supra 


Above. 


Syrupus, -i 


Syr. 


Syrup. 


Tabella 


Tab. 


A lozenge. 


Talis 


Tal. 


Such a one. 


Tempori dextro 


Tempor. dext. 


To the right temple. 


Tempus, -oris 


Temp. 


Time, or Temple. 


Ter 


Ter 


Thrice, of Three times. 


Ter in die, or Ter die 


T. i. d., or T. d. 


Thrice daily. 


Tere 


Tere 


Rub. 


Tere simul 


Tere sim. 


Rub together. 


Tero 


Tero 


I rub. 


Tertius 


Tert. 


Third. 






LIST OF LATIN WORDS, PHRASES, ETC. 



711 



Word or Phrase. 


Contraction. 


English Equivalent. 


Tinctura 


Tinct. or Tr. 


Tincture. 




Tincturae Herbarum Re- 


Tinct. Herb. Recent. 


Tinctures of Fresh Herbs. 




centium 








Tres 


Tres 


Three. 




Triduum 


Trid. 


Three days. 




Tritura 


Trit. 


Triturate. 




Trochiscus, Trochisci 


Troch. 


A lozenge or troche, Lozenges 
troches. 


or 


Tussis 


Tus. 


A cough. 




Ultimo [or Ultima) prae- 


Ult. prsesc. 


The last ordered. 




scriptus 








Una 


Una 


Together. 




Uncia 


Unc. or 3j 


An ounce. 




Ut dictum 


Ut diet. * 


As directed. 




Utendum 


Utend. 


To be used. 




Uto, Uti 


Uto, Uti 


To make use of. 




Vas vitreum 


Vas vit. 


A glass vessel. 




Vehiculum 


Vehic. 


A vehicle, or menstruum. 




Vel 


Vel 


Or. 




Venaesectio brachii 


Venaesec. brach. 


Bleeding in the arm. 




Vesper, -eris 


Vesp. 


The evening. 




Vices 


Vic. 


Turns. 




Vinum 


Vin. 


Wine. 




Vires 


Vir. 


Strength. 




Vitellus 


Vitel. 


Yolk. 




Vitello ovi Solutus 


Vitel. ovi Sol. 


Dissolved in the yolk of an egg. 




Vitellus ovi 


Vitel. ovi 


Yolk of egg. 




Vitreum, Vitrum 


Vitr. 


Glass. 




Vomitione urgente 


Vom. urg. 


Vomiting being severe. 





Note. — For the dangerous abbreviations, see ante, page 451. 
scription Writing. 



ider the title Pre- 



Pronunciation. 

Attention is particularly directed to the accentuation of words commonly mispronounced ; 
as, for example, acetas, atropa, chimaphila [kima), chloridum, codeia, conium, enema, 
iodidum, radicis, ricinus, sinapis, syrupus, eczema, umbilicus, abdomen, bromidum, 
paresis. 

Verbs. 

The Verbs used in prescription writing are nearly all in the imperative mood, giving 
directions to the compounder, and having their object in the accusative case. Such are — 



Adde, add. 
Cola, strain. 
Divide, divide. 
Extende, spread. 



Fac, make. 
Filtra, filter. 
Macera, macerate. 
Misce. mix. 



Recipe, take. 
Signa, write. 
Solve, dissolve. 
Tere, rub. 



A few verbs are found in the subjunctive mood, taking their subject or predicate in the 
nominative case. The most usual are — 



Fiat, let be made. 
Fiant, let be made. 
Coletur, let be strained. 
Coloretur, let be colored. 
Sumatur, let be taken. 



Bui Hat, let boil. 
Capiat, let take. 
Detur, let be given. 
Dividatur, let be divided. 
Sit, let it be. 



712 



PARTICIPLES GENITIVE CASE ENDINGS. 



Participles. 

Participles or Verbal Adjectives are occasionally used, and should agree with their 
respective nouns in gender, number and case. Such are the following, viz. : — 

Dividendus, -a, -um, to be divided. 
Sumendus, -a r -um, to be taken. 
Adhibendus, -a, -um, to be administered. 



Prepositions. 

Those in the first column require the noun following to be in the accusative case,- 
those in the second column require the ablative case. 

Ad, to, up to. Cum, with. 

In, into. Pro, for. 

Supra, upon. Sine, without. 

Ana, of each,— governs the genitive case. 

Sundry Words and Phrases, in most frequent use. 



Bene, well. 
Bis, twice. 
Dein, thereupon. 
Et, and. 

Gradatim, gradually. 
Gultatim, by drops. 
In dies, daily. 
Da, give. 



Non, not. Ad saturandum, to saturation. 

ATumerus, number. Numero, to the number of. 

Octarius, a pint. Quantuni sufficiat, as much as necessary. 

Seniel, once. Pro re nata, according to need. 

Simul, together. In paries-cequales, into equal parts. 

Statim, at once. Redactus in pulverem, let be pulverized. 

Ter, thrice. Secundum arte?n, according to art. 

Quater, four times. Non Repeiatur, let it not be repeated. 



GENITIVE CASE ENDINGS, ETC. 



Nom. 


Gen. 


Exceptions. 


a 


se 


Cataplasma, Enema, Physostigma, Aspidosperma and Gargarysma, all have the 
genitive in -atis. Coca is unchanged, though the genitive Cocse is written by 
some authorities. Folia is plural, gen. Foliorum. 


us 
um 

OS 

on 


' 


Rhus, Rhois ; Flos, Floris ; Bos, Bovis ; Limon, Limonis ; Erigeron, -ontis. 
Fructus, Cornus, Quercus, Spiritus, Haustus, Potus, do not change, being of 
4th declension. 


as 


atis 


Asclepias, -adis ; Mas, Maris. 


is 


idis 


Pulvis, -eris; Arsenis, -itis ; Phosphis, -itis ; Sulphis, -itis, and all salts ending 
in -is, have genitive in -its. 


o 


onis 


Mucilago, -inis ; Ustilago, -inis; Solidago, -inis. 


1 


-lis 


Fel, Fellis ; Mell, Mellis ; Sumbul, Sumbuli. 


en 
ps 
rs 

r 

X 


inis 
pis 
rtis 
ris 
cis 


Words which do not change in the Genitive. 

*Amyl. Catechu. Digitalis. Kino. 
Azedarach. *Coca. Fructus. Matico. 
Berberis. Cundurango. Haustus. Quercus. 
Buchu. Cornus. Hydrastis. bassafras. 
Cannabis. Curare. Jaborandi. Sago. 
Sinapis. Potus. Spiritus. 

* But some authorities give Apiolum, -i ; Sumbul, -i; Amyl,Amylis; Coca, -se. 



HYPODERMIC FORMULAE. 



713 



HYPODERMIC FORMULA. 



Apomorphine. 
R. Apomorphinse Muriat., . . gr. j. 

Div. in pulv. xvj. One to four in Tt^xx 
of water as required. 



Aqua-puncture. 
R. Aquse Destillatse, .... Jfj. 
Sig. — ^ss-.^j as an injection. 



Arsenic. 



R. Liq. Potassii Arsenitis, . . q. s. 
Sig. — TT^ij-x, hypodermic? lly. 



R . Liq. Arsen. et Hydr. Iodidi, q. s. 
Sig. — tt^v-xx, hypodermically. 



Amyl Nitrite. 

R. Amyli Nitrit., gj. 

Sig. — mjij-v at a dose, which may be 
repeated in ]/ 2 an hour if necessary. 



Atropine. 
R. Atropinse Sulphatis, . . . gr. ij. 
Aquse Destillatse, .... ^j. 
Solve. Sig. — For hypodermic use, mjij 
= g r - -fa, TV) = g r - ih ■ 



Caffeine. 
R. Caffeinse Citratis, .... gr. xxiv. 
Aquae Destillatse, . . . . ^j. 
Solve. Sig. — TT\,xx contain gr. j. 



Carbolic Acid. 
R. Ac. Carbol. Purif., . . . . gr. x. 

Aquse Destil., §j. 

M. Sig. — TT^viij contain gr. y$ of the 
acid, which may be given up to gr. ij or iij. 



Chloral. 
R. Chloralis Hydratis, . . . giv. 

Aquse Destil., gj. 

M. Sig. — rt^xxx contain gr. x 
Chloral Hydrate. 



of 



Chloroform. 
R. Chloroformi Purif, . . . ^ss. 

Sig. — n\v-xv can be used as one deep 
injection. (See ante, page 634.) The 
spirit is safer, in somewhat larger doses. 



Coniine. 

R . Coniinae Hydrobromat., . gr. j. 

Aquse Destillat., gj. 

Sig. — ITlx contain gr. Jg. 



M. 



Cocaine. 
R. Cocainse Hydrochlorat., . gr. v. 
Aquse Destillatse, .... gj. 
Solve. Sig. — TT^vj contain gr. ss. 



Curare. 

R. Curarce (Merck), . 

Acidi Acetici, . . . 

Aquse Destillatse, 



gr- J- 

rr\v. 

. . advene. 



M. et filtra. Sig. — Tr^x contain g 



R . Curarinse Sulphat., . . 
Aquse Destillat., . . . 
M. Sig — rtyv contain gr 



g r -J- 



R 



Daturine. 

Daturinse, gr. ss. 

Aquse Destil., ^j. 

Solve. 
Dose, rtyv-x. 



Digitaline. 
R . Digitalinse, gr. ss. 

Alcoholis, 

Aquse Destil., aagij. 

Solve Sig. — n\iv contain gr. T 
Dose, Ttyv-viij. 

Duboisine. 
R. Duboisinse Sulphat., . . . gr. j. 

Aquse Destil., S|j. 

M. Sig. — mjv contains gr. yi^. 



Ergot and Ergotine. 
R. Extr. Ergotse Fluid., . . . gss. 
Filtra. Sig. — Dose, ir^x. 



R. Extracti Ergotse (Squibb), . Hfj. 

Aquse Destillat., Jj. 

Solve et filtra. Sig. — tr^x contain gr. j. 
Dose, TT\,x-xx. 

Eserine. 
R. Eserinse Hydrochlor., . . gr. j. 

Aquse Destil., giv. 

Solve. Sig. — Ttyv contain gr. J^. 



714 



HYPODERMIC FORMULA. 



Hydrocyanic Acid. 

R. Acidi Hydrocyan. Dil., q. 
Sig. — 1\iv, a maximum dose. 



Hyoscyamine. 



R . Hyoscyaminae, gr. j. 

Ac. Sulphur. Dil., . . . . n\v. 

Aquae Destil., ^j. 

M. Sig. — rr\,x contain gr. ^ . 



B 



R 



Mercury. 






. Hydrarg. Chlor. Corr., 




gr. j. 


Aquae Destillat., . . . 


. . 


n 


M. Sig. — ft^x contain gr 


vi, 




. Hydrarg. Chlor. Corrosi 




Ammonii Chloridi, . 


aa 


g r - "J 


Misce et solve in — 






Aquas Destillatae, . . 




3 i ss - 


Dein adde — 






Albuminis Ovi, . . . 




gjss. 


Aquae Destillatae, . . 




3 V - 


Filtra, et adde — 






Aquae Destil., . . q. s 


ad 


Zx. 


Sig. — try containsgr. ^o- 


Dose, mji 



R . Hydrarg. et Sodii Iodidi, . gr. iij. 
Aquae Drstilhtae, .... 3 iijss. 
Solve. Sig. — rr\,x contain gr. ^. Dose, 
Tujc every second day. 



Morphine. 

R. Morphinae Sulphatis, . . . gr. xvj. 
Aquae Destillatae, . . . . 3jj. 
Solve et filtra. Sig. — n\vijss contain 
gr. tf. (Magendie's.) 



R. Morphinae Sulphatis, . . . gr. xvj. 

Acidi Carbolici, ^hj. 

Aquae Destillat., 5jj. 

Solve et filtra. Sig. — Tl\vijss contain 
gr. %. {Antiseptic, Magendie" 1 s.) 



Morphine and Atropine 



R. 



Morphinae Sulphatis, . . . gr. xvj. 

Atropinae Sulphatis, . . . gr. ss. 

Acidi Carbolici, ^ n j- 

Aquae Destillat., |jj. 

Solve et filtra. Sig. — TTLvijss contain gr. 
^ of Morphine Sulph., and gr. T -L of 
Atropine Sulphate. [Potter.) 



R . Morphinae Sulphatis, . . 

Atropinae Sulphatis, . . 

01. Amygdalae Amar., . 

Aquae Destillat., . . 

Solve. Sig. — TT^x contain 

Morphine Sulphate, and gr. ^ g of Atropine 

Sulphate. (Didamds Solution.) 



gr. xxiv. 

gr-j- 

Rtt. j. 

gr. l l of 



Pilocarpine. 



R . Pilocarpinae Nitratis, . . . gr. xvj. 

Aquae Destillat., %'). 

M. Sig. — TT\,v contain gr. */(,. 



Potassium Iodide. 

R. Potassii Iodidi, gj. 

Aquae Fontanae, . . . . . £iv. 
Solve. Sig. — Dose, nvvj-xx. 



Quinine. 



R 



Quininae Disulph., .... gr. 1(50). 
Ac. Sulphurici Dil., . . . tt\,c(ioo). 

Ac. Carbolici, n\v (5). 

Aquae Fontanae, ^j. 

Solve. Sig. — 3 j containsgr. vj. (Lente.) 
Is irritant. (B.) 



R. Quininae Hydrobrom., . . gr. xlviij. 

Aquae Destillat., % iv. h 

Solve. Sig. — V\xx contain gr. iv. 



R 



R 



. Quininae Bimur. Carbamidat., 

Aquae Destillatae, . . . aa giv. 
Solve. Sig. — TT\x contain gr. v. 



Strychnine. 



. Strychninae Sulphat., . . . er. j. 

Aquae Destillatae, .... ^j. 
Solve sine alcohol. Sig. — TT^x contain 



R. Strychninae Sulphatis, . . gr. j. 

Aquae Destillatae, H\,ccl. 

Solve. Sig. — TT\v contain gr. ^. Dose, 
TT\v-viij. 



Notes. — Solutions for hypodermic use should be neutral in reaction, neither acid nor 
alkaline ; and freshly prepared, especially solutions of the alkaloids, which develop a 
penicillium, which grows at the expense of the alkaloid. Aqua Fontana, if filtered, is a 
better menstruum than Aqua Destillata which has been kept for a week, and frequently 
exposed to the atmosphere. To run the least risk of producing a sore at the point of 



CHLORODYNE. 



715 



injection, use very fine needles, and deliver the injection into the areolar tissue beneath 
the skin, instead of into the skin, as lay parties generally do for themselves. I have given 
injections of Morphine and Atropine to a dying girl 3 and 4 times daily for two months, 
and never produced a sore. Always force out all fluid, and wipe the needle-point dry 
between the fingers, before returning it to the case; the sebaceous matter on the fingers 
keeping it free from rust. There is an area of several inches square, on the upper and 
exterior aspect of the thigh, just below the great trochanter of the femur, which is 
remarkably insensible, being sparingly supplied with cutaneous nerves. (See Fig. 307, 
Gray's Anatomy, loth English edition.) An injection delivered in this area will not be 
felt by the patient. Avoid puncturing a vein; if you do so, watch the patient and pre- 
pare an injection containing gr. ^ of Atropine Sulphate, to administer if dangerous 
symptoms arise. Never, except under special circumstances, administer the salts of Mor- 
phine or Atropine hypodermically to children less than 15 years of age. 

/(cetanilide, in minute proportion, added to aqueous solutions for hypodermic use, is 
said to preserve them from decomposition more efficiently than any other agent hitherto 
employed for that purpose. 



CHLORODYNE. 

A COMPARISON OF ITS INGREDIENTS, ACCORDING TO TEN FORMULAE 

THEREFOR, THE QUANTITIES BEING CALCULATED FOR EACH 

FORMULA TO A FOUR-OUNCE MIXTURE, OR n\ 1920. 







Quantity of each article in a 3iv mixture as per the formula of 


Articles. 


* 

Ph* 
O 

°3 
a* 

CO 


H 
S 


G 

a 

X. 

U 


a. 
Q 

S3 


d 
5 


* 

6 

O 

a 

Q 

Oh' 


A 


JO 



M 




V 

1 


n 

M 
"O 

u 


Morphine Muriate, . . . 

Chloroform, 

Chloral, 

Ether, 

Cannabis Indica, Tinct., . 
Cannabis Indica, Extr., . 
Hydrocyanic Acid, 2 p. c, 
Ol. Menthae Pip., .... 
Capsicum, Fluid Extr., . 
Capsicum, Tinct., .... 
Capsicum, Oleo-res., . . 

Alcohol, 

Hydrochloric Acid, . . . 

Sugar, Burnt, 

Glycyrrhizse, Extr., . . . 

Acacia, Mixture 

Tragacanth, Mucil., . . . 
Theriaca, or Syr. Fusci, . 

Syrup 

Glycerin, 


gr. 

m 

gr. 

m 
m 

gr. 

m 
m 
m 
m 
m 
m 
m 

gr. 
gr. 

m 
m 
m 
m 
m 
m 


1 
236 

59 

118 
2 

236 
147 

236 
io33 


16 
192 

■96 

192 

6 
290 

384 

760 
760 


16 
240 

32 

' 16 

4 

810 
818 


32 
372 

248 

5° 
10 

4 
994 
126 

126 


33^ 
375 

250 

5° 
8 

37 

IOIO 

62 
128 


14 

207 

207 

42 
7 

7 

690 

760 


16 

240 

120 

20 

90 
7 

120 

30 
20 

903 
150 

240 


1* 

247 

62 

123 
2 

247 

154 

247 
992 


4 
240 

60 

120 
2 

240 

240 

240 
q.s. 


24 

240 

24 

48 

1632 




Total No. of Minims, . . 




1920 


1920 


1920 


1920 


1920 


1920 


1920 


1920 


1920 


1920 






Adult Dose, 


m 


5-10 


5-3o 




3-10 


5-15 


5-3° 


5-3° 


5-i5 


5-10 


10-30 


Morphine in n\xv, .... 


gr. 


T55 


% 


Vs 


V, 


% 


tV 


% 


1 

12s 


A 


1 
5 



Note. — See ante, page 173, for remarks on this preparation, and the number of formulae representing it. 

* Author of " A Companion to the Br. Pharmacopoeia." 

t See Hartshorne's " Essentials," 5th ed., p. 625. ** Parke, Davis & Co., Detroit. 

J Made by Eli Lilly & Co., Indianapolis. ff Tinct. Chloroformi et Morphinae, B. P. 

% 2d ed., page 430. \ As given by Stokes and Blyth in" Hygiene." 



y\6 



PATENT MEDICINES. 



PATENT MEDICINES. 



Note. — These formulae have been published from time to time in various journals and 
formularies, and are supposed to represent the preparations designated. The name of 
the author is appended in each case when known. 

Alcoholic Strength of Quack Bitters. 

Hostetter, 43-20 

Drake Plantation, 30.24 

Rush, 34.20 

Peruvian, 22.40 



Hoofland, 20.85 

Oxygenated l9- 2 3 

California Wine Bitters, 18.20 

Walker's Vinegar Bitters, 7.20 



Ayer's Ague Cure. 
This, according to Churchill's analysis, is 
alleged to consist of a syrupy tincture of 
Peruvian Bark with Aromatics, each bottle 
holding six fluid ounces, and each fluid 
ounce containing 3.2 grains of amorphous 
Cinchona alkaloids, 3 grains Cinchonia, 0.7 
grain Cinchonidia, 0.8 grain Quinia, and 
I grain of Quinidia. 



Ayer's Cherry Pectoral. 



. • gr- "J- 



Morphine Acetat., . 

Vini Antim. et Potass. Tartrat., 

Vini Ipecacuanhae, . , . aa 3 iij 

Tinct. Sanguinariae, 

Syr. Pruni Virginian. 



3»K 



Ayer's Pills. 
Consist of Colocynth, Gamboge and 
Aloes, coated with Starch and Sugar. 



Ayer's " Recamier Balm." 

Zinc Oxide, It>s. 5. 

Glycerin, dr. 2. 

Alcohol, oz. 2. 

Mercuric Chloride, . . . . oz. 4. 

Distilled Water, qts. 64. 

[Boston Herald.) 



Ayer's " Recamier Cream." 
Rice Flour, oz. 48. 



Zinc Oxide, . . . 
Glycerin, .... 
Cocoa Butter, . . 

Lard, 

Mercuric Chloride, 
Make 32 pints. 



. oz. 60. 

. oz. 640. 

. oz. 48. 

. oz. 48. 

. oz/4. 

[Boston Herald. 



Ayer's Sarsaparilla. 
Alcohol, . fl. oz. 3. 

Fluid Extr. of Sarsaparilla, fl. oz. 3. 
Fluid Extr. of Stillingia, . fl. oz. 3. 
Fluid Extr. of Yellow Dock,fl. oz.,2. 
Fluid Extr. of Podophyllum,fl. oz. 2. 

Sugar, oz. 1. 

Iodide of Potassium, . . . grs. 90. 

Iodide of Iron, grs. 10. 

Mix. 



Ayer's " Vita Nuova." 

Cocaine, gr. 8. 

Pepsin (golden scale), . . gr. 48. 

Port Wine, gall. I. 

[Boston Herald.) 



Brandreth's Pills. 



Podophylli Radicis, 


. . gr. x. 


Extracti Podophylli, . 


• gr- x. . 


Extr. Phytolacca Baccae 


. gr. xxx. 


Pulv. Caryophylli, . . 


. gr. x. 


Cambogiae, 


. • gr- ij-v. 


01. Menthae Piperita, . 


. TTUij. 


Croci, . 


. . sr. n. 


Misce, fiat masse, et div. in 


pil. xxiv. 




(Hager.) 


Castoria. 




Senna, . ... 


av. oz. 2. 


Pumpkin seed, . . . 


. . dr. 6. 


Rochelle salts, . . 


. dr. 4. 


Wormseed, Levant, 


. . dr. 3. 


Sodium Bicarbonate, . 


. dr. 2. 


Anise seed, . 


. dr. 1. 


Oil of Gaultheria, . 


. dr. y 2 . 


Oil of Peppermint, . . 


. -dr. y s . 


Sugar 


av. oz. 2. 



Water, enough to make . . fl. oz. 16. 

Exhaust the vegetable drugs by boiling 

with water, evaporate to the proper volume, 

and dissolve the sugar and other ingredients. 

( Western Druggist.) 



Chlorodyne, Collis Browne's. 
Morphine Hydrochlor., . . gr. 6. 
Chloroform, dr. 6. 

Cannabis Indica, . . . . gr. 6. 
Prussic Acid (Scheele's), . rr\, 6. 
Treacle, to make . . . . oz. I. 
Dose. — 10 to 30 minims. {Hygiene.) 



PATENT MEDICINES. 



717 



Clarke's Blood Mixture. 

Potassium Iodide, . . . . gr. 48. 

Chloric Ether, dr. 4. 

Liquor Potassae, 1\ 30. 

Water, colored with Burnt 

Sugar, oz. 7^. 

Dose. — One tablespoonful four times a 
day. {Hygiene.) 



Ely's Cream Balm 

consists of Vaseline, 1 ounce; Thymol, 3 
grains ; Carb. Bismuth, 15 grains; Oil Win- 
tergreen, 2 minims. The directions are to 
dip the little finger into the balm and insert 
up the nostrils, giving two or three full 
inhalations. {Medical Record.) 



Garfield Tea 



consists chiefly of Senna leaves and Couch- 
grass (Triticum), with aromatics. 

{Prof. Lengtield.) 



Hamburg Tea. 



Sennae Foliorum, . . . . pt. viij. 

Mannse, pt. iv. 

Coriandri, pt. j. 



Hamlin's Wizard Oil. 



Spt. Carnphorae, . 


5i 


Spt. Ammoniae, 




Olei Sassafras, . . 


. . aa 5ss. 


Olei Caryophylli, 
Chloroformi, 


• • • 3ij- 


Olei Terebinthinae, 


. . aa ^ss. 


Alcohohs, . . . 


. ad %v. 



Helmbold's Buchu. 

Said to resemble the genuine. 

Short Buchu, oz. 9. 

Uva Ursi, oz. 4^. 

Licorice root, dr. 10. 

Macerate in 9 pints of boiling water, 
strain and add — 

Caramel, oz. 2. 

Molasses, ........ oz. 8. 

Mix well and add — 

Cubeb (fluid extract), . . . oz. 5. 

Alcohol, pts. 2. 

Peppermint Oil, oz I. 

Water, sufficient to make . pts. 12. 

{Lillara n s Prac. Hints and Formulae.) 



Holloway's Ointment. 
Has in 159 parts — 

Olive Oil, 62 1 prts. 

Lard, 50 " 

Resin, 25 " 

White Wax, \z\ " 

Yellow Wax, 3 " 

Turpentine, 3 " 

Spermaceti, 3 " 



Holloway's Pills. 
Have in 144 Pills — 

Aloes, gr. 62. 

Rhubarb, gr. 27. 

Saffron, gr. 3. 

Glauber's Salt, gr. 3. 

Pepper, gr. 7. 

{Dorvalt.) 

Hostetter's Bitters. 
Sacchari Albi, 
Aurantii Corticis, 
Calami, 
Cinchonae, 
Gentianae, 

Calumbae, aa ft) j. 

Rhei Pulv., ....... j| iv. 

Cinnamomi, Jij. 

Caryophylli, |j. 

Alcohohs Diluti, C ij. 

{Med. Bulletin, 1884.) 



Keelpy's " Chloride of Gold " Cure. 
For drunkenness and the opium habit. 
The composition is said to be as follows : — 
Chloride of Ammonium, . gr. 1. 

Aloin, gr. 2. 

Compound Tincture of 

Cinchona, fl. 5 3. 

Water, sufficient to make fl. 5 4. 
The hypodermic injection, administered 
4 times daily for 5 weeks, contains Strych- 
nine and Atropine, with Codeine and Co- 
caine for the opium cases. The whiskey 
supplied to the victims contains about gr. 
J^ of Apomorphine to each average drink. 



Laville's Gout Mixture. 
Calcium Chloride, Chinoi- 

din, each ...... grm. 5. 

Extract Colocynih, . . . grm. 2.5 

Water, grm. 85. 

Alcohol, grm. 100. 

Spanish Wine, grm. 800. 

Made into a solution. A pill of very 
complicated composition is used in connec 
tion with the gout remedy. {Hager.) 

See also page 190, ante. 



PATENT MEDICINES. 



Morrison's Pills. 




Powdered Colocynth, . 


• 8 r - 


3- 


Powdered Gamboge, . 


• g r - 


6. 


Powdered Aloes, 


• g r - 


9- 


Cream of Tartar, 


• g r - 


12. 


Syrup enough for 12 pills 


Serious re- 


suits are often produced by large doses of 


these pills. 


or 


n. 




Orange Bloss 




Zinc Sulphate, . . . 


• g r - 


60. 


Alum, 




• g r - 


15- 


Oil Almond Exp., . 




• • g r - 


90. 


Extract Hyoscyamus, 




• g r - 


1. 


White Wax, 




. • gr. 


3°- 


Oil Theobroma, : . 




• g r - 


180. 


Made into oblong suppositc 


ries, one inch 


long, one and a half wide and half an inch 


thick, weighing 32 grains eac 


h. 





Perry Davis's Pain Killer. 

Tinct. Capsici, £]. 

Spt. Camphorae Jij. 

Guaiaci Resinas, % ss. 

Alcoholis, ^iij. 

Tinct. Myrrhas, q. s. ad coloret. 



Pierce's Favorite Prescription. 

Sabinas, Cinchonas, 

Agarici Albi, aa gij. 

Cinnamomi, gr. xv. 

Coq.in aq. suff., utft. decoct, ^viij. 
Deinde cola, et adde — 

Sacchari Albi, ^ss. 

Acacias, gj. 

Solve, et addantur — 

Tinct. Opii Deodorat., 

Tinct. Digitalis, . . . . aa 5 ss. 

01. Anisi, gtt viij, in Alco- 
holis, SJ SS - 

Misce. {Hager.) 

Pierce's Golden Discovery. 

Ext. Lactuci, ^j. 

Mellis, jf j. 

Tinct. Opii Deodorat., . . £ss. 

Alcoholis Diluti, 5|iij. 

Aquas, ^iij. 

{Hager.) 

Radam's " Microbe-Killer." 
Oil of Vitriol (impure), . . dr. 4. 
Muriatic Acid (impure), . . dr. I. 

Red Wine, oz. 1. 

Water, gall. I. 

{Eckels.) 



Radway's Ready Relief. 

Tinct. Capsici, 
Aquas Ammonias, 

Alcoholis, aa ^j. 

Linimenti Saponis, .... 3jiij. 

{Hager :) 

Radway's Resolvent. 

Vini Zingiberis, 

Vini Cardamomi, . . . aa ^iij. 

Sacchari Albi, q. s. 

{Hager.) 

Revalenta Arabica Food. 

Consists solely of Lentils ground up into 
a fine powder. [Stokes in " Hygiene." ) 



Sage's Catarrh Remedy. 

Salis Culinaris (Sodii Chlor.), partes xx. 
Pulv. Camphoras, .... part.j. 

Acidi Carbolici, part.j. 

M. — To be dissolved "in water and either 
injected or sniffed up the nose. 



Pulv. Hydrastis Canadensis, partes v. 

Pulv. Indigo, part. y 2 . 

Pulv. Camphoras, 

Acidi Carbolici, . . . . aa partes ij. 

Sodii Chloridi, partes L. 

{New Remedies. 



Sanford's Catarrh Cure. 

According to an analysis made by Prof. 
A. B. Lyons for the New Idea, this prepa- 
ration is composed of distilled extract of 
Witch-hazel, containing a little Alcohol and 
Glycerin and some Morphine. The pro- 
portions of the constituents were not de- 
termined. {Nat. Druggist.) 



Seigel's (Mother) Syrup. 

Contains Aloes, gr. 30 to the oz. Also 

Borax, Capsicum, Liquorice, and Treacle. 

{Stokes in "Hygiene") 



Sequah's Oil. 



Fish 

Oil, scented with a few drops of Oil of 
Camphor. {Stokes in " Hygiene.") 



PATENT MEDICINES. 



Sequah's Prairie Flower. 

Has to the ounce — 

Aloes, gr. 52^. 

Carbonate of Soda, . . . . gr. 17^. 

Water, gr. 362^. 

and a few drops of the Tinctures of Capsi- 
cum and Myrrh. {Stokes in " Hygiene."} 



St. Jacob's Oil. 

Gum Camphor, oz. 1. 

Chloral Hydrate, . . , . . oz. 1. 

Chloroform, oz. I. 

Sulphuric Ether, oz. 1. 

Tinct. of Opium, . . . . oz. ]/ z . 
Oil of Origanum, . . . . oz. )/ z . 

Oil of Sassafras, oz. y 2 . 

Alcohol, gal. y z . 

Dissolve the Gum Camphor in the Oils 
and Alcohol, then add the other ingredients. 

Squibb says that it is a weak Aconite 

Liniment, also containing Ether, Alcohol, 

Turpentines, red coloring matter, and water. 

{Ephe?neris, p. 114.) 



Swift's Specific " S. S. S." 

Fluid Extr. of Smilax Sarsaparilla, 16 parts. 
Fluid Extr. of Stillingia Sylvatica, 16 parts. 
Fluid Extr. of Lappa Minor, . . 1 6 parts. 
Fluid Extr. of Phytolacca Decan- 

dra, . 16 parts. 

Tinct. of Xanthoxylum Carolini- 

anum, . 8 parts. 

{Registered Pharmacist.) 

Stearns' New Idea gives the following : 
Stillingia, Pokeroot and Sarsaparilla, with 
Nitrate of Potash and a small quantity of 
Iron and enough Alcohol to preserve it. 



Tamar Indien. 



According to the Report de Pharmacie, 
the formula for this preparation is as fol- 
lows : — 

Tamarind (pulp), 450; powd. Sugar, 
40; powd. Sugar-of-milk, 60 ; pure Gly- 
cerin, 50 (all parts). Mix and evaporate 
to the consistence of a soft extract, then 
add powd. Anise, 10; Ess. Lemon, 3 ; Tar- 
taric Acid, 3 (all parts). Mix and divide 
into 100 boluses. Roll in the following 
mixture : Cream of Tartar, 5 ; White Su- 
gar, 35 ; Sugar- of-milk, 35 ; Tragacanth, 2 ; 
Tartaric Acid, 2; powd. Red Sandal, 25 
(all parts). Dry and put up in tin foil. 

{American Druggist.} 



Thompson's Eye-Water. 
Sulphate of Copper, . 
Sulphate of Zinc, . . 

Rose-water, 

Tincture of Saffron, . 
Tincture of Camphor, . 
Mix and filter. 



gr. 10. 
gr. 40. 
pints 2. 
drchm. 4. 
drchm. 4. 



Van Buskirk's Sozodont. 

Saponis Albi, g ss. 

Alcoholis, Jj. 

Aquae, . . 5Jvj. 

Glycerini, gij. 

Olei Gaultheriae, 
Olei Caryophylli, 
Olei Menthae Piperitae, 

aa q. s. ad saporem grat. 
Cocci Cacti, q. s. ad coloret. 



Calcis Praecipitat., 
Magnesia Carbonatis, 
Iridis Florent. Radicis, 

M. et trit. 



aa p. aeq. 
{Hoffmann.) 



Walker's Vegetable Vinegar Bitters. 

Aloes Socotrin., ^ij. 

Guaiaci Resinae, 3 iv. 

Sassafras Mucil., ^j 

Aceti, gij. 

Aquae, q. s. 

Coque, et ft. decoctum, ad ^xix, 
deinde cola, et addantur — 



M 



Walker's Bitters — Continued. 

Sodii Sulphatis, % j. 

Acaciae, gij. 

Spt. Anisi, 10 p. c, . . . 31J. 

Alcoholis, %]. 

. Dose, gij. {Eberbach. 



Warner's Safe Kidney and Liver Cure. 
In Germany each maker of patent medi- 
cines must furnish the government with^ 
the formula for the patent he makes. This 
is the one furnished by Warner for " Safe 
Kidney and Liver Cure." Each bottle 
contains: — 

Extr. Lycopus Virginiana 

(herb) , grs. 308. 

Extr. Hepatica (herb), . grs. 322. 

Extr. Gaultheria, . . . grs. 7^. 

Potassium Nitrate, . . . grs. 39. 

Alcohol (90 ), .... ozs. zy 2 . 

Glycerin, drs. 10. 

Water sufficient to make one pint. 
{Formulary and Druggists' Magazine?) 



20 THE TREATMENT OF POISONING. 



THE TREATMENT OF POISONING. 

The most energetic poisons are Hydrocyanic Acid, some reptile poisons, Strychnine 
and Nicotine. (See pages 67, 294, 389.) Those usually selected for criminal purposes 
are Arsenic, Colchicum, and Tartarized Antimony, the symptoms of which resemble those 
of natural disease. 

General Principles of Treatment. JeaunePs General Antidote. — R . Liq. Ferri 
Sulphatis (sp. gr. I.45) ^ijss; Magnesias Calcinat. t ^ij; Carbonis Animalis ^j ; Aquae 
^ xx. The ingredients should be kept separate — the solution of the sulphate in one ves- 
sel, the others together. When needed, the former should be added to the latter and 
violently agitated. Dose, ^ jss to ^iij. This is a perfect antidote to Arsenic, Zinc, Digi- 
taline, etc. It delays the action of salts of Copper, Morphine and Strychnine, and slightly 
influences compounds of Mercury. It is valueless for Cyanide of Mercury, Tartar Emetic, 
Hydrocyanic Acid, Phosphorus, or the caustic Alkalies. 

Bellini, of Florence, considers the Iodide of Starch a valuable antidote to alkaline 
Sulphides, earthy Sulphides, vegetable and caustic Alkalies, and Ammonia. In the first 
two cases he considers it superior to all other antidotes. 

A fresh mixture of the Sulphide of Iron, Magnesia, and the Sulphide of Sodium, is a 
perfect antidote for salts of Copper, the Bichloride of Mercury (Corr. Sub.), and the 
Cyanide of Mercury. 

If the nature of the poison is unknown, a harmless yet in most cases effectual antidote 
is : R . Magnesias, Carbonis Ligni, Ferri Oxidi Hydrati, aa partes gequales ; Aquae q. s. 
Give ad libitum. 

Castile Soap, dissolved in 4 times its bulk of hot water, drunk by the cupful, is one of 
the best remedies in many cases, especially poisoning with metals, corrosive acids or cor- 
rosive vegetable substances. It is injurious in cases of alkali poisoning. 

Albumen. White of egg, dissolved in water, is especially useful for metallic substances. 
Vinegar, for alkalies, and many narcotics. Coffee, made strong (black), in general anti- 
doting narcotic poisons. Camphor, the principal antidote to all vegetable poisons, espe- 
cially the corrosive. Milk, Oil, Mucilaginous Substances, for corrosive acids, and alkalies. 
Charcoal, for Arsenic, Corrosive Sublimate, etc. 

Emetics. — Zinc Sulphate is the best (R.) ; gr. v-^ss; is non-nauseating. Apomor- 
phine, gr. -fa hypodermically, when narcosis prevents administration by stomach. For 
children, Antim. Tart. gr. ]/ z , in a little sweetened water. Use but little water in mixing 
the antidotes. 

Antidote Bag, designed By Martindale, of London, contains the following-named articles, 
labeled with directions for use, viz. — . 

Dialysed Iron. Spt. Ammonise Aromat. Amyl Nitrite. 

Syrup of Chloral. Oil of Turpentine. Zinc Sulphate. 

Chloroform. Acetic Acid. Ipecacuanha. 

Spt. Chloroformi. Tinct. Digitalis. Potassium Bromide. 

Calcined Magnesia. Tannic Acid. 

Also a Hypodermic Syringe and Solutions therefor of — 

Morphine Acetate. . , . Pilocarpine Nitrate. 

Atropine Sulphate. " " * Strychnine Nitrate. 

Acids. Alkalies, for those least irritating. Magnesium Oxide, Slaked Lime, chalk, 
or magnesia; plaster from wall, with water, milk, oil, white of egg. Bland mucilaginous 
and oily fluids, and poultices (R.). Acetic. — Magnesia, or its carbonates. Arsenious; 
see Arsenic. Carbolic. — Stomach-pump ; a strong solution of the official Syrup of Lime. 
Magnesium or Sodium Sulphate, up to ^ iij , to form a sulpho-carbolate, is a very efficient 
antidote. Atropine is a good physiological antagonist (B.). Characteristic symptoms, 
very dark, black urine. When used locally to excess, apply a strong solution of Sodium 
Carbonate ; also as a wash for the mouth, if necessary. Carbonic ; see Gas. Hydro- 
cyanic (Dilute). — TT\,xl have killed. Ammonia, in any form; cold douche ; Calcium or 
Sodium Chloride, gtt. xxx-xl, in water; Aqua Chlori is the antidote. Inhalations of 
Chlorine or Ammonia; artificial respiration. Muriatic, Nitric, or Sulphuric. — Albu- 
men, Carbonate of Magnesium, Calcium, Potassium, or Sodium, Chalk, Soap, or whiting, 
in milk; Oil. No water in Sulphuric cases. Oxalic. — Calcium Carbonate the antidote 



THE TREATMENT OF POISONING. 721 

(R.) ; Magnesium Oxide (R.)« Prepared Chalk, plaster from ceiling, or common whiting, 
made into a creamy paste with a little water. Bland mucilaginous drinks, and poultices 
to the abdomen. Avoid potash or soda, and all alkaline carbonates. " Salts of Lemon," 
or of" Sorrel," is Potassium Oxalate, used for removing ink stains; it should be treated 
as Oxalic Acid. 

Aconite ^compare Belladonna). Stimulants, emetics, Castor-oil or other purgatives ; 
powdered animal Charcoal, in water; coffee. Bland fluids, and poultices, for abdominal 
irritation. Digitalis, to restore heart's action (Fothergill). 

Alcohol. [Compare Alcoholism and Delirium Tremens in Part III.] Cold water 
smartly sprinkled over face, or cold douche from a height on the head (R.). Stomach- 
pump ; warmth to cardiac and gastric regions, and extremities. Artificial respiration. 

Alkaloids. Tannic Acid, holds a high place (P.). 

Alkalies. Dilute Acids, especially Vegetable Acids; fixed oils (R.)- Vinegar unites 
with them, producing innocuous acetates (L.). 

Alum. Ammonium, or Potassium Carbonates, etc. 

Ammonium. {Common Sources of Danger, Spt. of Hartshorn, Smelling Salts, 
Liquor Ammonia? kept for cleaning purposes by housekeepers.) Vinegar, Lemon-juice, 
Orange-juice, followed by demulcents. If vapor has been inspired, inhale Acetic or 
Hydrochloric Acid. 

Antimony. Alkalies, Tannin, or strong tea and coffee (R.). Astringent infusions ; 
Magnesium and Sodium Carbonates; milk; large draughts of warm water; emesis by 
tickling ; Magnesia in milk, especially for Chloride of Antimony. Tannic Acid especially 
valuable (P.). 

Arsenic (Arsenious Acid). Gr. ij have been fatal. Magnesium Bicarbonate, or other 
alkalies (R.). Charcoal ^ss, or more (R.)- Magnesium Oxide (R.). Emesis by Zinc 
Sulphate %] (avoid tartar emetic), or by feather tickling. Albumen. Oil and Lime-water 
mixed (Taylor), before and after emesis. Milk or other bland fluids to aid emesis in 
washing stomach. Castor-oil after emesis. Linseed tea and Magnesia. Dialysed Iron 
is a good antidote, especially for chronic poisoning. After free emesis, the Ferri Oxidum 
Hydratum (add Liq. Ammon. to Tinct. of Iron); Ferri Subcarbonate just as good ; ^ij 
followed by 01. Ricini (Leale) ; or Hydrated Magnesia; or Magnesia and sugar (Cavl), 
as antidotes. Poultices and fomentations over abdomen. Common sources of danger are 
arsenical wall-papers, arsenic mistaken for " salts" or "magnesia," or adulterated confec- 
tionery; Paris Green (Aceto-Arsenite of Copper) taken with suicidal intent. 

Barium. Fixed oils ; Calcium, Magnesium, Potassium, or Sodium Sulphates. 

Belladonna, or Atropine. (Compare Aconite). Opium a direct antidote, gtt. iij-v 
or more. Brandy, astringent infusions, Coffee. Cold to head, electricity, flagellation, 
pepper. Alkalies, especially Magnesium Bicarbonate, in poisoning by alkaloids (R.). 
Avimonia, breathed into air passages (R.). Charcoal, ^ss or more necessary (R.). Phy- 
sostigma possibly (R.). 

Bees and Insects. Aquae Ammonia, solution of Sodium Bicarb., or Chloride, or Car- 
bolic Acid, applied to the wound; or IT^xv of a 2 per cent/solution hypodermically, Liq. 
Ammon. Acetatis internally. [Compare Stings, in main Index, Part III.] 

Cannabis Indica. Stimulation by Brandy, evacuation of stomach, Strychnine and 
Faradic Electricity are antagonistic, also Lemon-juice freely. 

Camphor. Stimulants, as wine, and Opium. 

Cantharis. Emesis. No oils, but oleagkious injections into bladder. Warm bath, 
Camphor, Milk copiously, Broths, Enemata of demulcents, Opium. 

Chloral. Strychnine, the antidote (R.). Hot bath, or pack, frictions, stimulants, arti- 
ficial respiration. Coffee, fresh air, warmth over cardiac region. In fact, the treatment 
of narcotism. 

Chlorine. After emesis with warm water, give milk, white of egg, flour and water, 
or Lime-water ; Aqua Ammonia;. 

Chloroform, or Ether. Fresh air, cold effusions, flagellation, coffee, electricity, arti- 
ficial respiration. Amyl Nitrite, as antidote (Schuller). Atropine, hypodermically as 
antagonist to Ether (Amidon in N. Y. Med. Record, May 2d, 1885); is equally efficient 
in chloroform narcosis, as I have found by experience ( Potter) . Invert patient, draw tongue 
well forward with forceps, then compress and relax chest ; the position to be maintained 
46 



722 THE TREATMENT OF POISONING. 

until breath and pulse are good (Nelaton). Ice in rectum. Faradization of respiratory 
muscles. If swallowed, use stomach-pump, then Ammonia and warmth. Liq. Ammon. 
injected (rr\x-xl aq.) into veins, — Bartholow says unsuccessfully. 

Colchicum. Treatment same as for Aconite. 

Conium. Alcohol, etc.; external warmth after evacuation from stomach. 

Copper. Albumen, gluten, milk, sugar, Po f assium Ferrocyanide. No vinegar. In 
absence of eggs, give a thin paste of flour and water. 

Creasote. Mucilage, Oil, are antidotes. Ammonia when great depression. 

Digitalis. The treatment is similar to that for Aconite. Emetics, brandy, horizontal 
position ; galvanism, in bad cases. 

Fish. Capsicum, Chloroform, Potassium Chlorate freely ; Liq. Ammon. Acet., Opium. 

Gamboge. Potassium or Sodium Carbonate, or Magnesium in milk ; mucilaginous 
drinks. Opium. 

Gases. Carbonic Acid. — Galvanism, Oxygen inhaled; artificial respiration indis- 
pensable. Ammonia inhalations. Sponge with brandy or alcohol and water. Open air, 
horizontal position, clothing removed, cold douche, hot water to feet, stimulants, frictions. 
Subsequently, warm bed, open windows ; Condy's fluid about room ; stimulants sparingly ; 
cold acid drinks ad libitum. Sulphuretted Hydrogen. — Chlorine Gas, well diluted 
with common air. 

Gelsemium. Galvanic current, stimulants, Brandy and Cayenne Pepper, warm baths, 
frictions, hot bricks to feet. 

Glass, coarse or in powder. — Much bread in crumbs to envelope it, then emetics. 

Gold. Ferric Sulphate, Mucilage. 

Hyoscyamus. See Belladonna. 

Iodine. Starch or flour given in tepid water ; white of egg and milk ; free emesis, so 
long as liquid rejected tinges blue a solution of starch. Sodium Bicarbonate. 

Iron. Carbonates of Ammonium and Sodium; Magnesia; Mucilaginous drinks. 

Lead. Albumen, milk; alkalies especially Magnesium Bicarbonate (R.). Lukewarm 
drinks, or Sulphates of Sodium or Magnesium, or freshly precipitated Ferric Sulphate (R.). 
Promote vomiting ; stomach-pump (R.). Sulphuric Acid and Magnesium Sulphate, for 
the constipation. The cachexia is much relieved by a combination of Sulphate of Quinine, 
Sulphate of Iron, and dilute Sulphuric Acid (B.). Potassium Iodide, gr. xv-xx 3 or 4 
times each day (B.) ; as after eliminative, in chronic cases (R.). When great pain at 
defecation give Extr. Belladon., gr. y%, Rhei, gr. ij, in pill twice daily (Da Costa). Alum, 
the most effective agent for the colic. [See Colic for formula.] Or to a pint of boiling 
milk add 90 grs. of alum, powdered ; separate the curd, and sweeten with sugar. Sig. — 
A wineglassful every hour or two (B.). Electricity, in the paralysis (dropped wrist), a 
slowly-interrupted current until it causes reaction. Cure to be completed by the'faradic 
current (B.). Strychnine, in paralysis, gives good results (B.). Sulphides, as baths, in 
chronic form (R.). 

Marked Diagnostic Signs. — Drop-wrist (paralysis of extensor muscles) ; dark-blue line 
around edges of gums. 

Lime. Calcium Chloride. Albumen, mucilaginous drinks, oils, milk, flour, and 
water. No acids. 

Mercury. Gr. iij of Corrosive Sublimate have proved fatal. Albumen, Yolk of egg, 
vegetable astringents, gluten, flour, milk; Potassium Iodide, as after-treatment. The 
Hydrated Protosulphide of Iron, if given within twenty minutes, is said to be a chemical 
antidote. Potassium Iodide, converts the metal into soluble combinations (B.). Bismuth, 
locally in salivation (B.). Sodium Sulphite, locally gj-^j aquse (B.). Tannic Acid, 
locally, as gargle in salivation. ]£ . Acidi Tannici, gj, Mel. Rosce 3 ij, Aquae ^vj. M. 
Gargle (B.). Belladonna, to diminish secretion in ptyalism, v-x drops of tincture every 
4 to 6 hours (B.). Hyoscyamine, for tremor, gr. -^ gradually to j 1 ^ (Oulmont). Alkalies, 
Bicarb, of Magnesium best (R.). Baths, simple or sulphurous (R-). Charcoal, ^ss or 
more necessary in poisoning by Corrosive Sublimate (R.). Cod-liver Oil, in chronic cases 
(B.). Nitric Acid, gtt. ij of the dilute acid in water ter die; also gargles of lukewarm 
water, acidulated with same (R.)- Sulphurous Acid, int. and as gargle (R.). 

Mezereum. Albuminous and mucilaginous drinks; milk, oils, and fats; albuminous 
enemata; cool poultices to abdomen ; Opium. 



THE TREATMENT OF POISONING. 723 

Mushrooms. Emetics, if soon after; Purgatives, if some time has elapsed. After 
general treatment, Stimulants, unless inflammatory symptoms present themselves. Poul- 
tices to abdomen. Tannic Acid has been recommended. 

Opium or Morphine. Common Sources of Danger. — Soothing Syrups for quieting 
of children. (The American Journal of Pharmacy estimates the loss from this cause at 
150,000 every year.) Paregoric. Overdosing with Cough mixtures. 

Treatment. — Vegetable astringents ; strongest, hot black Coffee. Cold douche, flagel- 
lation, artificial respiration, persevered in for hours. Belladonna, Hyoscyamus or Stramo- 
nium. Faradism of phrenic nerves; Stimulants. Comp. Tinct. Iodine. Emetics by 
mouth are usually useless, may be given as enemata; or Apomorphine, gr. ^ to y% as 
emetic (hypoder. Jg-), must be administered before narcosis has set in (B.). Stomach- 
pump probably best, afcer which Vegetable Acids, to contract the narcotism. Cream of 
Tartar and water, Vinegar and water, Lemon-juice, etc., every ten minutes (R.). Atropine; 
g r - )i~% hypodermically (R.) ; gr. T ^ every 15 minutes up to three doses (B.) ; in large 
amounts till pupil dilates, a successful antagonist (R.). No one is warranted in omitting 
Belladonna (P.). Amyl Nitrite, inhaled, has proved eminently successful in a case in 
which Belladonna or its alkaloid proved useless to restore the patient. Ammonia, as 
intravenous injection for failure of heart's action from Opium and Chloroform narcosis, etc. 
(B.) ; breathed into air-passages (R.). Potassium Bromide, controls the disagreeable 
cerebral effects and vertigo resulting from Opium (R., B.). Water, hot water and ice 
alternately to nape of neck, in stupor of Opium-narcosis (B.). Copper Sulphate, as emetic, 
prompt and effective (B.). Zinc Sulphate, gr. vj as emetic, well diluted with water (B.). 
Effervescent Emetics, effective but dangerous (B.). Caffeine, hypodermat. (B., P.). Heat, 
alternately with cold (B.). Charcoal, ^ss or more (R.). 

Phosphorus. Emesis by Cupric Sulphate ; Magnesia in Linseed-tea ; Carbo Animalis ;■ 
mucilaginous drinks; Liquor Calcis. Avoid all oleaginous mixtures. Poultices to epigas- 
trium. Sulphate of Copper, the best emetic, combining to form the less active phosphide 
(B.). Turpentine emulsion with hydrated Magnesia, freely (B., R.) ; n\xxx in mucilage, 
every % hour, excellent (P.). Transfusion, has been employed to repair blood (B.). 

Physostigma. Minimum fatal dose, grain i t 2 q. Chloral, the antidote (R.), if admin- 
istered very early. Belladonna, gr. 3L to ^ Atropinae, hypodermically repeated until 
effects are evident. The nine-thousandth ol a grain of Atropine, injected rive minutes 
before giving a minimum fatal dose of physostigma, prevents its fatal effects (R). 

Picrotoxine, or Cocculus Indicus. Chloral, the antidote (B.). 

Potassium Salts. Potassium Bromide. Nervous Stimtilants — Brandy, Opium. 
Potassium Nitras (Saltpetre), — No chemical antidote. Emetics and stomach-pump, 
demulcent drinks, Opium, milk, aromatics, emollient enemata. 

Quinine. Emetics and cathartics, Opium, Coffee, Brandy, or wine, diuretics and sudo- 
rifics as after-eliminatives. 

Reptiles. (Compare Slings.) Ligate limb above wound ; cleanse thoroughly, and 
cauterize with mineral acids or strong Carbolic. The wound should be forcibly sucked 
by a person with perfect mucous surface. Internally, Arsenic, when rapid prostration 
(R.) ; Ammonium, diaphoretics, Sodium Bisulphate, Whiskey, largely. Agave Ameri- 
cana. R . Potass. Iodidi gr. iv, Hydrarg. Chlor. Corr. gr. ij, Bromi 3 v, Aquae 3 j ; gtt. 
x in ^ ^ of Brandy; repeat if necessary (Hammond). Ammonia, by intra-venous injec- 
tion, is shown to be unavailing by Brunton and Fayrer (B.). 

Rhus (Poison Oak or Ivy), — Carbolic Acid, locally, a 5 per cent. sol. Sulphide of 
Potassium, baths, ^ j to C xx. Lobelia, as infusion, ^j ad Oj,a good application locally. 
Grindelia, the fluid extract, I part to 10 of water, as lotion; maybe used undiluted. 
Cocaine, a 10 per cent, oleate, or a 5 per cent solution in water, as a local application, 
promptly relieves the symptoms. Acetate of Lead, gij, Ammonii Chloridi (crude) i|ss, 
Aqua? ^viij, as lotion on cloths constantly wetted tnerewith, used with uniform success 
(Burns). Soapsuds and water, hot, frequent washing with this the surest, speediest, and 
best treatment (Couch). Aristol, freely dusted over the part, gives magical relief 
(Levick). 

Silver Nitrate. Alkalies, especially the Magnesium Bicarbonate (R.). Sodium Chlo- 
ride, largely diluted, effects a double decomposition, precipitating the silver as the harm- 
less insoluble chloride (R.). The resulting irritation may be allayed by milk, which 
should serve as food until the stomach is restored. 

Silver, Metallic. Albumen, Milk. 



724 THE TREATMENT OF POISONING. 

Stramonium. See Belladonna. 

Strychnine or Nux Vomica. Fatal dose of strychnine gr. ]/ 2 for adult, gr. T L for 
child. Chloral, the antagonist, especially when given soon. Physostigma, as an anti- 
dote (R.). Chamomile Oil, remarkably subdues reflex excitability in frogs after poison- 
ing by Strychnine or Brucine (P.). Tobacco, a good antagonist. The Stomach-Pump, if 
available before tetanic symptoms. Animal Charcoal, largely; Tannin freely; Solution 
of Iodine. Chloroform Inhalations, injections of Curare, or Urethan, or Methyl and 
Ethyl compounds of Strychnine, Brucine, or Thebaine. Artificial respiration ; fats ; 
Nitrite of A my I, inhaled; Magnesia (R.). Tube in oesophagus, and flexible catheter 
in larynx (R.). Veratrum Viride has cured a bad case ; a teasp. was given at once, 
then gtt. ij every io minutes (R.). Ice to spine. Tobacco enemata. Lobelia, Potassium 
Bromide, Monobromated Camphor, hot bath. Valerian mitigates the spasms (P.). 
Curare, warmly recommended, but its claims are doubtful (P.). Nicotine, many cases 
prove its curative power (P.). 

Tin. Albumen, Ammonium and Sodium Carbonates, Milk. 

Tobacco. Strong Coffee and Brandy; warmth and friction; artificial respiration. 

Vegetable Poisons. Generally albuminous or mucilaginous drinks, oils, etc. Stimu- 
lants, Opium, ice ; cool poultices and fomentations to abdomen. 

Veratrum Viride. Digitalis, Opium, Stimulants. 

Wounds. Ammonium Carbonate, gr. v, hypodermically in vicinity of wounds caused 
by poisoned arrows, repeatedly used with success in saving life, by Dr. Parke, surgeon 
to Stanley's last African expedition. 

Zinc. Albumen, mucilaginous drinks, milk, Tannin. Potassium and Sodium Carbo- 
nates, if given early. Soapsuds given freely. Warm water in copious draughts. 



FORMS OF BRIGHT S DISEASE. 



725 



DIFFERENTIAL DIAGNOSIS. 
Forms of Bright's Disease. 

Compared with Acute Nephritis and -with each other. 







a. 

V 



< 


(il Acute 

Bright's 

Disease. 

Acute 

Parenchy. 

Nephritis. 


Chronic Bright's Disease. 


Clinical Phenomena. 


(11) Chron. 

Parenchy. 

Nephritis 

{Large 

White 

Kidney) . 


J 3) 

Fatty 

Kidney. 


f4) 

Amyloid 
or Waxy 
Kidney. 


(5) Chron. 
Interstitial 
Nephritis 
( Cirrhotic 
Kidney.) 


H 


Quantity , 


Normal 
or — 


- 


-or + 


Normal 
or — 


Normal 
or + 


Normal 
or + 


Reaction, 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 


Color, 


Wine 
yellow. 


Dark 

smoky. 


Brown 

yellow. 


Pale. 


Pale. 


Clear. 


Sp. Gr., 


Normal 
or — 


High. 


- 


1.015-1 030 


— , above 

1. 010 


— 1. 010 


Urea, .... 


Normal. 


- 


- 


- 


Normal 
or — 


Normal. 


Chlorides, 


Normal. 


- 


- 


- 


- 


Normal. 


Albumen {per cent.), . . 


A to i 


1 to 6 


y 2 to 2 


1 to 6 


A to % 

of 

globulin. 


A t0 % 


Casts, 


Hyaline 

and 
Epithel. 


Blood. 
• Epithel. 
Hyaline. 


Granular 
Hyaline. 
No blood. 


Fatty. 


Few and 
hyaline. 


Very few. 


Sediment {macroscopical), 


Mucus. 
Blood. 


Brown 

cells. 

Urates. 


Kidney 

epithel'm 

Blood 

Lymph. 


Free oil. 


Seldom 
any. 


Seldom 
any. 


D 




Seldom. 


Great, 

especially 

of face. 


Never 
absent. 


Great. 


Trifling. 


In last 
stages. 






TT 






Often 

great. 


Not 
marked. 




Great. 













Other Symptoms, 


Stiff 

joints. 

Sacral 

pain. 

Lassitude. 


Fever. 


Tempera- 
ture low. 
No fever. 
Inflam. of 

serous 
membr's. 
Cardiac 

hyper. 


Face pale, 

puffy. 

Cardiac 

hyper. 


Emacia- 
tion, sal- 
low face, 
enlarged 
liver and 
spleen, 
thirst, 
diarrhoea. 


Retinitis. 
Tense, 
quick 
pulse. 

Hyper, of 
heart. 


Prognosis, 


Favorable 


Recovery 
or No. 2. 


Recovery 
(?)orNo.3. 


Depends 
Always on con- 
fatal. 1 st.tutional 
disease 
1 present. 


Unfavor- 
able, but 

course 
perhaps 

long. 



Note. — The signs + and — respectively denote a specific gravity greater than 1.024, or less than 1.018, 
in the line entitled Sp. Gr. 



726 



DIFFERENTIAL DIAGNOSIS. 



Cancer. 



Cancerous {Malignant') Tumors. 

Are of constitutional origin. 

Have no cyst, but invade and convert the 

sui rounding tissues. 
Cancer material is short-lived from rapid 

deterioration, but is rapidly reproduced. 
Severe increasing pain. 
Extend to remote parts, reappearing chiefly 

in lymphatic glands. 
Cancerous cachexia of general health. 
Recur after extirpation, fatal in end. 



Non malignant Tumors. 



Origin, some local error of growth. 
Limited by a cyst ; may compress, but do 

not invade adjacent tissues. 
Have uncertain period of increase, after 

which may remain stationary. 
Usually no pain. 
Are local, have no disposition to spread. 

Impair functions of paits pressed on. 
Do not recur. 



Scirrhtis. 

Is hard. 

Appears mostly on female breast. 

Hard kernel, movable under skin. 

Becomes fixed to adjoining structmes, which 

it puckers. 
Single and grows slowly. 
Course slow — 2-4 yea:s. 
Never in the young. 



Encephaloma. 

Is soft and brain-like. 

Most frequently on the limbs. 

At first deeply seated, hard to recognize. 

Spreads through loose textures, which it 

pusl es aside and distends. 
Has numerous tumors, grows rapidly. 
Generally fatal in 1-2 years. 
Often in the young, even at biith. 



Carditis. 



Endocarditis. 

Blowing sound. Excited heart action. 
Slight if any increase of percussion dulness. 
Impulse strong. 

Sounds normal, or more distinct, except at 
site where murmur is heard. 



Pericarditis. 

Friction sound. Excited heart action. 
Marked increase in effusion stage. 
Wavy and feeble. 
Feeble and muffled; no blowing sounds. 



Cerebral. 



Concussion. 



Patient can be roused ; pupils act. 
Breathing seldom stertorous. 
Urinary action normal. 
Symptoms appear closely after accident. 



Compression. 



Complete insensibility ; motionless pupils. 
Breathing usually stertorous. 
May be either retention or incontinence. 
Frequently do not. 



Chancre and Chancroid. 



Chancre. 



Commences about 3d week after coitus. 
First as a papule, abrasion, or crack. 

Generally indurated (rarely not). 

Develops slowly. 

Discharge slight, unless irritated. 

Is soon limi'ed and seldom phagedenic. 

Edges sloping, not undermined. 

Scanty serous secretion. 

Sore remains solitary, and cannot be multi- 
plied. 

Followed by numerous buboes, rarely sup- 
purating, never furnish inoculable pus. 



Chancroid. 

In 24 hours to 3 days. 

First as a red spot, then a pustule, then a 
suppurating sore. 

Not on an indurated base. 

Develops rapidly. 

Suppurates profusely. 

Tends to invade surrounding tissues, or be- 
come phagedenic. 

Edges undermined. 

Discharge is pus and copious. 

May be transplanted at will, and is seldom 
single. 

A single bubo may appear and suppurate. 



DIFFERENTIAL DIAGNOSIS. 



7?7 



Cholera, 



Asiatic. 



Preceded by painless diarrhoea. 
Not directly from error in diet. 
First pain shooting down thighs. 
Prostration rapid and overwhelming, and 

out of ratio to evacuations. 
Rapid reduction of surface tempeiature; 

high temperature in cavities. 
Evacuations like rice-water from first. 

Cramps commence in extremities. 
Veins congested ; tongue, lips, and extremi- 
ties livid purple. 
Urine albuminous. 



Simple. 



Seizure sudden. 

Generally is from error in ditt. 

First pain, abdominal colic. 

Prostration gradual, less marked than the 

vomiting and purging. 
Gradual reduction of surface temperature ; 

internal temperature normal. 
Discharges bilious, causing burning and 

smarting pain; only colorless at very last 
Cramps commence in abdomen. 
Not so. 

Not so. 



Croup and Diphtheria. 



Croup. 

Premonitory hoarse, metallic cough, with- 
out illness. 

A child's disease. 

Tenacious mucus, covers the swollen mem- 
brane. 

A local disease. 



Diphtheria. 

Premonitory illness, shivers, fevers, t>ore 

throat, without cough. 
Attacks adults as well. 
Distinguished by a false membrane. 

A blood poison ; great general depression. 



Epilepsy and Hysteria. 



Epilepsy. 

Sudden, complete loss of consciousness. 

Livid face, frothy saliva escapes, eyelids 
half open, eyeballs rolling, teeth grind- 
ing, tongue biting ; more or less insensi- 
bility of pupils to light. 

Countenance is distorted. 

Patient shows no feeling. 

Aura epileptica. 

Short paroxysm, followed by heavy coma- 
tose sleep and dull intellect. 

Frequently occurs at night. 

Not necessarily of uterine connection, 
though a paroxysm often occurs at the 
menstrual period. 



Hysteria. 

Gradual and partial or apparent. 

Face flushed, or complexion unaltered, no 

froth on lips, eyelids closed, eyeballs 

fixed, no grinding of teeth, or biting of 

tongue ; pupils react readily. 
Is not. 

Sighs, or laughs, or sobs. 
Globus hystericus. 
Longer paroxysm, not sleepy, but usually 

wakeful and depressed in spirits. 
Rarely occurs at night. 
Often connected with uterine or menstrual 

disorders. 



Gout and Rheumatism. 



Gout. 



Chiefly affects small joints, especially the 
metatarsal joint of the great toe. 

From 35-50 years; rarely before puberty. 

Most frequent in men, and result of idle, 
intemperate and luxurious life. 

Is strongly hereditary. 

Chalk stones (urate of soda) in ext. ear, on 
tops of fingers, or elsewhere. 

Uric acid in the blood, absent from urine. 

A fit often affords temporary relief. 

Is confined to temperate zone. 



Rheumatism. 
Large joints chiefly implicated. 

Generally in young adults. 

Affects both sexes equally, and equally tie 

poor and the rich. 
But slightly so. 
Not so. 

Lactic acid in the blood. 

Quite the contrary. 

Is ubiquitous— prevails in all climates. 



728 



DIFFERENTIAL DIAGNOSIS. 



Hematemesis and Hemoptysis. 



Hematemcsis. 

If from the stomach, the blood is of a dark 

color, and is vomited. 
Often mixed with food, not froth. 
Preceded by nausea and stomach distress, 

and blood is passed with the stools. 



Hemoptysis. 
If from the lungs, it is bright red, and 

generally coughed up. 
Generally frothy, mixed with sputa. 
Preceded by pain in the chest and dyspnoea. 
No blood in the stools. 



Pleurisy and Pneumonia. 



Pleurisy. 

Sharp pain, friction sound, dry cough, im- 
paired chest motion. 

In stage of effusion, obliteration of inter- 
costal spaces, enlargement of the side, 
viscera displaced. 

Dullness, with enfeebled or absent respira- 
tion, voice, and fremitus. 

Sputa frothy, rarely any rales. 
Febrile symptoms slight usually. 
Temperature irregular, rarely high. 



Pneumonia. 

Dull pain, crepitant rale, cough followed 

by expectoration. 
In stage of hepatization none of these 

signs are present. 

Dullness, with marked bronchial respira- 
tion, distinct thoracic voice, increased 
vocal fremitus. 

Sputa rusty color, rales common. 

Febrile symptoms severe. 

Sudden elevations and falls, high tempera- 
ture not uncommon. 



Phthisis. 



Tubercular. 
First symptom, a dry, short cough. 

No exciting cause apparent. 

Hereditary cases are of this class. 

Frequently preceded by enlarged or sup- 
purating glands, or other evidence of 
scrofula. 

Voice changes from tubercular deposit. 



Non- Tubercular. 

First stage follows catarrh, bronchitis, or 

some other acute disease. 
Is referable to some exciting cause, as cold, 

inflammation, or inhaling of heavy dust. 
Not hereditary. 
No evidence of scrofula. 



No change of voice. 



Scarlet Fever. 
Incubation I day to weeks. 

Fever, great heat of skin, 
and frequent pulse, un- 
abated during eruption. 

Brilliant stare. 

Eruption on second day, not 
rough, first on neck and 
chest, spreads rapidly, 
white streak on pressure 
with nail. 



Exanthemata. 

Measles. 
Incubation, 7-14 days. 

Same fever rather increased 
by eruption. 



Liquid watery eye. 

On fourth day, on face, 
rough, spreads gradually, 
streak lasts shoit time. 



Smallpox. 

Incubation, 6-20 days. 
Average, 10. 

Fever often violent, bound- 
ing pulse, pain in loins, 
greatly relieved by erup- 
tion. 

Usually on third day, at first, 
oTi lips and forehead, 
spreading rapidly. 



DIFFERENTIAL DIAGNOSIS. 



'2Q 



Scarlet Fever. 

Uniform, or large patches, 
interspersed raised spots 
and some vesicles, rash 
scarlet, on its seventh day 
very complete desquama- 
tion in large patches. 

Sore throat, rarely coryza 
or bronchitis. 

" Raspberry " tongue, red. 

Cerebral symptoms frequent 
and grave. 

Temperature may be 105 - 
122 to 10th day, subsides 
gradually, falls on 5th, 
loth, and 15th days. 

No secondary ftver. 

Pneumonia rare, pleurisy 
more frequent. 

Sequelae: Bright' s disease, 
dropsy, deafness, conjunc- 
tivitis, phthisis, chronic 
diarrhoea ; glandular en- 
largements. 



Measles. 

Crescentic patches, last 
about 5 days, and then 
partial desquamation, 
scales very fine. 



Coryza and bronchitis very 
constant, rarely sore 
throat. 

Tongue coated, may be red 
at edges. 

Not so. 

I03°-io6° before eruption, 
remains hi^h for 1-2 days 
after, then falls suddenly. 

None. 

Pneumonia a frequent com- 
plication. 

Sequelae : chronic bronchi- 
tis, phthisis, conjunctivitis. 



Smallpox. 

Papular, then vesicular, 
finally pustular ; pustules 
maturate on 8th day of 
eruption. 



Sore throat often and dry 
cough. 

Coated and swollen, may be 
red at edges. 

Cerebral symptoms are fre- 
quent. 

Belore eruption often 106 , 
then rapidly sinks to ioo° 
in 36 hours ; rises during 
secondary fever. 

Always secondary fever. 

Pneumonia not a very fre- 
quent complication. 

Sequelae : chronic diarrhoea, 
glandular enlargements, 
various eye diseases. 



Typhus and Typhoid. 

Typhus Fever. Typhoid {Enteric) Fever, 



Attacks quickly, incubation 9 days. 
Occurs at any age. 

Rare among the higher classes, except 

those exposed. 
Mulberry eruption on 4th or 5th day, on 

extremities, lasts till close. 

Brain chiefly affected ; bowels are often but 
little so; abdomen natural, evacuations 
dark, but never bloody (these are occa- 
sionally reversed). 

Contracted pupils, dusky face. 

Pulse and temperature rise to 120 and I05 
till 3d day, high for 6 days, then fall. 

Lasts 2-3 weeks. 
Relapses rare. 

Death from coma, or congestion of the 
lungs, in 1st or 2d week. 

Arises from destitution, over-crowding, bad 
ventilation, is contagious, and generally 
epidemic. • 



Post-mortem : not constant, most frequent 
are dark blood and enlarged spleen, soft 
heart. 



Commences slowly, incubation about 13 

days. 
Most common in youth and childhood, 

rarely after 40. 
As common among the rich as the poor. 

Rose eruption, few, on abdomen, and in 
successive crops, which fade and disap- 
pear. 

Bowels chiefly affected, evacuations ochre- 
color and watery, sometimes hemorrhage, 
or even ulceration, abdomen tumid. 

Dilated pupils, cheeks flushed. 

Pulse and temperature rise and fall inde- 
pendently, and without uniformity, but 
both are usually high to 15th day. 

Lasts 4-6 or more weeks. 

Relapses frequent. 

Death from asthenia, pneumonia, hemor- 
rhage, or perforation of intestine, in or 
after 3d week. 

Bad drainage, poisoned drinking water, 
putrid animal matter, want of ozone, 
certain electrical conditions; is not con- 
tagious, often sporadic. 

Post-mortem : morbid Peyer's patches, en- 
larged mesenteric glands, ulcerated 
mucous coat of intestines ; enlarged and 
soft spleen, ulcerated pharynx. 



73Q 



TEMPERATURE IN DISEASE. 



Yellow and Bilious Fevers. 

Yellow Fever. Bilious Remittent. 



Short duration ; ends in 3-7 days. 

Incubation 5-9 days. 

A disease of one paroxysm, terminating in 

recovery or collapse. 
Very severe nausea and vomiting, early 

epigastric tenderness. 
Black vomit. 

Hemorrhages from various parts. 
Tongue clean, or slightly coated. 
Pulse variable, slow at end. 
Injected and humid eye. 
Supra-orbital pain, pain in back and in 

calves of legs. 
Rarely delirious, mind clear generally. 
Urine albuminous, usually suppressed. 
Rapid convalescence, no sequelae. 
Little muscular prostration. 
High mortality, epidemic. 
Treatment unsatisfactory. 
Autopsy : inflamed or congested stomach, 

enlarged yellow liver, filled with oil 

globules, muscular fibres of heart are 

often disintegrated. 



Lasts 9 days or more. 

Incubation may extend to months. 

A disease of several paroxysms, wilh inter- 
vening remissions. 

These symptoms are not so severe nor to 
early. 

Bilious vomiting. 

No hemorrhagic tendency. 

Tongue heavily coated. 

Pulse quick to convalescence. 

Eye natural. 

Headache, sense of fullness in head, often 
no loin or leg pains. 

Delirium frequent, mind dull. 

Not so. 

Slow convalescence, tedious sequelae. 

Greater muscular prostration. 

Slight mortality, endemic. 

Very amenable to treatment. 

Autopsy : stomach' congested, rarely in- 
flamed, liver olive or bronze hue, not 
fatty. 



Vomiting. 



Cerebral. 



Little or no nausea, vomiting continues after 

stomach is emptied. 
No tenderness or pressure over the liver or 

stomach. 
Pulse infrequent and hard. 
Tongue clean, breath sweet, conjunctivae 

normal or injected, and headache primary. 

Generally obstinate constipation. 
No salivation. 



Gastric or Hepatic. 



Nausea relieved by discharge, returns when 
food is taken. 

Liver and stomach are tender, pressure pro- 
duces inclination to vomit. 

Pulse frequent and weak. 

Tongue furred, breath offensive, conjunc- 
tivae often yellowish, and headache sec- 
ondary as to time. 

Griping abdominal pain, diarrhoea and 
clay-colored stools. 

Increased salivation. 



NOTES ON TEMPERATURE IN DISEASE. 

Temperature, average normal, of adults, 98. 6° F. ; of children, 99 ; of the aged, 
98. 8°. Diurnal variation i° to 1.5° F., highest from 9 A. M. to 2 P. M. Above 108 F. is 
a fatal sign, which issue may be averted by cold baths, reduced by ice from 96 to about 
6o° F. (A.). The clinical thermometer placed in the mouth, axilla or rectum, and retained 
in situ for five minutes, should go hand in hand with Aconite in the treatment of inflam- 
mations (R.). [For antipyretics see the articles Fever, Inflammation, in part III, also 
the list of these agents on page 42.] • 

Clinical Thermometry is one of the principal means of positive diagnosis. The ther- 
mometer should be self-registering, certified, and accurately marked according to the 
Fahrenheit scale. The most reliable temperature is that in recto, or in the vagina; less 
so in the axilla and folds of skin, and still less reliable in the mouth. A correct reading 
of the thermometer cannot be obtained in less time than five to seven minutes. (Da Costa. ) 

The Average Normal Temperature of the body is 98.6 ; which, like the pulse, will 



TEMPERATURE IN DISEASE. 73 I 

vary somewhat in individual ca«es; as a general practical result, it is agreed that in tem- 
perate regions the normal temperature at completely sheltered parts of the surface of the 
human body amounts to 98.4 Fahr., or a few tenths more or less; and a rising above 
99. 5 , or a depression below 97. 3 F., are sure indications of some kind of disease, if the 
increase or depression is persistent. The temperature is increased at the prime of life, is 
raised and depressed temporarily by the influence of diet, stimulants, exercise, etc. The 
minimum diurnal temp, is observed at 2 A. M., the maximum at 4 to 6 P. M. Any rise 
above 99. 5 , or fall below 97. 3 if persistent, indicates disease ; on the other hand, a 
normal temperature does not always indicate good health. The greatest recorded range 
of temperature in disease is 50.4 ; the minimum is 7 1.6° in a case of sclerema neonatorum 
(Quain's Diet.), the maximum 122 . In severe and fatal cases it rarely exceeds 107 °, 
and rarely falls below 92 , even in fatal collapse. It may rise 3°-4 n after death, as ob- 
served in a case of typhoid fever in which death occurred with a temperature of 107 , 
which ^increased shortly afterward to 1 10.5 . A temperature of 107 indicates malig- 
nancy, and where met with for two consecutive days in typhus, scarlatina, measles, pneu- 
monia, pyaemia, meningitis or rheumatism, death may be expected shortly. In relapsing, 
remittent and intermittent fevers, and in the initial chill of an abortion, the temperature 
may reach 107 ° without indicating great danger. During the last hours of life, in many 
diseases, the temperature rises to I09°-iii°; for example, in tetanus, sunstroke, typhus, 
etc. With a temperature of 96 collapse is imminent. 

Abnormally High Temperatures reported in the British Medical Jour., by Dr. Donkin. 
In these eight cases all but one were in females, and none proved fatal. Pain was a 
prominent symptom in all. No. I, ill. 6°; convalescing from enteric fever. No. 2, 108 ; 
no organic lesions; ovarian pain. No. 3, I15.8 ; great abdominal pain and excitement. 
No. 4, iii°; convalescing from enteric fever. No. 5,113°; enteric fever and double 
pneumonia. No. 6, 1 12°; synovitis. This was the only male. No. 7, 1 12°; painful 
stump, with necrosis. No. 8, 117°; pyonephrosis. 

A High Average Temperature (above 104°), is found in severe pneumonia, scarlatina, 
remittent, typhus, typhoid and relapsing fevers, pyaemia, etc. A Moderate High Tem- 
perature (102° and above), is seen in peritonitis, acute rheumatism, pericarditis, pleurisy, 
dysentery, cerebro-spinal-meningitis, catarrhs, etc. A temperature of ioo° and above is 
found in chronic affections, incipient inflammations, and mild fevers. When, in efferves- 
cence, the heat increases rapidly, it will, in defervescence, decline proportionately fast, 
and vice versa. Beware of a grave affection when the temperature is of a continuous type. 
A distinct interval between morning and evening temperature is a favorable sign. A slow 
and gradual increase indicates typhoid fever; in rheumatism and anomalous fevers the 
increase is more rapid, and still more so in acute inflammatory disease, pneumonia, angina, 
pleurisy, typhus, scarlatina, rubeola, etc. It is usually very rapid in intermittent fever, 
febricula, and ephemeral fevers. A rapid effervescence and slow defervescence indicates 
some complication of disease; the reverse order indicates great danger. When the tem- 
perature begins to fall from the evening to the morning, it is an indication of improvement ; 
while a rise of temperature from the evening to the morning is a sure indication that the 
patient is worse. Stability of temperature from morning to evening is a good sign, but 
from evening to the morning, unfavorable. 

A Decrease of Temperature below the normal heat is rare. It occurs sometimes 
transitorily, announcing thereby a favorable crisis, by preceding the return to a normal 
temperature. It is also met with occasionally during the morning remission of remittent 
fever; also during the apyrexia of intermittents ; in acute collapse, preceded or not by 
fever; in chronic wasting diseases; and sometimes, also, on the approach of death, 
especially in typhus fever. 

In Phthisis, the temperature is higher in the evening than in the morning ; later, higher 
at early bedtime than at noon, and high again at dusk. This is a valuable and delicate 
test of the progress of tuberculization. 

In Typhoid Fever, the accession is by a rise of one degree each day, with the diur- 
nal variation. If the evening temperature does not exceed 103. 5 , the disease will 
probably be mild; but a temperature of 105° in the evening indicates a severe type and 
much danger. A sudden reduction to 95° in the third week denotes intestinal hemor- 
rhage ; a lingering temperature of I0i°-102° in the fourth and fifth weeks indicates non- 
cicatrization of the intestinal ulceration. 

In Scarlatina, the rise of temperature is rapid, 104. 7 maybe reached in a few hours. 
It seldom rises above 105° and never above 106° ; is continuous until the eruption begins 
to fade, when remissions take place, unless complications arise. 

In Measles, 103° is the usual temperature, with daily variations, increasing with frhe 



732 OBSTETRICAL MEMORANDA. 

eruption and. catarrhal symptoms. A high temperature lasting beyond the tenth day 
denotes complications. 

' In Diphtheria, the temperature by the end of the third day will, in uncomplicated cases, 
not exceed I03°-I04°. It falls temporarily with the exudation. Defervescence in the 
severe, favorable cases, is from the twelfth to the fourteenth day; in the milder cases not 
before the sixth. In some fatal cases it occurs early, from the third to the fourth day. In 
asthenic cases the temperature of the surface falls, while that of the interior remains high 
— ioo° in the axilla, and 103 in the rectum. During convalescence, the temperature is 
low, and readily depressed, but may be raised by intercurrent maladies. Any increase 
after the first five days, or a continuous high temperature after the first ten days, is 
unfavorable. A sudden rise may indicate complications. 

Co- Relation of Pulse and Temperature. — As a general rule the co-relation of pulse 
and temperature may be stated as follows, namely : an increase of temperature of one 
degree above 98 F. corresponds with an increase of ten beats of the pulse per minute, as 
in the following table: — 

Temperature of 98 corresponds with a pulse of 60. 

99° " « 70. 

" ioo° " " 80. 

" 101 " " 90. 

" 102° " " IOO. 

" IO3 " " I IO. 

" IO4 " " I20. 

" IO5 " " I30. 

" io5° " " 140. 



> 



OBSTETRICAL MEMORANDA. 

Pregnancy. — Duration about 275 days; usually reckoned as about 280 days from 
the first day of the last menstruation. The extremes of 405 cases at the Hotel Dieu were 
6 months, and 1 1 months 8 days. Many rules for the calculation of the date when labor 
may be expected are given ; as good a one as any is to count backward three calendar 
months from the last day of the last menstruation, then add 7 days to obtain the date of 
expected confinement (Naegele). The French law makes a child illegitimate if born 
within 200 days after marriage, or over 300 days after the husband's death. 

Evidences of pregnancy may include : suppression of the menses ; nausea and vomit- 
ing, morning sickness; salivation; changes in the appearance of the breasts and nipples ; 
changes in the position of the uterus, which descends during the first two months, rising 
from the third month, until, at the fifth, its fundus is level with the umbilicus, at the eighth 
nearly to the sternum, settling down at the ninth month; oedema of limbs; neck of 
uterus becomes shortened, the os patulous. The most positive signs are quickening •, if 
the statements of the women are credible; ballottement ; and above all, the pulsations of 
the fatal heart. 

Labor. Preliminary Signs. — Abioninal tumor sinks lower, occasional uterine pains 
and contractions, freer respiration, discharge of glairy fluid from vagina, frequent desire 
to urinate, hemorrhoids, oedema of legs. 

Essential Signs. — Paroxysmal pains, at regular intervals; os uteri generally low, neck 
effaced, os affected by each pain (easily ascertained by keeping finger on it). Dilatation 
of os uteri, requiring longer to acquire the size of a hilf-dollar, than from thence to 
completion. Shiverings and vomiting, tremblings and fainting, especially at complete 
dilatation. 

Head Positions (4). — Right (1st), or left (5) occipitoanterior, forehead backwards ; 
right (3d), or left (4th) occipito-po^terior, forehead forwards. Order of their comparative 
frequency; 1st, 3d, 2d, 4th. The 3d rotates into the 2d, the 4th into the 1st. 

Facial Positions (4). — Right (ist), or left (2d) mentoposterior, forehead forwards; 
right (3d), or left (4th) mento-anterior, forehead backwards. The 2d rotates into the 3d, 
and the ist into the 4th. 

Pelvic, or Breech Positions (4). — Left dorso-anterior (ist), left trochanter forwards ; 
right dorso-anterior (2) right trochanter forwards ; left dorso-posterior (3), right trochanter 
forwards; right dorso-posterior (4), left trochanter forwards. Order of their comparative 
frequency, ist, 2d, 4th, 3d. 



OBSTETRICAL MEMORANDA. 



733- 



Shoulder Positions. — Varieties (2) ; dorso-anterior, and dorso-posterior, the former 
occurring twice as often as the latter. In each variety the head may lie in either iliac 
fossa ; the presenting shoulder being, in dorso-anterior position, the left if the head is in 
the right fossa ; in dorso-posterior position, the left if the head is in the left fossa, and 
vice versa. 

AVERAGE PELVIC DIAMETERS. 





As usually given. 


Prof. E. Wallace gives — 


Antero- 
posterior. 


Oblique. 


Transverse. 


Antero- 
posterior. 


Oblique. 


Transverse. 


Brim, 

Cavity, .... 
Outlet, .... 


4X in - 
47 " 
5.0 « 


4.8 in. 
5.2 " 


5.2 in. 

4.2 " 


4.0 in. 

4^ " 
4.2 « 


— 5.0 in. 
4.0 " 


+5 in. 
4^" 
4.0 " 



Circumferential measurement of the brim — about 17 inches. 

DEVELOPMENT OF THE FCETUS. 
[Entries in the column headed " Month " refer to the end of each month ] 



c 



Name. 


Length in 
inches. 


Weight. 


Appearance. 


1st 


Ovum 


one -twelfth 




Appears as a gray gelatinous mass. 


2d 


Embryo 


1.2 


60 grains. 


Extremities apparent ; points of ossifica- 
tion appear. 


3d 


c< 


iy 2 to y/ 2 


310 « 


Neck, eyes, fingers, nails begin to form; 
sexes distinct. 


4th 


Foetus 


6^ to 7^ 


9 oz. 


Hair, fat ; muscles capable of contrac- 
tion. 


5th 


« 


8 to 10 


IO to 12 OZ. 


Eyebrows, skin, scrotum; nails nearly 
solid. 


6th 


>< 


11 to 12 


I lb. 


Pupillary membrane formed, lips closed. 


7 th 


'* 


\2.y 2 to 14 


2% lbs. 


Eyelids open, testes begin to descend, 
foetus is viable. 


8th 


" 


15 to 17 


4 to 5 lbs. 


Skin red, smooth, covered with down. 


9th 


" 


19 to 24 


7 to 7X Ids. 


Testes near scrotum, left often therein. 



DIAMETERS OF THE FCETAL SKULL AT TERM. 



Diameter. 


Where measured. 


Inches. 


Fronto-mental, 

Occipito-mental, 

Occipito-frontal, 

Sub occipito-bregmatic, . . 

Cervico-bregmatic 

Bi-parietal, 

Bi-temporal, 


Apex of forehead to chin, 

Occipital protuberance to point of chin, . . 

Occiput to centre of forehead, 

Midway between occiput and foramen mag- 
num to centre of ant. fontanelle, .... 

Ant. margin of foram. mag. to centre of an- 
terior fontanelle, 


3X 

5 l Xs}4 

4^-5 
3X 

3H-A 
2> l A 


Between the parietal protuberances, .... 
Between the ears, 



[Compare the articles in Part III, entitled — Abortion, After-pains, False -pains, 
Hemorrhage Post-Partum, Labor, Lactation, Pregnancy, Puerperal Dis- 
orders, Vomiting of Pregnancy, etc. 



» 



734 ASPHYXIA AND APXCEA. 



ASPHYXIA AND APNGEA. 

From Drowning. — Remove the person from the water as rapidly and gently as 
possible, turn the face downwards for a moment, and depress the tongue, in order that 
water, mucus, etc., may be removed from immediately over the entrance of the windpipe. 
Give the patient plenty of fresh air, fully exposing neck and chest to the breeze, unless 
inclement. Turn gently on the face, one forearm being under the forehead, and raise the 
body up that the water may have free discharge from the mouth. Place the patient upon 
the side and apply stimulants (ammonia, etc.) near the nostrils; or the cold douche, in 
order to excite respiration. 

The above measures being ineffectual, convey the body to the nearest convenient spot, 
strip it carefully and dry it, and place it on a warm bed, with head and shoulders slightly 
raised, and at once employ one of the following methods, known as Silvester's and 
Marshall Hall's. 

Silvester 1 s Method. — Pull the tongue forward, to prevent obstruction to entrance of air 
into the windpipe; produce expansion of the chest by drawing the arms from the sides of 
the body and upwards until they almost meet over the head. Then bring the arms down 
to the sides again, causing the elbows almost to meet over the pit of the stomach, and 
thus producing contraction of the chest. This imitation of the act of respiration should 
be continued at the rate of fifteen or sixteen times a minute, as in health. 

Marshall Hall's Method. — The person should be placed flat on the face, gentle inter- 
mittent pressure being made with the hands on the back, the body turned on the side, or 
a little beyond, then on the face, and the same pressure, etc., continued as at first. The 
whole body must be worked simultaneously. The same number and frequency of these 
artificial processes of respiration should be employed as in the other method. 

The Michigan Method. — Lay the body face down, the head upon the arm, and stand 
astride it; grasp it then about the shoulders and armpits, and raise the chest as high as 
you can without lifting the head quite off the arm, and hold it about three seconds; then 
replace the body upon the ground, and press the lower limbs downwards and upwards, 
with slowly-increasing force, for ten seconds; then suddenly let go, to perform the lifting 
process again. 

Whichever process be employed, the effort to restore the temperature of the body must 
be maintained, the body being well rubbed in an upward direction with the hands, with 
warm flannels, etc. ; bottles of hot water, hot bricks, etc., being applied to the stomach, 
the axilla?, the soles of the feet, etc., stimulants and beef tea being judiciously adminis- 
tered when restoration is about taking place. The attempts at resuscitation must be per- 
severed in for several hours, if necessary.- 

Laryngotomy or tracheotomy, with or without catheterization, or forced insufflations of 
air or oxygen, have proved successful, as also electro-puncture (Garratt). 

In artificial inflation, always press the larnyx and trachea against the vertebral column, 
so as to close the oesophagus and thus prevent the air entering the stomach. 

After Long Submersion is Recovery Possible ? — According to Harley (p. 881), dogs 
kept under water \y z minutes always died, if water had entered the lungs. If it had not, 
the trachea being plugged, they survived a submersion of 4 minutes. When persons rise 
after sinking they usually get some air, and less speedily come into a state from which 
recovery is impossible. The greatest period between the last inspiration and the stoppage 
of the heart is 4 minutes. Some think that no recovery has been made after complete 
cessation of the heart's action. W T e infer that after complete submersion for 5 minutes 
recovery is improbable, unless the person had been previously choked, or in a fainting 
state, so that no water entered the lungs. But in Anderson's case, the patient had been 
under water at least 15 minutes, and in Garratt's the time was variously estimated at from 
15 to 60 minutes. 

When is a Case Hopeless ? — Harley says (p. 892) : " If the eyes are open, the pupils 
dilated, the conjunctiva insensible, the countenance placid, the skin cold, frothy mucus 
round the nostrils and mouth, no attempt at respiration, and the heart's action inaudible 
(when the ear is applied to the chest), the case is hopeless. " 

Signs of Death. — The following have been suggested as mehods of deciding whether 
death has occurred : — 

(a) Tie a string firmly about the finger. If the end of the finger becomes swollen 
and red, life is not extinct. 

(b) Insert a bright steel needle into the flesh. If it tarnishes by oxidation in the course 
of half an hour, life may be considered not extinct. 



CLINICAL EXAMINATION OF THE URINE. 



735 



(c) Inject a few drops of Liquor Ammonias under the skin. During life a deep red 
or purple spot is formed. 

(d) Moisten the eye with Atropine. During life the pupil will dilate. 

(e) Look at a bright light or at the sun, through the fingers held closely side by side. 
During life the color is pink; after death a dead white. 

(/) After death a dark spot is said to form gradually on the outer side of the white of 
the eye, from drying of the sclerotic, so that the dark choroid shows through. 

(g) Putrefaction is an absolute sign of death. Better delay for it than run any risk of 
burying alive. 

From Foreign Bodies in Air Passages. — If round and smooth, invert the patient 
and strike on the back; laryngotomy; tracheotomy. 

Of the New-Eorn. — Clean the mucus out of nostrils and throat; catheterize the 
trachea, and suck up the mucus. " Marshall Hall's method : " by placing child on abdo- 
men, then bringing into lateral posture, repeating slowly and deliberately. " Schultze's 
method :" by placing the thumbs upon the anterior surface of thorax, the indices in the 
axillae, and the other fingers along the back, the face of the child being from you ; rotate 
the child, by swinging upward, so that the inferior extremities turn over toward you. In 
a moment re-rotate to the original position. Do not support head or legs in the forward 
rotation; their bending upon or toward the abdomen gives a forced expiration. 



CLINICAL EXAMINATION OF THE URINE. 

Note. — Use morning urine, or a sample of all passed during the 24 hours. 



Color J 



Pale (and copious), 1.030-f- . . 
Pale (and copious), below 1. 018 
Of urine and froth, very yellow 

or greenish, 

Bright yellow to crimson, . , . 

Dark, odor of violets, 

High (scanty), sp. gr. -J- ... 

High (scanty), sp. gr. — ... 



Dark, muddy, smoky, 
Black, 



Smell 



Fragrant, 
Fetid, . 
Of violets, 



ndicates Sugar. 

" Hysteria and convulsions, 
nervous disease. 

" Bile, Rhubarb. 

" Santonin. 

" Turpentine. 

" Fever, Uric Acid, Dia- 
thesis. 

" A grave symptom of 
Bright's Disease. 

" Blood, strong Coffee. 

" Putridity, disintegrated 
Blood, Tar, Creasote. 

" Cystine, Sugar, etc. 

" Alkalinity. 

" Turpentine. 



Quantity (in 24 hours). Normal about 50 fl. oz., from which there may be consider- 
able variation either way, according to the quantity of sweat, the fluidity of food used, etc. 

Specific Gravity. If possible, take the mixed urine. Normal is about 1.018, i. e., 
18 grains of solids in each fl. oz. If sp. gr. is high, suspect sugar; if low, suspect 
albumen. 

Reaction, in health is always acid in 24--hours' urine. It maybe alkaline from medi- 
cine, or disease, or shortly after a meal. If excessively acid, examine for crystal of uric 
acid. If alkaline, let the test-paper dry. so as to ascertain whether the alkali be fixed or 
volatile. 

Albumen by Heat and Nitric Acid. With Acetic Acid, or dilute Ammonia, make 
the urine slightly acid. If a precipitate appear on boiling, it may be Albumen or Phos- 
phates. Add a drop or two of Nitric Acid. If the precipitate dissolve, it is Phosphates ; 
if not, it is Albumen. If a deposit or turbidity disappears on heating, it consists of 
Urates ; if not, add a drop of Nitric Acid. If now dissolved, we have Phosphates ; if 
not, Cystine. Other Tests are the Potassio-Mercuric Iodide, the Sodium Tungstate, 
Potassium Ferro-cyanide, and Picric Acid Tests ; but the above described one, if care- 
fully done, will give as good results as any. 

Bile Pigment and Acids, if necessary. VogeVs color-table. MarechaPs Test, as 
follows: Put gj of urine in a test-tube, and pour one or two drops of Tinct. Iodi. to 



73^ 



CLINICAL EXAMINATION OF THE URINE. 



trickle down along the side of the tube, held horizontally nearly, so that the two fluids 
may touch, but not mix. If bile pigment be present, a fine green color will at once be 
developed below the red Iodine layer. NoeVs Test, Pettenkofer 's Test, Nitric Acid Test, 
Oxide of Silver Test. 

Sugar, if necessary. Urine containing sugar is usually light-colored, froths readily 
when poured from one vessel to another, and has a high specific gravity. Fehlimfs Test, 
as follows : Add to the boiling urine a few drops of freshly-prepared solution of Potassio- 
Cupric Tartrate [Fehling's Solution). If sugar be present, a yellow, orange, or red pre- 
cipitate of Cuprous Oxide will form, 10 cubic centimeters of the solution being reduced 
by 0.05 gram, of diabetic sugar. To prepare Fehling's Solution, dissolve 34.639 grams 
of pure, crystallized Copper Sulphate in about 200 grams of Distilled Water; also 173 
grams of chemically pure, crystallized, neutral Tartrate of Sodium in 500 or 600 grams of 
a solution of Caustic Soda, of specific gravity 1.12, pouring the first solution into the 
latter, slowly and a little at the time. The clear, mixed fluid is then diluted with distilled 
water up to a litre. This solution soon spoils, and must be kept in a dark, 'cool place. 
Much more convenient are Dr. Piffard's Cupro-Potassic Paste, and Dr. Pavy's Cupric 
Test Pellets (see Tyson on Urine, page 57) ; and still more handy are Wyeth's Compressed 
Tablets for preparing Fehling's Solution of Potassio-Cupric Tartrate, U. S. P., 1880, a box 
of which costs 50 cents, and may be obtained from any good drug-store. The writer has 
used these Tablets for some two or three years, with extreme satisfaction. 

Pavy's Solution is a modification of Fehling's ; is equally good for qualitative and 
volumetric testing, and is intended for those who prefer the apothecaries' weights and 
measures to the metric system. It is made in the same manner as Fehling's, 100 minims 
corresponding to y z grain of diabetic sugar, and consists of — Copper sulphate, gr. 320 ; 
Potassium Tartrate (neutral), gr. 640; Caustic Potash, gr. 1280; and Distilled Water, 

f^20. 

Other Tests for Sugar are Boucher's Bismuth Test, the Fermentation Test, Moore's, 
Trommels, the Picric Acid and the Indigo- Carmine. They are all useful, but will not 
be detailed here, as one good method is all that the average practitioner wants. 

Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a precipitate 
ceases to form. Thus estimate the amount of Chlorides. 

Urea. Place a drop of urine on platinum-foil, and to it add a drop of Nitric Acid, 
and leave undisturbed in a cool place for a minute or two. If the urea is in excess, 
crystals of Uric Nitrate form immediately. 

To ascertain the percentage of urea present, use Parke, Davis & Co.'s Ureometer, em- 
ploying the Solution of Hypobromite of Sodium, instead of the solution of Chlorinated 
Soda, the former giving much the best results. This apparatus is simple, reliable, and 
quite accurate enough for clinical purposes. 

Mucus and Pus resemble each other so closely under the microscope, that it is almost 
impossible for any one, except an expert, to distinguish between them thereby. Mucus 
is more cloudy and flocculent to the naked eye than Pus, which latter is generally of a 
stringy consistence and thickish yellow appearance at the bottom of the vessel. The 
supernatant liquid being poured off, and an equal bulk of Liquor Potassae added, the 
deposit, if containing much pus, becomes gelatinized, and so tough that it cannot be poured 
out. If Mucus, Acetic Acid added coagulates it, forming delicate molecular fibres. 

Other Deposits are best examined with the microscope, and compared with good 
plates, rather than with printed descriptions. The plates in Hoffmann and Ultzmann on 
Analysis of the Urine, will answer the wants of most general practitioners, but the text 
follows the metric system. The urinary deposits may be classified thus : — 



In Alkaline Urine 
only. 


In Alkaline or Acid 
Urine. 


Organized Deposits. 


Calcium Phosphates 
Ammonium Urates 
Ammoniaco- 

magnesian, or the 
Triple Phosphates. 


Uric Acid 

Urates 

Phosphates 

Oxalates 

Cystine 


Mucus Toruke 
Pus Sarcinse 
Blood Vibriones 
Tube-casts Bacteria 
Spermatozoids, etc. 



ETHICS. 



737 



Necessary Apparatus. A dozen test tubes. Alcohol lamp. A small porcelain 
dish. 2 watch-glasses. A sheet of platinum foil, 3^ inch square. 3 pipettes of different 
sizes, to be used only for urine. A 2-oz graduate. Urinometer. Blue and red litmus- 
paper. The reagents mentioned above. A little Grape-sugar, for use in testing the 
Fehling's solution. Ureometer (Parke, Davis & Co's). 

The foregoing directions comprise all that the average practitioner will usually perform 
in the matter of urinary analysis. P'or fuller directions, the reader is referred to one of 
the numerous manuals on the subject, among which may be mentioned Da Costa on 
Medical Diagnosis, Chapter VII, — Tyson on the Practical Examination of Urine, — and 
Sir Henry Thompson's Clinical Lectures on Diseases of the Urinary Organs, Lecture 

XXIV. 

A " Physician' 's Pocket Reagent Case," intended for urinalysis at the ^bedside, is put up 
by Parke, Davis & Co., and sold at the low price of $1.50. It contains a set of Dr. 
Oliver's Test Papers or Pellets (the latter preferable), a color scale, specific gravity beads, 
two test-tubes, a pipette, and full directions for the use of the reagents, which are to be 
absorbed by the test-papers. 

ETHICS. 

The Hippocratic Oath. — I swear by Apollo, the physician, and .Esculapius, and 
Health, and Allheal, and all the Gods and Goddesses, that according to my ability and 
judgment I will keep this oath and this stipulation: — to reckon him who taught me this 
Art equally dear to me as my parents, to share my substance with him and relieve his 
necessities if required ; to look upon his offspring in the same footing as my own brothers, 
and to teach them this Art, should they wish to learn it, without fee or stipulation; and 
that by precept, lecture, and every other mode of instruction, I will impart a knowledge 
of the Art to my own sons, and those of my teachers, and to disciples bound by a stipu- 
lation and oath, according to the law of medicine, but to none others. 1 will follow that 
system of regimen which according to my ability and judgment I consider for the benefit of 
my patients, and abstain from what is deleterious and mischievous. I will give no deadly 
medicine to any one, if asked, nor suggest any such counsel; and in like manner I will 
not give to a woman a pessary to produce abortion. With purity and holiness I will pass 
my life and practice my art. I will not cut persons laboring under the stone, but will 
leave this to be done by men who are practitioners of this work. In whatever houses I 
enter, I will go into them for the benefit of the sick, and will abstain from every voluntary 
act of mischief and corruption; and further from the seduction of females or males, of 
freemen and slaves. Whatever-, in connection with my professional practice, or not in 
connection with it, I see or hear in the life of men, which ought not to be spoken of 
abroad, I will not divulge, as reckoning that all such should be kept secret. While I 
continue to keep this oath unviolated, may it be granted me to enjoy life and the practice 
of the Art, respected by all men, in all times. But should I trespass and violate this oath, 
may the reverse be my lot! [Adam's Genuine Works of Hippocrates, Sydenham 
Society, London, 1849 ] 

Extracts from the Code. 

Consultations should be promoted in difficult cases. During them no jealousy or rival- 
ship should be indulged. Candor, probity, and all due respect should be exercised 
toward the physician in charge. The attending physician should first question the patient, 
the consulting one afterwards putting such other questions as may seem fit to further eluci- 
date the case. The discussion should take place in a private place, and no opinions 
delivered which are not the result of concurrence. In discussion the attendant delivers his 
opinion first, the others in the order in which they have been called. 

A Regular Medical Education furnishes the only presumptive evidence of professional 
abilities and acquirements, and ought to be the only acknowledged right of an individual 
to the exercise and honors of his profession. No one can be considered a fit associate in 
consultation, whose practice is based on an exclusive dogma, to the rejection of the accu- 
mulated experience of the profession. 

Punctuality should especially mark the keeping' of these engagements; if one of the 
parties be delayed, the other should wait a reasonable time, and then, if the attendant, 
prescribe; if the consulting, he should retire, unless the case is urgent or he be called 
from a distance, when he should prescribe for the emergency or leave a written opinion 
under seal. All theoretical discussion should be avoided. Should diversity of opinion 

47 



733 



SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. 



prevail, the majority should rule; should the numbers be equal on each side, the decision 
should rest with the attending physician. The consulting physician should always justify, 
as far as may be consistent with truth, the course pursued by the attending one, and 
no hint impairing confidence in him, or his reputation, should be thrown out. A double 
fee should be expected in all consultations. 

Interference. — A physician should not visit or prescribe for a patient who has been 
under the care of another for the same malady, unless in, ist, a case of emergency ; 2d, 
of consultation ; 3d, of relinquishment, by the physician, of the case ; 4th, or a regular 
notification to him that his services are no longer desired. When the case is assumed by 
another, he should indulge in no insinuations against the former attendant. If called 
because the family physician is not at hand, or is sick, he should resign the case to him 
on his arrival. In case several physicians are simultaneously called, as in accidents, the 
first arriving should take full charge of the case, unless the family attendant be present, 
when he should assume the charge ; if not present, he should be sent for, and the further 
treatment resigned to his hands. 

Miscellaneous. — A case should never be abandoned because it is supposed to be a 
hopeless one. 

Contumelious and sarcastic remarks relative to the Faculty, as a body, should always 
be avoided. " It's a foul bird that fouls its own nest." 

It is held unprofessional to resort to " public " advertising, to hold a patent upon an 
instrument, or to dispense or prescribe a secret nostrum. 

Gratuitous services should be given to an 'afflicted brother practitioner. If compelled 
to temporarily suspend his practice, on account of sickness, the physician who has been 
invited to take charge of his cases should turn the accruing fees over to the sick one, save 
in surgical or obstetrical cases. 



TABLE OF SPECIFIC GRAVITIES AND SPECIFIC 
VOLUMES. 

(Temperature at 59 F., except when otherwise stated.) 



Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Acid, Acetic 

Ac. Acet. Dil., .... 
Ac. Hydrobromic 

(34 per cent.), .... 
Ac. Hydrobrom. Dil., . 
Ac. Hydrochloric, . . . 
Ac. Hydrochlor. Dil., . 

Ac. Lactic, 

Ac. Nitric, 

Ac. Nitric. Dil., . . . 

Ac. Oleic, 

Ac. Phosphoric, . . . 
Ac. Phosphor. Dil., . . 
Ac. Sulphuric, .... 

Ac. Sulphuric. Dil., . . 
iEther, ........ 

iEther Fortior 

Alcohol, at 6o° F., . . 
Alcohol, at 77 F., . . 

Alcohol, Dil., at 6o° F., 

Alcohol, Dil., at 77 F., 

AquaDestilL, at 39 F., 

Aqua Ammoniss, . . . 

Aq. Ammon., Fort . . . 

Benzin, 

Carbon Bisulphide, . . 

Chloroform, Purif., . . 

Chloroform. Venale, . 

Glycerin, 

Liq. Ferri Acet , . . . 

Liq., Ferri Chlor., . . 


1.048 
1.008 

* 303 
1.077 
1 160 
1.049 
1. 212 
1.420 
1.059 
0.800 

1-347 

1.057 

1 840 

1.094 

.750 

■7^5 

.820 

.812 

.928 

.920 

1.000 

■959 
.900 
.670 
1.272 
1.488 
1.470 
1.250 
1.160 

1 l :™ 


•954 
.992 

■767 
.928 

.862 
•953 
•833 
.704 

•944 
1.250 
.742 
•945 
•543 
.914 

1-333 

I -379 

1.219 

1. 231 

1.077 

1.087 

1. 000 

1.043 

1. 111 

i-493' 

.786 

.672 

.680 

.8ro 

.862 

.711 


Liq. Ferri Tersulph. 
Liq. Potassse, . . . 




1 329 
1.036 
1.059 

1-333 
.900 
.917 
.860 
.875 

1.050 
.890 
.920 
.900 

i-i73 
•9 2 5 
.890 
.850 
•936 
.900 
.920 
.916 
.960 
.900 

1. 091 
.918 
.862 
.824 
.920 

•93° 
1. 310 
1. 000 
1. 000 


•757 
.965 
•944 
•75o 
1. in 
1 091 
1. 163 
1 143 
•952 
1. 123 
1.087 
1. in 
.852 
i.c8i 
1. 123 
1.176 
1.068 
1. in 
1.087 
1.092 
1.042 
1 000 
.917 
1.089 
1. 160 
1. 314 
1.087 
1.075 
•7 6 3 
1. 000 
1. 000 


Mel (Honey), . . . 








01. Amyg Expres., 
01. Aurant. Cort , . 




01. Caryophilli, . . 




Ol. Cubebse, . . . 




Ol. Eucalypti, . . 
01. Gaultheriae, . . 
Ol. Gossyp. Sem., . 
Ol. Lavandulae . . 




Ol. Lini, 




01. Menthse Pip., . 




Ol. Olivse, .... 
01. Ricini, .... 




Oi. Rosmarini, . . 
01. Sassafras., . . 




01. Terebinthinae, 
Spt. iEtheris Nitrosi 


, ■ 


Spt. Vini Gallici, . 
Syrupus Simplex, . 
Vinum Album, . . 
Vinum Rubrum, . 





DROPS IN A FLUIDRACHM. 



739 



TABLE SHOWING THE NUMBER OF DROPS IN A 
FLUIDRACHM OF VARIOUS LIQUIDS, ALSO THE 
WEIGHT OF ONE FLUIDRACHM IN GRAINS. 

(Compare page 438.) 



Liquid. 


Drops 
in f5j. 

(mix.) 


Weight 
of f5j in 

grains. 


Liquid. 


Drops 
in f5j. 

(mix.) 


Weight 
off5j in 
grains. 


Acetum Opii, 

Acetum Scillae, 

Acid. Acetic, 

Ac. Acetic. Dil., .... 

Acid. Carbolic 

Ac. Hydrochloric, . . . 
Ac. Hydrocyanic, . . . 

Acid. Lactic, 

Acid. Nitric, 

Ac. Nitro-hydrochlor., . 
Ac. Phosphor. Dil , . . . 

Ac. Sulphuric, 

Ac. Sulph. Aromat., . . 
Ac. Sulph. Dil, .... 
Ac. Sulphurosum, . . . 

JEiher Fortior, 

Alcohol, 


90 

68 
108 

68 
in 

7° 
60 
in 
102 
76 
59 
128 
146 
60 

59 
176 
146 
60 
60 
101 
250 
250 
no 
122 
136 
150 
134 
133 
120 
158 
137 
150 

67 

150 

67 

71 


61 
57 
58 
55 
59 
65 
54 
66 
77 
66 

57 
101 

53 

58% 

55 

39 

44 

55 

& 

165 
80 
5* 

56^ 
57 

47% 
62 
60 
60 
61 
62 

49 
48 

68 
760 
55 

73 


Liq. lodi Compos., .... 

Liq. Potassae, 

Liq. Zinci Chloridi, .... 

Oleores. Aspidii, 

Oleores. Capsici, 

Oleores. Cubebae, 

Oleum Anisi, 

Oleum Bergamii, 

Oleum Cari, 

Oleum Juniperi, 

Oleum Limonis, 

Oleum Ricini, 

Oleum Rosae, 

Oleum Terebinth, 

Oleum Tiglii, 

Spt. ^Etheris Comp., ] . . 
Spt. ^Etheris Nitrosi, . . . 

Spt. Camphorae, 

Syrupus Simplex, 

Syrupus Acaciae, 

Syrupus Ferri lod., .... 

Syrupus Scillae, 

Syr. Scillae Comp., .... 

Syrupus Senegae, 

Tinctura Aconiti, 

Tinctura Belladonnae, . . . 
Tinct. Benzoini Comp., . . 
Tinct. Cantharidis, .... 

Tinct. Digitalis, 

Tinct. Ferri Chlor., .... 
Tinct. lodi, 


63 
62 

89 
130 
120 
123 
119 
130 
132 
148 
129 

77 
132 
136 
104 
148 
146 
143 
65 
44 
65 
75 
102 
106 
146 
*37 
148 
131 
128 
150 
148 
130 
130 
no 
107 
in 
100 


59 
58 
88 
52 
5i 
52 
54 
46 
50 
49 

47 1/ 
5t% 

47 i/ 
45% 

5o 
45 
47 
47 
72 

73 
77 
74 
70 
70 
46 
53 
48 
5i 
53 
53 
47 
53 
52 
54 
55 
54 
55 


Aqua Destillata, .... 

Bals. Peruvian, 

Bromine, 

Chloroform, Pur., .... 

Copaiba, 

Creasote, 

Ext. Belladon. Fl., . . . 

Ext. BuchuFl., 

Ext. Digitalis Fl., ... 
Ext. Ergotae FL, . . . . 
Ext. Ipecac. FL, .... 

Ext. Rhei Fl 

Ext. Senegae Fl 

Ext. Valerianae Fl., . . . 
Ext. Zingib. FL, .... 

Glycerin, 

Hydrargyrum, ..... 
Liq. Acidi Arseniosi, . . 
Liq. Ferri Chloridi, . . . 


Tinct. Opii, 

Tinct. Opii Camph., . . . 
Tinct. Opii Deodor., . . . 
Vin. Colchici Rad., .... 
Vin. Colchici Sem., .... 
Vinum Opii, 



WEIGHTS AND MEASURES 



APOTHECARIES OR TROY WEIGHT. 

Pound. Ounces. Drachms. Scruples. Grains. 

ft). t 5 3 gr. 

1 = 12 = 96 = 288 = 5760 

1 = 8 = 24 = 480 

1 = 3 = 60 



METRIC WEIGHTS. 

i Milligram, o.ooi = gr. ^\ 

1 Centigram, o 01 = gr. £ 

1 Decigram, o.i = gr. i£ 

1 Gram, 1. = gr. 15.432 

1 Kilogram, . iooo. = ft) 2.7 



APOTHECARIES OR WINE MEASURE. 

Gallon. Pints. Fl' ounces. Fl'dr'ms. Minims. 

c. o. it fs m 



= 16 



1024 
128 



61440 
7680 



APPROXIMATE EQUIVALENTS. 



illlori gr. 
1 f5 or 1 5/ 
if§. 



1 f§ Glycerin, 
1 f'S Syrups, . 



= .06 grams. 

= 4- 

= 30. 

= 3i- 

= 37- 

= 40. 



; 4 o 



METRIC CONVERSIONS. 



TABLE FOR CONVERTING APOTHECARIES' WEIGHTS 
AND MEASURES INTO GRAMS. 

Adapted from Maisch. 

[Multiply all grains, or fractions of a grain, by 6479 ( or 648) for the metric equivalent 

in milligrams. — Potter.] 



Troy Weight. 


Metric. 


Apothecaries' 


Grams for Liquids. 












Grains. 


Grams. 


Measure. 


Lighter* than 
Water. 


Specific 

Gravity f of 

Water. 


Heavier % 
than Water 




Milligram. 


*l I 


•055 


.06 


.08 


l 
64 


.001 


2 


.IO 


.12 


•15 


l 
3o 


.0015 


3 


.16 


.18 


•24 


1 

30 


.002 


4 


.22 


.24 


•32 


1 
20 


.003 


5 


.28 


.30 


.40 


1 

T6 


.004 


6 


•3 2 


.36 


.48 


1 

T2 


.005 


7 


•38 


.42 


•55 


1 

To 


.006 


8 


•45 


•50 


.65 


1 
'8 


.008 


9 


■5o 


•55 


•73 




Centigram. 


10 


•55 


.65 


.80 


1 
6 


.010 


15 


.80 


•72 


.96 


1 

4 


.016 


16 


.90 


1. 00 


1.32 


1 
"3 


.02 


20 


1. 12 


1.25 


1.60 


1 
2 


•03 


25 


1.40 


i-55 


2.00 




.065 


30 


1.70 


1 90 


2.50 




Decigram. 


35 


2.00 


2.20 


2.90 


2 


•13 


40 


2.25 


2.50 


3-30 


3 


.20 


48 


2.70 


300 


4.00 


4 


.26 


50 


2.80 


3.12 


4-i5 


5 


•32 


6of 5 j 


340 


3-75 


5.00 


6 


•39 


72 


4.00 


4-5° 


6.00 


8 


•52 


80 


4-5o 


5. CO 


6.65 


10 


.65 


90 


5.10 


5.60 


7-5° 




Gram. 


96 


5-4o 


6.00 


8.00 


15 


1. 00 


100 


5.60 


6.48 


8.30 


20 9j 


1.30 


120 f 3 ij 


6-75 


7-5o 


10.00 


24 


1.50 


160 


9.00 


10.00 


i3-3o 


26 


1.62 


180 fipij 


10.10 


11.25 


15.00 


30 3ss 


1-95 


240 f 3 ss 


i3-5o 


15.00 


20.00 


40 


2.60 


13 V 


16.90 


18.75 


25.00 


5o 


3.20 


f 3 v J 


20.25 


22.50 


30.00 


60 3J 


3-90 


f 3 vij 


23.60 


26.25 


35oo 


100 


6.48 




27.00 


30.00 


40.00 


1 20 3 ij 


7.80 


54.00 


60.00 


80.00 


180 * 


11.65 


1000 


59.00 


64.79 


85.00 


250 % ss 


15-5° 


f&»j 


81.00 


90.00 


120.00 


300 ' 


19.40 


f ^iv 


108.00 


120.00 


160.00 


360 


23-50 


f^v 


i35-oo 


150.00 


200. CO 


420 


27.20 


f 3 v J 


162.00 


180.00 


240.00 


480 1) 


31.10 


fgviij 


216.00 


240 00 


320 00 


960 gij 


62.20 










1000 


64.79 










S» 


124.40 










.? V J 


186.60 










^ viij 


248.80 











* Lighter than water are tinctures, spirits, compound spirit of ether, sweet spirits of nitre, fixed and 
volatile oils. iEther Fortior, f5j = grams 2.80. 

f Same as water are waters, liquids, decoctions, infusions, most fluid extracts, and tinctures made 
with dilute alcohol. 

\ Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the latter 
f5j = grams 5.50. 



PRESCRIPTION DOSES AND QUANTITIES. 74 1 

A TABLE OF PRESCRIPTION DOSES AND QUANTITIES. 

Designed and Calculated by Dr. Sam'l O. L. Potter, M.R.C.P. Lond. 



Grains in each 5 dose in a mixture of 



gij 



7 

I i I 



1* 


4 

7 




If 


1 1 
16 


H 


3 

4 


T 5 


4 

o 


H 


T~5~ 


H 


2 


I 


H 


ItV 



3t 



3l 



34 



i4 



5IIJ 



t7 



TT 



247 


1 




1 

T"S"2 


1 

2o6 


1 

3S4 


1 

144 


1 

T92 


1 

28 S 


1 

96 

72 


1 
T2S" 


T*2 


1 

96 


1 

144 


1 

48 


1 
6T 


1 
9 6 


1 
36 

1 
32 


1 
48 


fV 


JL 

43 


1 
64 


1 
24 


1 
32 


1 
48 



Siv 3v 



H\H 



A 



Svnj 5XIJ 5 XVI 



sV 



A 



h 



48 

1 
40 

1 
36 



28 
1 
24 

T8 



* I 



A 



! -A, 



_9 [ 11 

1 i 1 
8 ! TO 

¥ 1 To 

l i 1 



A I A 

4 I 5 



Grains 
in Entire 
Mixture 



XXXI 



XXXIJ 



XXXIIJ 



XXXIV 



XXXVI 



XXXVIIJ 



XXX IX 



XLIJ 

XLIIJ 



xtv 



XLVIJ 



XLIX 



LIJ 



L1V 
LVI 



LVIIJ 



31— LX 



Drachm 



31SS 



IJSS 



"J 



1 


1 i 


7 


9 1 


1 


] 




8 1 


l 


1 


6 


8 j 


_3_ 
1 6 


1 1 

7 


1 
5 


1 
7 


1 


1 


s 




1 


1 1 













1 


9 


6 



njss 



vij 



£i— vnj 



^ ISS — XIJ 



XIV 



.1 1 J — XVI 



Grains in each 5 dose in a mixture of 



sS; 



224 
26A 

30 

371 

45 

5** 
60 



75 

90 
105 
120 



2 

_2JL 

o3 

2 8 



2^ 



•7X1 

"Li. 
24 



2| 

z 10 

3 

3j 

Jt 

_3i 
31 



_5f_ 

9i 



£3i 
15 



1 84 



26A 



3° 



33f 

37i 
ili 

45 
52i 

60 



JUT 



H 



r# 



6 A 



7i 



15 



i7i 



25 



27A 



30 



35 



40 



I A 



IA 



^ 



l4 



Z TT 

3* 



74 



£3* 

15 



16^ 



1S-1 



20f 

224 



2* 



3± 



44 



^ 



i\ 



I2i 



34 



15 



17* 



5VIIJ 



ICMr 



20 I 15 



ixij 



6 

1 6 


1 
4 


i 


4 


1 


TT 


4 
1 1 


3 

1 1 


4 

TT 
3 

8 


2 

7 
2 

7 


£ 


3 

To 


I 


_5_ 



51 



64 



64 



Explanation. — In Writing a Prescription look for the dose of the ingredient (dose say gr. ^) 
in the column headed by the size of your mixture (Svi) ; then on that line in the left marginal column is 
the quantity you must put into the entire mixture (dose gr. ijss) to get your dose in each drachm thereof. 
In Reading a Prescription find the quantity of any ingredient called for, in the left marginal column 
(dose say gr. %£), and on the same line in the column headed by the number of ounces in the mixture 
(Snj) you will find the quantity in each drachm dose (gr. ^). Of course when the dose is more or less 
than 5i the result must be proportionately multiplied or divided accordingly. 
Copyrighted, 1892, br P. Blakiston, Son & Co. 



INDEX 



Note. — This Index has been arranged with the object of enabling instant reference to 
be made to the mention of every article of the Materia Medica, every drug, official or 
unofficial, and each preparation, derivative or constituent thereof, which is treated of in 
the first part of the book, every article, preparation or operation discussed in the pharma- 
ceutical portion, and every disease or other title contained in the therapeutical section. 
Many of the entries are only made once, but double and even treble entries are made for 
every item which seemed of sufficient importance to warrant such repetition. 

Salts are each placed but once in the Index, under their English names and the titles 
of their acid factors, thus, Acetate of Potassium. A basic view of the salts under their 
basis titles is seen in the section on Materia Medica, but as no such view of the Allyl, 
Ethyl, Methyl, Propyl and similar compounds exists in the book, these are each indexed 
twice, under both the acid and basic portions of their names, as Cetyl Pahnitate and 
Palmitate of Cetyl. 

Plants are indexed under both English and Latin names', except where the technical 
name of the plant corresponds in part with the official drug-title, in which case the one 
entry serves for both. Thus the entry Conium answers for the plant Conium maculatum, 
as well as for the official drug ; but the drug Nux Vomica and the plant Strychnos Nitx- 
vomica receive separate index entries. 

Alkaloids are each entered once only and under their chemical termination, ine ; their 
salts following the same rule as other salts. 

Glucosides and similar principles (except such are acids) are indexed under their 
chemical termination, in. 

Preparations are indexed under their Latin names where the reference is to the class, 
as Infusa, 430 ; but the several individual preparations are placed under their English 
titles, thus, Infusion of Digitalis, 204; the reference being to the Infusum Digitalis, 
page 204. 



Abbreviations, their use, 45 1 
Table of, 451, 703 

Abdominal Plethora, 488 

Abies, 323 

Abies balsamea, 392 
canadensis, 323 



excels 



^5 



Abietic Anhydride, 393 

Abortion, 48, 488 

Abrus, 55 

Abscess, 489 

of the Liver, 600 
Mammary, 489 

Absinthe, 56 

Absinthium, 56 

Abstract of Aconite, 77 
of Belladonna, 129 
of Conium, iqi 



Abstract of Digitalis, 204 

of Hyoscyamus, 253 

of Ignatia, 255 

of Jalap, 264 

of Nux Vomica, 294 

of Podophyllum, 328 

of Senega, 371 

of Valerian, 402 
Abstracta, 437 
Acacia, 56 

Catechu, 163 
Aceta (see also Vinegars), 436 
Acetanilide, 56 
Acetanildium, 56 
Acetate of Copper, 199 

of Ethyl, 79 

of Iron, 221 

of Iron and Ammonium, 223 



743 



< 



744 



INDEX. 



Acetate of Lead, 325 

of Morphine, 300 

of Potassium, 330 

of Sodium, 376 

of Zinc, 411 
Acetic Ether, 80, 83 
Acetous Preparations, 436 
Acet-Phenetidine, 184, 310 
Acetum, 59 
Acid Abietic, 341 

Abric, 55 

Acetic, 59 

Aconitic, 76 

Agaric, 84 

Aloetic, 91 

Anemonic, 336 

Angelic, 389, 398 

Arabic, 56 

Arsenious, 119 

Artanthic, 284 

Benzoic, 132, 183 

Boracic, 59 

Boric, 59 

Brassic, 375 

Calumbic, 149 

Camphoric, 150 

Camphretic, 150 

Capronic, 117 

Caprylic, 117, 

Carbazotic, 73 

Carbolic, 61, 88, 183 
Solutions of, 61 
Gauze, 61 

Carminic, 188 

Caryophyllic, 160 

Caryophyllinic, 160 

Catechuic, 163 

Catechu-tannic, 163 

Cathartic, 344, 371 

Cathartogenic, 372 

Cerotic, 164 

Cetraric, 1 65 

Cevadic, 404 

Chelidonic, 166, 360 

Chromic, 62 

Chrysammic, 91 

Chrysophanic, 178, 344, 352 

Cinnamic, 127, 132, 384, 

Citric, 272 

Coca-tannic, 214 

Copaibic, 193 

Cresylic, 61 

Cubebic, 198 

Ergotic, 210 

Ergotinic, 210 

Erucic, 375 

Eugenic, 291 

Euonic, 219 

Euphrastic, 220 

Filicic, 123 

Fluoric, 64 

Gallic, 64, 229 

Gallo-tannic, 75 



Acid Gambogic, 149 
Gelsemic, 230 
Gentesic, 231 
Gentianic, 231 
Glycyrrhizic, 234 
Guaiac, 238 
Guaiaconic, 238 
Guaiarec, 238 
Gurjunic, 239 
Gynocardic, 165 
Hydriodic, 258 
Hydrobromic, 65 
Hydrochloric, 66 
Hydrocyanic, 67 
Hypopicrotoxic, 317 
Igasuric, 294 
Ipecacuanhic, 262 
Juglandic, 265 
Kinic, 181 

Kinotannic, 181, 267 
Kinovic, 181 
Kinovo- tannic, 181 
Lactic, 70, 298 
Lactucic, 269 
Linoleic, 274 
Lobelic, 276 
Lupulinic, 244 
Maizenic, 410 
Malic, 128 
Mastichic, 283 
Meconic, 298 
Melassic, 355 
Methyl-salicylic, 229 
Mezereinic, 287 
Mineral, 66 
Muriatic, 66 
Myristic, 291 
Nitric, 70 

Nitro-hydrochloric, 66, 70 
Nitro-muriatic, 66, 70 
Oleic, 71, 297 
Ophelic, 168 
Oxalic, 48, 495 
Palmaric, 341 
Palmitic, 297 
Phenic, 61 
Phosphoric, 72 
Phytolaccic, 316 
Picric, 73 
Picrotoxic, 317 
Pinic, 341 
Piperonylic, 195 
Podophyllinic, 328 
Polygonic, 329 
Protocatechuic, 328 
Prussic, 67 
Punico-tannic, 236 
Pyrogallic, 64, 183 
Pyroligneous, 323 
Quercitannic, 75, 340 
Rhatania-tannic, 75, 268 
Rheotannic, 344 
Rheumic, 344 



INDEX. 



745 



Acid Ricinoleic, 348 

Sabadillic, 404 

Salicylic, 183, 357 

Salicylous, 358 

Salicyluric, 358 

Sanguinarinic, 360 

Scheele's, 67 

Sclerotinic, 210 

Silvic, 341 

Sphacelinic, 210 

Strychnic, 294 

Sulphuric, 73 

Sulphuric, Aromatic, 73 

Sulphurous, 74 

Succinic, 92 

Tannic, 75, 229, 236 

Tannic and Iron, 461 

Tartaric, 76 

Thebolactic, 298 
• Tiglinic, 398 

Toxicodendric, 346 

Tropic, 129, 253 

Valerianic, 389, 401 

Vanillic, 403 

Vegetable, 59 

Veratric, 404 
. Viburnic, 407 

Xylic, 61 
Acids, their action, 36, 66 
Acidity, 489 
Acipenser Huso, 255 
Acne, 490 
Aconine, 76 
Aconite, 76 
Aconitine, 76 
Aconitum, 76 

Cammarum, 77 

Chinense, 77 

ferox, 77 

Japonicum, 77 

Napellus, 76 
Acorin, 146 
Acorus Calamus, 146 
Acrinyl, Sulpho-cyanate, 375 
Acrolein, 232 
Addison's Disease, 491 
Administration of medicines, 20 
Adynamia, 491 
Adeps, 79 

Benzoinatus, 79, 132 
.'Ether, 79 
/Ether, Acetic, 80 
After-pains, 492 
Agalactia, 492 
Agaricin, 84 
Agaricus-albus, 84 

chirurgorum, 84 

muscarius, 85 
Agave Americana, 91 
Ague, see Intermittent Fever, 609 
Ailanthus glandulosa, 86 
Albau, 240 
Albumen in Urine, Test, 735 



Albumin, 408 
Albuminate of Iron, 223 

of Mercury, 249 
Albuminuria, 492 
Alcohol, 86 

Amylic, 88 

Caustic, 377 

Ethylic, 88 

Methylic, 88 

Phenylic, 61, 88 
Alcoholic Preparations, 431 

strength of Bitters, 716 
Alcoholism, 89, 493, 540 
Aldehyde, 88 

Proto-catechuic, 403 
Alder bark, 64, 90 

Black, 334 

Buckthorn, 227 
Ale, 87 

Alkalies, their action, 36 
Alkaline Mineral Waters, ill 
Alkaloids, 417 

Liquid, 389, 417 
Allium cepa, 90 

porrum, 90 

sativum, 90 
Allspice, 320 
Allyl Sulphide, 90, 122 

Sulpho-cyanide, 375 
Almond, 68, 98 
Alnus, 64, 90 
Aloe socotjina, 90 
Aloes, 90 

Alopecia, 494, 684 
Alstonia scholaris, 207 
Alteratives, 41 

Uterine, 48 
Althaea officinalis, 92 
Alum, 92 

Alum, Ammonio- ferric, 222 
Alum root, 64 
Alumen, 92 

Alumen Exsiccatum, 93 
Aluminium, 93 
Amanita Muscaria, 85 
Amaurosis, 494 
Amber, 385, 393 
Amblyopia, 30, 494 
Amenorrhcea, 495 
Amido-benzene, 183 
Ammonia, 94 ' 
Ammonia-alum, 92 
Ammoniated Mercury, 245 
Ammoniacum, 94 
Ammonium, 94 
Amorphous Bodies, 424 
Amygdala, 98 

Amara, 68, 98 

Dulcis, 98 
Amygdalin, 68, 98, 335 
Amyl Chloride, 82 

Hydrate, 88 

Hydride, 82 



746 



INDEX. 



Amyl, Nitrite, 99 
Amylene, 82 

Hydrate, 168 
Amylic Alcohol, 88 
Amylum, 101, 355 

Iodatum, 101, 257 
Anaemia, 496 

cerebral, 520 
Anaesthesia, 81, 175, 497 

Local, 25, 215 
Anaesthetics, 25, 27, 81, 82, 175 

Local, 25 

Mixtures, 80 

Modes of using, 175 
Anacyclus Pyrethrum, 337 
Analgesics, 27 
Anamirta paniculata, 317 
Anaphrodisiacs, 47 
Anaphrodisiac Pills, 476 
Anasarca, see Dropsy, 549 
Andira Araroba, 178 
Anemone, Meadow, 336 

patens, 336 

pratensis, 336 

Pulsatilla, 336 
Anemonin, 336 
Aneurism, 497 
Angelate of Butvl, 102 
Angina. — See Croup, Laryngitis, Pharyn- 
gitis, Throat, Tonsillitis, etc. 
Angina Pectoris, 497 
Anhidrotics, 46 
Anilin, 183 
Anilin Red, 227 
Anise, 102 

Star, 102, 256 
Anodynes, 25, 27, 483 

Local, 25 
Ant-acids, 36 
Antagonists, 52 

List of, 53, 459 
Anthelmintics, 40 
Anthemis, 102 

Anthrax. — See Carbuncle, Pustule, Malig- 
nant. 
Antibilious Pills, 477 
Antidote, Jeaunel's, 720 
Antidote-bag, 720 
Antidotes, 52, 720 
Anti-emetics, 37 
Anti-fat, 228 
Antifebrin, 56 
Antikamnia, 57 
Antilithics, 45 
Antimonial Powder, 103 
Antimony, 103 

Sulphurated, 103 
Antinervine, 57 
Antiperiodics, 43 
Antiphlogistics, 43 
Antipyretics, 42 
Antipyrine, 105 

Salicylate, 106 



Antiseptic Fluid, 397 
Antiseptics, 51, 397 
Antisialics, 35 
Antispasmodics, 28 
Antizymotics, 51 
Antrum, Disease of, 49 
Anus, Fissured, 498 

Prolapse of, 658 
Aperients, 38, 476 
Aphonia, 498 
Aphrodisiacs, 47 
Aphthce, 499 
Apiin, 108 
Apiol, 108 

Apis mellifica, 164, 284 
Apnoea, 734 
Apocynin, 109 
Apocynum, 109 
Apomorphine, 109, 298 
Apoplexy, 499 
Apotheme, 437 
Appetite, 500 
Approximate Measures, 446, 739 

Weights, 739 
Aqua, no 

Bulliens, III 

Carbonata, 1 10 

Communis, in 

Destillata, no 

Fervens, 1 r r 

Fluvialis, in 

Fontana, in 

Marina, in 

Pluvialis, in 

Regia, 70 
Aquae (see also Water of), 427 
Aqueous Preparations, 427 
Arabin, 56, 399 
Arbor Vitae, 396 
Arbutin, 166, 184, 229, 401 
Arctostaphylos glauca, 401 

Uva-ursi, 400 
Argentum, 1 15 
Argol, 329 
Argyria, 115 
Aristol, 261 
Aristolochia reticulata, ^75 

Serpentaria, 373 
Aristolochine, 373 
Arnica, 1 17 
Arnicin, 117 

Aromatic Fluid Extract, 187 
Aromatic Powder, 187 
Aromatic Sulphuric Acid, 73 
Arseniate of Iron. 223 

of Sodium, 119 
Arsenic, 119 
Arsenite of Bromine, 119 

of Copper, 119, 721 

of Potassium, 119 
Arsenium, 119 
Artemisia Absinthium, 56 

maritima, 362 



INDEX. 



747 



Arterial Transfusion, 21 
Artanthe elongata, 284 
Asafoetida, 122 
Asagreea officinalis, 404 
Ascarides. — See Worms, 700 
Ascites, 500 
Asclepias, 123 
Ash, Flowering, 282 

Prickly, 409 
Asparagin, 92, 219, 234 
Asphyxia, 734 
Aspidium, 123 

Aspidosperma Quebracho, 339 
Aspidospermine, 339 
Asthenia. — See Adynamia, Convalescence, 

Atrophy. 
Asthenopia, 500 
Asthma, 500 
Astigmatism, 502 
Astragalus gummifer, 399 
Astringents, 42, 50, 64, 476 

Intestinal, 39 

Powder, 480 

Urinary, 45 

Vegetable, 64 
Atheroma, 502 
Atrophy, 502 
Atropine, 128 

and Morphine, 306, 714 
Atrosin, 128 
Aurantiin, 124 
Aurantium, 124 
Aurum, 125 
Ava-kava, 267 
Avena Sativa, 126 
Ayer's Ague Cure, 716 

Cherry Pectoral, 716 

Pills, 716 

Recamier Balm. 716 
Cream, 716 

Sarsaparilla, 716 

Vita Nuova, 716 
Azedarach, 126 

Azoturia. — See Urinary Disorders, 691 
Azulen, 284 



Balanitis, 503 

Baldness. — See Alopecia, 494, 685 

Balm, 285 

of Gilead, 392 
Balnea, 470 
Balneum Maris, III 

Vaporis, in 
Balsam of Copaiba, 193 

of Fir, 392 

Friar's, 132, 385 

Gurjun, 239 

of Peru, 127 

of Tolu, 127 
Balsamodendron Myrrha, 292 
Balsamum Dipterocarpi, 239 



Balsamum Peruvianum, 127 

Tolutanum, 127 
Bandoline, 201 



tisia, 125 
Baptisin, 128 
Barberry, 133 
Bark, Cuprea, 181 

Peruvian, 180 

Huxham's Tincture of, 181 
Barley, 279 
Barosma, 140 
Barosmin, 140 
Basham's Mixture, 223 
Basilicon Ointment, 342 
Bassorin, 399 
Baths, Formulae, 470 
Bay-berry, 290 
Bay Rum, 291 
Bear-berry, 400 
Bed-sores, 503 
Beer, 87 
Belladonna, 128 
Belladonnine, 128 
Benne Oil, 373 
Benzene, 82 
Benzin, 131 
Benzoate of Ammonium, 95, 132 

of Lithium, 132, 274 

of Sodium, 132 
Benzoin, 132 
Benzoinated Lard, 132 
Benzol, 82, 131, 183 
Benzoyl Sulphonic-imide, 354 
Benzyl Cinnamate, 127 
Berberine, 133, 149, 251, 285, 328, 409 

Muriate of, 133, 251 
Berberis, 133 
Bergamium, 134 
Bergamot, Oil of, 134 
Bergaptene, 134 
Beta-naphthol, 293 
Beta vulgaris, 355 
Bhang, 153 

Bibliography and References, 487 
Bicarbonate of Potassium, 330 

of Sodium, 377 

commercial, 377 
Bichloride of Ethene, 82 

of Ethylene, 173 

of Mercury, 245 

of Methylene, 174 
! Bichlorinated Cloride of Methyl, 172 
J Bichromate of Potassium, 63 
Bile, Agents affecting the, 40 
Bile Pigment in Urine, Test, 735 
Biliary Solvents, 45 
Biliousness, 503 
Bilious Remittent Fever, 730 
Bind-weed, 243 
Biniodide of Mercury, 246 
I Bird-lime, 408 
\ Bismuth, 134 
I Bismuth Mixture for Children, 465 



743 



INDEX. 



Bisulphate of Quinine, 182 
Bisulphide of Carbon, 82, 158 
Bisulphite of Sodium, 74 
Bitartrate of Potassium, 331 
Bites and Stings, 678 
Bitters, Action of the Simple, 149 

Alcoholic Strength of, 716 
Bittersweet, 208 
Black berry, 64, 351 

Bark, 351 
Black Draught, 372 

Drop, 299 

Paste, 581 
Bladder, Inflammation of, 537 

Irritable, 504 

Paralysis of, 504 

-wrack, 228 
Blende, 410 
Blepharitis, 504 
Blistering Cerate, 155 
Blisters, 49, 484 
Blood-root, 360 
Blood-stains, 677 
Blue Flag, 263 

Mass, 245 . 

Ointment, 245 

Pill, 245 
Boiling, 419 
Boils, 505 
Boldine, 135 
Boldo, 135 
Boldus, 135 
Bolus, 471 
Bone Diseases, 505 
Boneset, 219 
Borate of Quinine, 182 

of Sodium, 60 
Borax, 60 

Boro-citrate of Magnesium, 60, 514 
Boro-glyceride, 60 
Bos-taurus, 220 
Bots, 126 

Bougies, Formulae for, 483 
Boxwood, 308 

Brain Disorders. — See Cerebral Anaemia, 
Cerebral Concussion, etc. 

Fever. — See Meningitis,Cerebro-spinal 
Meningitis, Typhoid Fever, Typhus 
Fever. 
Brandreth's Pills, 716 
Brandy, 87 
Brayera, 135 
Breasts. — See Abscess, Lactation, Mastitis, 

Nipples. 
Breath, Fetid, 505 
Bright's Disease, Acute, 506 

Chronic, 507 

Diagnosis, 725 
Bromide of Ammonium, 95, 136 

of Arsenic, 119 

of Calcium, 136 

of Ethyl, 80, 82 

of Iron, 136, 221 



Bromide of Lithium, 136, 274 

of Methyl, 82 

of Potassium, 136 

of Sodium, 136 

of Zinc, 136 
Bromides, Formulae for, 564, 64] 
Bromidrosis, 569 
Bromine and Bromides, 136 
Bromism, 137 
Bronchiectasis, 507 
Bronchitis, Acute, 508 

Capillary, 509 

Chronic, 509 
Bronchocele. — See Goitre, 579 
Bronchorrhcea, 5 II 
Broom, 368 
Brown Mixture, 234 
Brucine, 243, 255, 294 
Bruises, 511 
Bryonia, 138 
Bryonin, 139 
Bubo, 511 
Buchu, 140 

Helmbold's, 717 
Buckthorn, 162, 227 
Bulimia, 500 
Bunion, 512 
Burdock, 270 

Burnett's Disinfectant, 51, 411 
Burns, 512 
Bursitis, 513 
Butternut, 265 
Butyl Angelate, 102 

Chloral Hydrate, 172 

Chloride, 82 

Hydride, 82 

Valerianate, 102 
Buxine, 308 
Buxus sempervirens, 308 



Cacao-butter, 395 
Cachets, 479 
Cachexias, 513 
Cadmium, 140 
Caffea, 141 
Caffeine, 141 
Cajuput Oil, 146 
Cajuputene Bihydrate, 146 
Cajuputol, 146 
Calabar Bean, 314 
Calabar in e, 314 
Calamine, 411 

Ointment, 413 
Calamus, 146 
Calcination, 420 
Calcium, 146 
Calculi, Biliary, 513 

Renal, 514 

Solvents of, 45 

Vesical, 514 
Calendula, 148 



INDEX. 



749 



Calomel, 245 


Cardamom, 159 


Calumba, 149 


Cardiac Disorders. — See Heart. 


Calx, 146 


Sedatives, 33 


Chlorata, 177 


Stimulants, ^^ 


Sulphurata, 386 


Tonics, ^^ 


Cambogia, 149 


Cardialgia. — See Pyrosis, 664 


Camellia Thea, 141 


Carduus, 159 


Camp Fever. — See Typhus, 689 


Carica Papaya, 307 


Camphor, 150 


Caries, 516 


Baldrian, 401 


Carminatives, 37 


Bergamot, 134 


Dewees', 122, 278 


Carbolated, 152 


Carmine, 188 


-Chloral, 152 


Caroval, 200 


Camphor-Cymol, 150 


Carron Oil, 147., 274 


Monobromated, 150 


Carthamus tinctorius, 197 


Peppermint, 286 


Caruen, 160 


Salicylated, 152 


Carum, 160 


Canadian Hemp, 109 


Caruol, 160 


Cancer, 515 


Caryophyllin, 160 


Diagnosis of, 726 


Caryophyllus, 160 


of Uterus, 693 


Casca Bark, 161 


Cancrum Oris, 515 


Cascara Amarga, 161 


Cane Sugar, 355 


Sagrada, 162 


Cannabene, 152 


Cascarilla, 162 


Cannabin, 152, 169 


Cascarillin, 162 


Cannabis, 152 


Cassia acutifolia, 371 


Americana, 152 


bark, 187 


Indica, 152 


elongata, 371 


sativa, 152 


Fistula, 162 


Cantharides, 154 


Castanea, 64, 163 


Cantbaridin, 154 


vesca, 163 


Cantharis, 154 


Castor Oil, 348 


Capsicin, 156 


Emulsion ; Formula, 532 


Capsicum, 156 


Castoria, 716 


Capsules, 477 


Catalepsy, 517 


Caraway, 160 


Cataplasmata, 485 


Carbo, 158 


Cataract, 517 


Animalis, 158 


Catarrh, Acute Nasal, 517 


Purified, 158 


Broncho-pulmonary. — See Bronchitis, 


Ligni, 158 


Bronchorrhoea. 


Carbolate of Iodine, 257 


Chronic Nasal, 518 


Carbon, 158 


Duodenal, 550 


Bisulphide, 158 


Epidemic. — See Influenza, 607 


Dioxide, 82 


Gastric. — See Gastritis, Chronic, 575 


Monoxide, 82 


Genito-urinary. — See Bladder, Catarrh 


Tetrachloride, 82, 174 


of, Cystitis, Endometritis, Gonor- 


Carbonei Bisulphidum, 82, 158 


rhoea, Leucorrhcea, etc. 


Carbonate of Ammonium, 95 


Intestinal. — See Dysentery, Jaundice. 


of Calcium, Precipitated, 146 


Summer. — See Hay Fever, 583 


of Iron, 221 


Catechol, 184 


Saccharated, 221 


Catechu, 64, 163 


of Iron and Manganese, 281 


Cathartics, 38 


of Lead, 325 


Catharto mannite, 372 


of Lithium, 275 


Caulophyllin, 1 63 


of Magnesium, 278 


Caulophyllum, 163 


of Potassium, 330 


Caustic, Lunar, 115 


of Sodium, 376 


Potash, 330 


Dried, 377 


Soda, 376 


of Zinc. Precipitated, 411 


Caustics, 49 


Carbonated Mineral Waters, ill 


Cedar, Oil of, 362 


Carbonization, 420 


Red, 353 


Carbuncle, 516 


White, 396 


Carcinoma. — See Cancer, 515 


Celandine, 166 



7 So 



INDEX. 



Cellulose, 234, 355 
Centaurea benedicta, 159 
Cephaelis Ipecacuanha?, 262 
Cephalalgia, 584 
Cera, 164 
Cera Alba, 164 
Flava, 164 
Cerata, 441, 483 
Cerate of Camphor, 150 
of Cantharides, 155 
of Cantharides Extract, 155 
of Cetaceum, 165 
of Lead Subacetate, 325 



of Resin, 



; 4 2 



of Sabine, 353 
Cerates, 441, 483 

Compounding of, 483 
Ceratum, 164, 441 
Cerebellum, Agents affecting, 28 
Cerebral Anaemia, 520 

Compression, Diagnosis, 726 

Concussion, 520 
Diagnosis, 726 

Congestion, 521 

Depressants, 26 

Excitants, 26 

Softening, 521 

Vomiting. — Diagnosis, 730 
Cerebro-spinal Fever, 626 
Cerium Oxalate, 164 
Cerolein, 164 
Cetaceum, 165 
Cetin, 165 
Cetraria, 165, 178 
Cetyl Palmitate, 165 
Cevadilla, 404 
Cevadilline, 404 
Cevadine, 404 
Chalk, Prepared, 147 
Chalybeate Waters, 112 
Chamomile, 102 

German, 284 
Chamomilla, 284 
Chancre, 521 

Diagnosis of, 726 
Chancroid, 521 

Diagnosis of, 726 
Change of Life. — See Climacteric, 526 
Chapped Hands and Lips, 522 
Charcoal, 158 

Chartae (see also Papers), 442 
Chartulae, 479 
Chaulmoogra Oil, 165 
Chelerythrine, 166 
Chelidonine, 166 
Chelidonium, 166 
Chelidoxanthin, 166 
Chelsea Pensioner, 478, 670 
Chemical Incompatibility, 456 
Chenopodium, 166 
Cherry-laurel, 67, 69 
Cherry, Wild, 335 
Chestnut, 163 



Chestnut-leaves, 64 

Chest-pains, 522 

Chian Turpentine, 392 

Chicken-pox, 52?, 696 

Chilblains, 522 

Children, Dosage for, 22 

Chimaphila, 166 

Chimaphilin, 166 

China, Pride of, 126 

Chinicine, 183 

Chininum Amorphum Boricum, 182 

Chinoidin, 183 

Chinoline, 167, 183 

Chiratin, 168 

Chiretta, 168 

Chittem Bark, 162 

Chloral, 168 

Analogues of, 168 

Butylic, 169, 172 

Formidate, 169 

Hydrate, 168 
Chloralamid, 169 
Chloral-habit, 171 
Chlorate of Potassium, 330 

of Sodium, 377 
Chloride of Ammonium, 95 

of Amyl, 82 

of Arsenic, 1 16 

of Butyl, 82 

of Calcium, 147 

of Cocaine, 214 

of Ethene, 82 

of Ethyl, 82 

of Ethylidene, 174 

of Gold, 125, 717 

of Gold and Sodium, 125 

of Iron, 221 

of Lime, 177 

Mercur-ammonium, 246 

of Mercury, Corrosive, 245 
Mild, 245 

of Methane, 82, 174 

of Methyl, 82, 174 

of Sodium, 377 

of Zinc, 411 
Chlorides in Urine, Test, 736 
Chlorinated Waters, 112 
Chlorine, 176 
Chlorine-water, 176 
Chlorodyne, 173 

Collis Browne's, 716 

Formulae for, compared, 715 
Chloroform, 81, 172 

Commercial, 173 

Methylic, 173 

Purified, 173 
Chlorosis, 523 
Chlorum, 176 
Chocolate, 143, 395 
Choking, 523 
Cholagogues, 39 

Pills, 476 

Purgatives, 38 



INDEX. 



75T 



Cholera Asiatica, 523 

Infantum, 524 

Simplex, 525 

Diagnosis of, 727 
Cholera Mixture (Squibb), 299, 524 
Cholesterin, 408 

Chondodendron tomentosum, 308 
Chondrus, 178 
Chordee, 525 
Chorea, 525 
Choroiditis, 526 
Chrysarobin, 178 
Chrysophan, 344 
Churrus, 153 

Cigarettes, Formulae for, 502 
Ciliary Excitants, 2,3 
Cimicifuga, 179 
Cimicifugin, 179 
Cinchona, 180 

Flava, 180 

Rubra, 180 

Red, 181 
Cinchonidine, 181 
Cinchonine, 181 
Cinchonism, 185 
Cinnabar, 246 
Cinnamein, 127 
Cinnamomum, 187 

Camphora, 150 
Cinnamon, 187 
Cinquefoil, 647 

Circulation, Agents affecting, ^i, 
Circumcision, 650 
Cissampeline, 308 
Cissampelos Pareira, 308 
Citrate of Bismuth, 134 

of Bismuth and Ammonium, 134 

of Caffeine, 141 

of Cocaine, 214 

of Iron, 221 

of Iron and Ammonium, 222 

of Iron and Quinine, 223 

of Iron and Strychnine, 223 

of Lithium, 275 

of Magnesium, Granulated, 278 

of Potassium, 330 
Citrates, 272 
Citrine Ointment, 246 
Brown, 246 
Citron, 272 

Citrullus Colocynthis, 189 
Citrus acris, 272 

Aurantium, 124 

Bergamia, 134 

Limonum, 272 

medica, 272 

vulgaris, 124 
Clarification, 423 
Clarke's Blood Mixture, 717 
Classification of Medicines, 23 
Claviceps purpurea, 210 
Clavus. — See Headache, 592 
Clemen's Solution, 119 



Climacteric Disorders, 526 
Cloves, 160 
Club-moss, 277 
Clysters, 469 
Cnicin, 160 
Cnicus benedictus, 159 
Coca, 143, 213 
Cocaine, 213 
Cocaine-habit, 215 
Cocculus Indicus, 317 
Coccus, 188 
Coccyodynia, 527 
Cochineal, 188 
Cocoa, 143 
Codamine, 298 
Codfish, 288 
Codeine, 298, 300 
Cod-liver Oil, 288 

Emulsion, 288, 467 
Coffee, 141 
Cohosh, Black, 179 

Blue, 163 
Colation, 422 
Colchiceine, 188 
Colchicine, 188 
Colchicum, 188 
Coldness, 527 
Colic, Hepatic, 528 

Intestinal, 527 

Lead, 528 

Renal, 528 
Colic-root, 207 
Collodia, 435 
Collodion, 235 

with Cantharides, 155, 235 

Flexible, 235, 435 

Styptic, 75, 235, 435 
Colloids, 424 
Collunarium, 469 
Collyrium, 468 

Formulae for, 468 

of Four Sulphates, 468 
Colocynth, 188 
Colocynthein, 190 
Colocynthin, 1S9 
Colocynthis, 189 
Colocynthitin, 190 
Cologne-water, 87 
Colophony, 341,393 
Columbo, 149 
Coma, 528 

Combination, Principles of, 449 
Comminution, 420 
Compounding Medicines, 442 

a Mixture, 464 
Condylomata, 529 
Condy's Fluid, 51 
Confectio Damocratis, 478 
Confection of Rose, 350 

of Senna, 372, 391 
Confectiones, 439, 478 

Formulae for, 478 
Conhydrine, 190 



752 



INDEX. 



Coniine, 190 
Conium, 190 
Conjunctivitis, Catarrhal, 529 

Diphtheritic, 530 

Gonorrhceal, 530 

Granular, 530 

Phlyctenular, 530 

Purulent, 531 
Conspergative, 471, 472 
Constipation, 531 
Constituents of Drugs, 416 
Convalescence, 533 
Convallamarin, 192 
Convallaria Majalis, 192 
Convallarin, 192 
Convolvulin, 264, 366 
Convolvulus Scammonia, 366 
Convulsions, 533 

Infantile, 533 

Puerperal, 662 
Copaiba, 193 

Emulsion, 467 
Copaifera Langs d or ffii, 193 
Copper, 198 
Cordial, Cascara, 162 
Coriander, 194 
Coriandrum, 194 
Corneal Opacities, 534 
Corneitis. — See Keratitis, 613 
Corn, Indian, 409 

Silk, 410 

Smut, 410 
Cornin, 195 
Corns, 534 
Cornus, 195 
Cornutin, 210 

Corpulence. — See Obesity, 637 
Corrosive Sublimate, 245 
Coryza. — See Catarrh, Acute, 517 
Coto Bark, 195 
Cotoin, 195 
Cosmoline, 310 
Cotton, 234 

Iodized, Formulae for, 591 
Cotton-seed Oil, 235, 297 
Couch-grass, 400 
Cough, 534, 648 

Mixtures, Formulae for, 536, 608, 649 
Counter-irritants, 49 
Court Plaster, 255 
Coxalgia, 536 

Coxe's Hive Mixture, 103, 367 
Crab Lice. — See Pediculi, 646 
Cramp Bark, 407 

Cramps. — See Trismus, Spasmodic Affec- 
tions. 
Cranberry Tree, 407 
Cranesbill, 64, 232 
Cream, Cold, 350 

of Tartar, 331 
Creasol, 196 
Creasote, 61, 196, 389 
Creolin, 197 



Creta Praeparata, 147 
Crocus, 197 

Croton-chloral, 169, 172 
Croton Eluteria, 162 

Oil, 398 

Tighum, 398 
Croup, Catarrhal, 536 

Membranous, 537 

Diagnosis, 727 
Cryptopine, 298 
Crystallization, 423 
Cubeba, 197 
Cubeben, 198 
Cubebene, 198 
Cubebin, 198 
Cuca, 213 

Cucumber, Squirting, 209 
Cucumber Tree, 279 
Cucurbita Pepo, 308 
Cucurbitine, 308 
Culver's Root, 271 
Cuprea Bark, 180 
Cuprum, 198 

Ammoniatum, 199 
Curare, 200 
Curarine, 200 
Cutaneous Irritants, 49 
Cyanide of Mercury, 246 

of Potassium, 68 

of Silver, 115 
Cyanosis, 537 
Cydonin, 201 
Cydonium, 201 
Cymene, 397 

Cynips Gallae tinctoriae, 229 
Cypripedin, 202 
Cypripedium, 202 
Cystitis, Acute, 537 

Chronic, 538 
Cysts, 539 



Damiana, 202 

Dandelion, 391 

Dandruff. — See Pityriasis, 654 

Daphne Mezereum, 287 

Daphnin, 287 

Datura Stramonium, 382 

Tatula, 203 
Datufine, 203, 382 
Deafness, 539 

Death, Signs of. — See Asphyxia, 734 
Debility. — See Adynamia, Anaemia, Con- 
valescence. 
Decantation, 422 
Decocta, 430 
Decoction of Cetraria, 165 

of Chimaphila, 167 

of Dulcamara, 208 

of Granatum, 236 

of Haematoxylon, 240 

of Hydrangea, 244 



INDEX. 



753 



Decoction of Inula, 257 

of Prinos, 334 

of Quercus, 340 

of Quillaia, 341 

of Ruraex, 352 

of Sarsaparilla, Compound, 365 

of Stillingia, 381 

of Viola Tricolor, 408 

of Viscum, 40S 

of Xanthoxylum, 409 
Decoloration, 423 
Deer, Musk, 290 
Deflagration, 420 
Deliquescence, 424 
Deliquescent Salts, List of, 474 
Deliriants, 26 
Delirium, 540 

Tremens, 540 
Delphinine, 380 
Delphinium Staphisagria, 380 
Dementia, 541 

Paralytica, 542 
Demulcents, 51 
Dengue, 542 
Dentition, 542 
Dentifrices, 34 
Deodorants, 52 
Depressants, Cerebral, 26 

Hepatic, 40 

Renal, 44 

Respiratory, 30 

Uterine, 48 
Desiccation, 419 
Destructive Metamorphosis, 42 
Dew-berry, 351 

Dewees' Carminative, 122, 278 
Dextrin, 355 
Dextrose, 355 
Diabetes Insipidus, 543 

Mellitus, 543 
Diachylon Ointment, 326 

Plaster, 326 
Diagnosis, Differential, 725 
Dialysis, 424 
Dialysed Iron, 425 
Diaphoretics, 46 
Diarrhoea, 544 
Diastase, 279 

Pancreatic, 306 
Dichlor-methyl Chloride, 172 
Dichloro-methane, 174 
Diffusate, 424 

Digestive System, Agents affecting, 34 
Digital ein, 203 
Digitalin, 203 
Digitalis, 203 
Digitonin, 203 
Digitoxin, 203 
Diluents, 46, 463, 479 
Dimethyl-ethyl-carbinol, 168 
Dimethyl-phenyl pyrazolon, 105 
Dioscorea, 207, 407 
Dioscorein, 207 

48 



Diospyros, 64 
Dioxide of Carbon, 82 
Diphtheria, 546 

Diagnosis of, 727 
I Dipsomania. — See Alcoholism, Delirium 

Tremens. 
: Discutients, 42 
Disinfectants, 51 

Burnett's, 52, 41 1 

Condy's, 52 

Labarraque's, 51, 177 
Dislocations, 573 
Dispensatories, 415 
Dispensing, 442 

by Physicians, 442 
Dispermine, 321 
Displacement, 425 
Distillation, 419 

Dry, 419 

Fractional, 419 
Disulphide of Iodine, 387 
Dita Bark, 207 
Ditaine, 207 
Ditamine, 207 
Dithymol-Iodide, 261 
Diuretics, 43 

Formulae for, 549, 692 
Diuretin, 144 

Dizziness. — See Vertigo, 697 
Dobell's Nasal Wash, 470, 519 
Dock, Yellow, 352 
Dog- wood, 195 

Jamaica, 322 
Domestic Measures, 446 
Donovan's Solution, 119, 246 
Dorema Ammoniacum, 94 
Dosage of Medicines, 54 
Doses, Table of, 741 
Dover's Powder, 261 

Fluid, 261 
Drastic Purgatives, 38 
Draught, 467 

Black, 372, 467 

Effervescing^ 467 
Drink, 467 

Imperial, Formula, 468 
Drops, 446 

Table of Drops to a Drachm, 445, 739 
Dropsy, 549 
Drosera* 207 

Drowning. — See Asphyxia, 734 
Drugs, Their Constituents, 416 
Drug-experimentation, 19 
Duboisia, 207 
Duboisine, 207 
Dulcamara, 20S 
Dulcamarin, 208 
Duodenal Catarrh, 550 
Dutch Liquid, 173 
Dyscrasiee. — See Cachexise, 513 
Dysentery, 550 
Dyspepsia, 553 
Dysphagia, 555 



754 



INDEX. 



Dysmenorrhea, 551 
Dyspnoea, 555 
Dysuria, 555 



Ear, Agents affecting it, 30 
Earache, 641 
Eau Sedative, 95, 150 
Ebullition, 419 
Ecballium Elaterium, 209 
Ecbolics, 47,48 
Ecboline, 210 
Ecchymosis, 556 
Ecgonine, 213 
Eclampsia, 662 
Ecthyma, 556 
Ectropium, 556 
Eczema, 556 
Efflorescence, 424 
Efflorescent Salts, List of, 474 
Egg, Yolk of, 408 
Eights, The Three, 681 
Elaterin, 209 
Elaterium, 209 
Elder, 360 
Elecampane, 256 
Electuaria, 439, 478 
Electuary for Piles, 478 
Elixir of Orange, 124 

of Opium, 299 

Simple, 124 

of Vitriol, 73 
Elixiria, 434, 467 
Elm, Slippery, 400 
Elutriation, 421 
Ely's Cream Balm, 717 
Emaciation, 558 
Embrocation, 469 
Emetics, 36 

General or Systematic, 37 

Local, 2,1 
Emetine, 261 
Emissions, 558 
Emmenagogues, 47 

Formulae for, 495 

Pills, 476 
Emollients, 50 
Emphysema of Lungs, 559 
Emplastra, 441, 484 
Empyema, 559 
Emulsification, 465 
Emulsin, 68, 98, 335 
Emulsion of Cod-liver Oil, 288, 467 

of Copaiba, 467 

Pancreatic, 306 
Emulsions, 465 

Natural, 465 
Encephaloma. — See Cancer, 515 

Diagnosis of, 726 
Endarteritis. — See Atheroma, 502 
Endocarditis, 559 

Diagnosis of, 726 



Endometritis, 560 

Enema of Tobacco, 389 

Enemas, Formulae for, 470, 561 

Enemata, 469, 560 

Enteralgia. — See Colic, Intes., 527 

Enteric Fever. — See Typhoid, 687, 729 

Enteritis, 561 

Entropium, 556 

Enuresis, 561 

Epididymitis, 562 

Epilation. — See Tinea Circin., 684 

Epilepsy, 562 

Diagnosis of, 727 
Epispastics, 49 
Epistaxis, 564 
Epsom Salt, 278 
Epulis.— See Teeth, 682 
Equinia. — See Glanders, 577 
Erections, 558 
Ergot of Rye, 210 

of Corn. — See Ustilago, 410 
Ergota, 210 
Ergotine, 210 
Ergotinine, 210 
Ergotism, 211 
Ericolin, 229, 401 
Erigeron, 213 
Eriodyction, 213 
Errhines, 32 
Eructations, 553, 571 
Eruptions caused by Drugs, 564 
Erysipelas, 565 
Erythema, 566 
Erythrophleine, 161 
Erythrophlceum Guinense, 161 
Erythroretin, 344 
Erythroxylon, 143, 213 
Escharotics, 49 
Eserine, 314 
Essence of Lemon, 273 

of Nutmeg, 291 

of Peppermint, 286 

of Spearmint, 287 
Ethene, 82 

Chloride, 82 

Dichloride, 82 
Ether, 79 

Acetic, 80, 83 

Chloric, 173 

Chlorinated Muriatic, 174 

Hydrobromic, 80, 82 

Hydricdic, 80, 82 

Methylene-di-methyl, 170 

Methylic, 82 

Nitrous, 8^ 

Petroleum, 131 
Ethereal Oil, 80 

Preparations, 435 
Ethics, 737 
Ethyl Acetate, 80 

Alcohol, 88 

Bromide, 80, 82 

Carbamate, 170 



INDEX. 



755 



Ethyl Chloride, 82 

Hydrate, 88 

Hydride, 82 

Iodide, 80, 259 

Nitrite, 80, 100 

Oxide, 79 
Ethylate of Sodium, 377 
Ethylene Bichloride, 173 
Ethylidene Chloride, 174 
Eucalyptene, 218 
Eucalyptol, 218 
Eucalyptolen, 218 
Eucalyptus, 217 
Eugenia caryophyllata, 160 

Pimenta, 320 
Eugenin, 160 
Eugenol, 160 
Euonymin, 219 
Euonymus, 219 
Eupatorin, 219 
Eupatorium, 219 

perfoliatum, 219 

purpureum, 219 
Euphrasia, 220 
Evaporation, 418 

Spontaneous, 419 
Exalgine, 57 

Exanthemata, Diagnosis of, 728 
Excipients, 438,463 

for Emulsions, 466 

for Pills, 471 
Excitants, Cerebral, 26 

Ciliary, 33 
Excoriation — See Intertrigo, 611 
Excretion. — Agents affecting, 43 
Exhaustion, 567 
Exodyne, 57 
Exogonium purga, 264 
Exophthalmos, 567 
Exostosis, 567 
Expectorants, 32 
Explosive Compounds, 457 
Expression, 425 
Exsiccation, 420, 424 
Extemporaneous Pharmacy, 442 

Preparations, 461 

Prescriptions, 447 
Extract of Aconite, 77 

of Aloes, Watery, 91 

of Arnica- root, 117 

of Baptisia, 128 

of Belladonna, Alcoholic, 129 

of Cannabis Indica, 153 

of Cinchona, 181 

of Colocynth, 190 

of Colocynth, Compound, 190,367 

of Colchicum-root, 188 

of Conium, Alcoholic, 191 

of Convallaria, 192 

of Damiana, 202 

of Digitalis, 204 

of Duboisia, 207 

of Ergot, 210 



Extract of Eriodyction, 213 

of Euonymus, 219 

of Gentian, 231 

of Glycyrrhiza, 234 

of Haematoxylon, 240 

of Hellebore, 242 

of Hyoscyamus, Alcoholic, 253 

of Iris, 263 

of Juglans, 265 

of Krameria, 268 

of Leptandra, 271 

of Malt, 280 

of Mezereum, 287 

of Nux Vomica, 294 

of Opium, 299 

of Physostigma, 314 

of Pichi, 317 

of Pinus Canad., 324 

of Podophyllum, 328 

of Polygonum, 329 

of Quassia, 338 

of Quebracho, 339 

of Rheum, 344 

of Rhus Toxicodendron, 347 

of Stramonium, 382 

of Taraxacum, 392 
Extract, 436 

Extracta Fluida. — See Fluid Extracts, 431 
Extractive, 437 
Eye-bright, 220 
Eye Diseases, 568 

Ointments. — Formulae for, 529 

Sensibility, Agents affecting it, 29 

Water, Formulae for, 529 
Eyelids, 568 



Fabiana imbricata, 317 
Face, 568 

Face-ache. — See Neuralgia, Tic Doulou- 
reux, 633, 684 
Fainting. — See Syncope, 680 
False Pains, 569 
Farcy, 577 

Fat. — See Obesity, 637 
Fatigue. — See Exhaustion, 567 
Favus — See Tinea Favosa, 684 
Febricula. — See Fever, Simple, 571 
Febrifuge, 183 
Feet, 569 

Fehling's Solution, 199, 736 
Fel Bovis, 220 

Inspissatum, 220 

Purificatum, 220 
Felon. — See Onychia, 638 
Fennel, 227 

Fermentation, Lactic, 356 
Fern, Male, 123 
Ferrier's Snuff, Formula, 518 
Ferro-cyanide of Potass., 68 
Ferrum, 220 

Dialysatum, 223, 425 



756 



INDEX. 



Ferrum Reductum, 220 
Ferula galbaniflua, 228 

Narthex, 122 

Scorodosma, 122 

Sumbul, 388 
Fever, 569 

Bilious Remittent, Diagnosis, 730 

Cerebro spinal, 626 

Hay, 583 

Hectic, 589 

Intermittent, 609 

Miliary, 629 

Milk. — See Lactation, 614 

Pernicious. — See Intermittent Fever, 
Remittent Fever. 

Puerperal, 662 

Relapsing, 665 

Remittent, 666 

Diagnosis of, 730 
Rheumatic, 667 

Scarlet, 671 

Diagnosis of, 728 

Simple, 571 

Spotted. — See Typhus Fever, also 
Meningitis, Cerebro-spinal. 

Surgical, 679 

Traumatic. — See Surgical Fever, 679 

Typhoid, 687 

Diagnosis of, 729 

Typho-malarial. — See Typhoid, 687 

Typhus, 689 

Diagnosis of, 729 

Yellow, 701 

Diagnosis of, 730 
Ficus (Fig), 226 
Filix Mas, 123 
Filtering-paper, 422 
Filtration, 422 
Fir, Balsam of, 392 

Scotch, 323 

Silver, 392 
Firs, 323 
Fish berries, 317 
Fistula, 571 

Fits. — See Apoplexy, Convulsions, Epi- 
lepsy, Hysteria, Syncope. 
Flatulence, 571 
Flavoring Agents, 464 
Flax-seed, 274 
Flea-bane, 213 

Fleming's Tincture of Aconite, 77 
Flooding. — See Hemorrhage Post-partum, 

Menorrhagia, and Metrorrhagia. 
Fluavil, 240 
Fluid Extract of Aconite, 77 

of Ailanthus, 86 

of Arnica-root, 1 17 

Aromatic, 187 

of Aurantium Amarum, 124 

of Baptisia, 128 

of Belladonna, 129 

of Berbeiis, 133 

of Brayera, 135 



Fluid Extract of Buchu, 140 
of Calamus, 146 
of Calumba, 149 
of Cannabis Indica, 153 
of Capsicum, 157 
of Cascara Amarga, 161 
of Cascara Sagrada, 162 
of Castenea, 163 
of Chimaphila, 167 
of Chirata, 168 
of Cimicifuga, 1 79 
of Cinchona, 181 
of Cocculus, 317 
of Coffee, Green, 141 
of Cokhicum-root, 188 
of Colchicum-seed, 188 
of Conium, 191 
of Convallaria, 192 
of Corn-silk, 410 
of Cornus, 195 
of Coto, 195 
of Cotton-root, 235 
of Cubeb, 198 
of Cypripedium, 202 
of Damiana, 202 
of Digitalis, 204 
of Drosera, 207 
of Dulcamara, 208 
of Ergot, 210 
of Eriodyction, 213 
of Erythroxylon, 214 
of Eucalyptus, 218 
of Eupatorium, 219 
of Frangula, 227 
of Gelsemium, 230 
of Gentian, 231 
of Geranium, 232 
of Ginger, 413 
of Glycyrrhiza, 234 
of Gossypium, 235 
of Granatum, 236 
of Grindelia, 237 
of Guarana, 239 
of Hamamelis, 241 
of Hellebore, Black, 242 
of Hydrangea, 244 
of Hydrastis, 252 
of Hyoscyamus, 253 
of Ipecacuanha, 261 
of Iris, 263 
of Jaborandi, 319 
of Krameria, 268 
of Lactucarium, 269 
of Leptandra, 271 
of Liquorice, 234 
of Lobelia, 276 
of Lupulin, 244 
of Manaca, 280 
of Matico, 284 
of Mezereon, 287 
of Nux Vomica, 294 
of Orange, Bitter, 124 
of Pareira, 308 



INDEX. 



757 



Fluid Extract of Phytolacca, 316 

of Pichi, 317 

of Pilocarpus, 319 

of Pink- root, 380 

of Piscidia, 322 

of Plantago, 325 

of Podophyllum, 328 

of Poke-root, 316 

of Polygonum, 329 

of Prunus Virginiana, 335 

of Quassia, 338 

of Quebracho, 339 

of Rhatany, 268 

of Rheum, 344 

of Rhubarb, 344 

of Rhus Aromatica, 345 

of Rhus Glabra, 346 

of Rose, 350 

of Rubus, 351 

of Rumex, 352 

of Sabina, 353 

of Sanguinaria, 361 

of Santalum, 362 

of Sarsaparilla, 365 
Compound, 365 

of Savine, 353 

of Scilla, 367 

of Scutellaria, 370 

of Senega, 371 

of Senna, 372 

of Serpentaria, 373 

of Spigelia, 380 

of Stigmata Maydis, 410 

of Stillingia, 381 

of Stramonium, 382 

of Sumach, Smooth, 345 
Sweet, 345 

of Taraxacum, 392 

of Tonga, 399 

of Triticum, 400 

of Ustilago, 410 

of Uva-ursi, 401 

of Valerian, 402 

of Veratrum Viride, 404 

of Viburnum, 407 

of Wild Cherry, 335 

of Witch-hazel, 241 

of Xanthoxylum, 409 

of Zingiber, 413 
Fluid Extracts, 431 
Flushing-heats, 572 
Fly-agaric, 85 
Foeniculum, 227 
Foetal Development, 733 

Skull, its Diameters, 733 
Fomentation, 468, 657 
Food, Horlick's, 280 

Mellin's, 280 

Parrish's, 312 
Foods, 41 

Foreign Bodies, 572 
Formulae, Hypodermic, 713 
Formyl Iodide, 258 



Fotus, 468 

Fowler's Solution, 119 
Fox-glove, 203 
Fractures, 573 
Franciscea uniflora, 280 
Frangula, 227 
Frangulin, 227 
Frankincense, 393 
Franklinite, 41 1 
Fraxin, 283 
Fraxinus Ornus, 282 
Freckles, 573 



Fuchsin, 227 
Fucus Vesiculosus, 22 
Furuncle. — See Boils, 
Fusel Oil, 88 
Fusion, 420 



505 



Gaduin, 288 

Gadus Morrhua, 288 

Galactagogues, 49 

Galhanum, 228 

Galla, 64, 229 

Galena, 325 

Gallipots, 476 

Gall-stones — See Calculi, Biliary, 513 

Gallus Bankiva, 408 

Gamboge, 149 

Gangrene, 573 

of Lungs, 621 
Garcinia Hanburii, 149 

mangostana, 282 
Garfield Tea, 717 
Gargarysma, 468 

Gargles, Formulae for, 468, 548, 650, 683 
Garlic, 90 

Gaseous Preparations, 485 
Gastralgia, 574 
Gastric Dilatation, 575 
Gastric Fever, — See Fever, Simple, — Ty- 
phoid Fever, Gastritis. 
Gastric Pain, 37 

Sedatives, 37, 480 

Tonics, 35 

Ulcer, 576 

Vomiting, Diagnosis, 730 
Gastritis, Acute, 575 

Chronic, 575 
Gastrodynia, 574 
Gaultheria, 229 
Gaultherilene, 229 
Gauze of Carbolic Acid, 61 

of Thymol, 397 
Gelatin, 255 

Capsules, 477 
Gelsemine, 230 
Gelsemium, 229 

Generative System, Agents affecting, 47 
Genitive Case-endings, 712 
Gentian, 231 



758 



INDEX. 



Gentianin, 231 
Gentopicrin, 231 

Geranium, 64, 232 

Gin, 87, 266 

Ginger, 413 

Glanders, 577 

Glandular Enlargements, 577 

Glass, Soluble, 331, 374 

Glauber's Salt, 377 

Glaucoma, 578 

Gleet, 483, 578 

Glonoin, 99 

Glossitis, 579 

Glottis, CEdema of, 579 

Gluco-pepsin, 309 

Glucose, 355 

Glucosides, 417 

Glycerin, 232 

Preparations, 436 
Glycerita, 436 
Glycerite of Carbolic Acid, 61 

of Tannin, 75 

of Starcb, 101 

of Yolk of Egg, 408 
Glyceryl, 297 

Trinitrate, 99 
Glycocholate of Sodium, 220 
Glycogen, 355 

Agents affecting production, 40 
Glyconin, 408 

Emulsion of, 288 
Glycyrrhetin, 234 
Glycyrrhiza, 233 
Glycyrrhizin, 234 

Glycyrrhizinum Ammoniatum, 234 
Gnoscopine, 298 
Goa-powder, 178 
Goitre, 579 
Gold, 125 

Chloride of, 125, 717 
Golden Seal, 251 
Gonorrhoea, 470, 579 
Gossypii Radicis Cortex, 235 
Gossypium, 234 
Goulard's Cerate, 325 

Extract, 325 
Gout, 581 

Diagnosis of, 727 
Granatum, 64, 236 

Granular Lids. — See Conjunctivitis, Oph- 
thalmia. 
Granulation, 424 
Granule, 471 
Grass, Ribbed, 324 
Gravel-root, 219 

Graves' Disease. — See Exophthalmos, 567 
Gray Powder, 245 
Griffith's Mixture, 221 

Pills, 221 
Grindelia, 237 
Grippe, 607 
Guarana, 143, 239 
Guaranine, 143, 239 



Guaiac, 238 

Lignum, 238 

Resina, 238 
Guaiacol, 196 
Gum Arabic, 56 
Gumboil. — See Gums, 582 
Gum-tree, Blue, 217 
Gums, 582 
Gun-cotton, 235 
Gunjah, 153 
Gurjun Balsam, 239 
Gutta, 240 
Gutta-percha, 240 
Guttae (Drops), 446 
Gynocardia odorata, 165 



Hager's Tincture, 182 

Hair, 583 

Hair-tonic, 583 

Hair Washes, Formulae, 494, 583 

Haller's Dictum, 19 

Hamamelin, 241 

Hamamelis, 64, 241 

Hamburg Tea, 717 

Hamlin's Wizard Oil, 717 

Hands. — See Chapped Hands, 522 

Hashish, 153 

Haustus, 467 

Haw, Black, 407 

Hay ah, 161 

Hay-fever, 583 

Haematics, 41 

Hematoxylin, 240 

Hsematoxylon, 64, 240 

Head-ache, Bilious Sick, 584 

Congestive, 585 

Nervous, 586 
Heart, Fatty, 588 

Dilated, 587 

Diseases, 587 

Hypertrophied, 588 

Palpitation, 588 

Valvular Disease, 589 
Heartburn. — See Pyrosis, 664 
Heart's-ease, 407 
Hectic Fever, 589 
Hedeoma, 241 
Helenin, 256 
Hellebore, 242 

American, 403 

Swamp, 403 

White, 404 
Helleborein, 242 
Helleborin, 242 
Helleborus, 242 
Hematemesis, 590 

Diagnosis of, 728 
Hematocele, Pelvic, 590 
Hematuria, 591 
Helmbold's Buchu, 717 
Hemeralopia, 591 



INDEX. 



759 



Hemicrania, 592 
Hemiopia, 593 
Hemiplegia, 593 
Hemlock, 190 
Hemlock Spruce, 323 
Hemoptysis, 593 

Diagnosis of, 728 
Hemorrhage, 594 

Intestinal, 595 

Post-partum, 595 
Hemorrhagic Diathesis, 594 
Hemorrhoids, 478, 596 
Hemostatics, 50 
Hemp, 152 

American, 152 

Canadian, 109 

Indian, 152 
Henbane, 253 
Hepar Sulphuris, 386 
Hepatalgia, 597 
Hepatic Abscess, 600 

Congestion, 598 

Cirrhosis, 597 

Depressants, 40 

Diseases, 599 

Stimulants, 39 

Vomiting, Diagnosis, 730 
Hepatitis, 600 
Hernia, 600 
Herpes, 600 

Zoster, 601 
Hesperidin, 124,272 
Heuchera, 64 
Hiccough, 601 
Hip joint Disease, 536 
Hippocratic Oath, 737 
Hive Mixture, 103, 367 

Syrup, 103 
Hives. — See Urticaria, 692 
Hoang Nan, 243 
Hoarseness. — See Aphonia, 498 
Hoffman's Anodyne, 40, 84 
Hoff's Malt Extract, 280 
Hollowav's Ointment, 717 

Pills, 717 
Homatropine, 129 
Honduras Bark, 161 
Honey, 284 

Clarified, 284 

of Rose, 284, 350 
Honeys (Mellita), 429 
Hong- Pang Chong, 345 
Hooper's Female Pills, 476 
Hope's Mixture, 545 
Hop tree, 346 
Hops, 244 

Hordeolum. — See Eyelids, 568 
Hordeum distichum, 279 
Horehound, 283 
Horlick's Food, 280 
Hostetters Bitters, 717 
Housemaid's Knee. — See Bursitis, 513 
Humulus, 244 



Hunger. — See Appetite, 500 
Hunyadi Water, 112, 532 
Huxham's Tincture of Bark, I Si 
Hwang-Xao, 243 
Hydragogue Purgatives, 38 
Hydrangea, 244 
Hydrargyrism, 247 
Hydrargyrum, 245 

Ammoniatum, 245 

cum Creta, 245 
Hydrastin, 252 
Hydrastine, 251 
Hydrastis, 251 
Hydrate of Aluminium, 93 

of Amyl, 88 

of Amylene, 1 68 

of Butyl chloral, 169 

of Chloral, 168 

of Ethyl, 88 

of Magnesium, 278 

of Methyl, 88 

of Potassium, 330 

of Sodium, 376 

of Terpine, 393 
j Hydrated Oxide of Iron, 222 

with Magnesia, 222 
Hydrated Silicate of Magnesium, 374 
Hydride of Amyl, 82 

of Butyl, 82 

of Ethyl, 82 
Hydriodic Ether. 80, 84 
Hydrobromate of Coniine, 190 

of Hyoscine, 169, 253 

of Quinine, 182 
Hydrobromic Ether, 79, 83 
Hydrocele, 602 
Hydrocephalus, 602 
Hydrochlorate of Apomorphine, no 

of Cocaine, 214 

of Quinine, 182 

Carbamide, 182 

of Morphine, 300 

of Narcotine, 300 

of Oxy-ethyl-chinoline-hydride, 184 

of Pilocarpine, 319 

of Rosanilin, 227 
Hydrocotarnine, 298 
Hydrocotyle, 253 
Hydrogen, Sulphuretted, 387 

Peroxide, 393 
Hydro- naphthol, 293 
Hydrophobia, 602 
Hydroquinone, 183, 184, 401 
Hydrothorax, 603 
Hygrine, 214 
Hygroscopic Bodies, 424 
Hyoscine, 169, 253 
Hyoscyamus, 253 
Hyoscyamine. 253 
Hyperidrosis, 647 
Hypnal, 106 
Hypnone, 169 
Hypnotics, 27, 169, 608 



760 



INDEX. 



Hypochondriasis, 603 
Hypodermic Formulas, 713 
Hypodermic Injections, 22, 714 
Hypophosphite of Calcium, 312 

of Iron, 221 

of Potassium, 312 

of Sodium, 312 
Hypophosphites, 312 

with Iron, Syrup of, 312 
Hyposulphite of Sodium, 74 
Hysteria, 603 

Diagnosis of, 727 



Ice, 113 

Iceland Moss, 165, 178 

Ichthyocolla, 255 

Ichthyol, 386 

Ichthyosis, 604 

Icterus. — See Jaundice, 612 

Igasurine, 294 

Ignatia, 255 

Ignition, 420 

Ileus. — See Intestinal Obstruction, 61 1 

Ilex Paraguayensis, 143 

Illicium, 256 

Anisafum, 102, 256 

religiosum, 256 
Impetigo, 604 
Impotence, 605 
Incineration, 420 
Incompatibility, 456 

Chemical, 456 

Pharmaceutical, 458 

Rules for avoiding, 460 

Therapeutical, 459 
Indian Tobacco, 275 
Indigestion. — See Dyspepsia, 553 
Indigo, Wild, 128 
Inflammation, 605 
Influenza, 607 
Infusa, 430 
Infusion of Arnica, 117 

of Brayera, 135 

of Buchu, 140 

of Cardamom, 159 

of Caraway, 160 

of Cascarilla, 162 

of Cinchona, 181 

of Cloves, 160 

of Convallaria, 192 

of Couch-grass, 400 

of Digitalis, 204 

of Gentian, Compound, 231 

of Hops, 244 

of Jequirity, 55 

of Juniper, 266 

of Linseed, 274 

of Lobelia, 276 

of Pareira, 308 

of Quassia, 338 

of Sassafras, 366 



Infusion of Senna, Compound, 372 

of Spigelia, Compound, 380 

of Tansy, 391 

of Tar, 323 

of Triticum, 400 

of Wild Cherry, 335 

of Uva-ursi, 401 
Infusions, 430 
Ingluvin, 309 
Inhalation of Thymol, 397 
Inhalations, Formulae for, 485 
Injection Brou, 470 

of Morphine, Hypodermic, 300 
Injections, 469 

Formulae, 22, 470, 714 
Injuries. — See Bruises, Burns, Ecchymosis, 

Fractures, Sprains, Wounds. 
Inoculation, 22 
Inosit, 355 
Insanity, 541 

Insolation. — See Sunstroke, 679 
Insoluble Salts, 457 
Insomnia, 608 
Intemperance. — See Alcoholism, Delirium 

Tremens. 
Intermittent Fever, 609 
Intertrigo, 611 
Intestinal Astringents, 39 
Intestinal Diseases. — See Colic, Constipa- 
tion, Diarrhoea, Duodenitis, Dysentery, 

Enteritis, Hemorrhoids, Hernia, In- 
testinal Obstruction, Intussusception, 

Typhlitis, Tabes Mesenterica, Worms. 
Intestinal Obstruction, 611 

Parasites. — See Worms, 700 
Intussusception, 611 
Inula, 256 
Inulin, 117, 257 
Iodide of Ammonium, 95, 257 

of Arsenic, 119 

of Cadmium, 140 

of Di-thymol, 261 

of Ethyl, 80, 259 

of Formyl, 258 

of Iron, 221 

Saccharated, 221 
and Manganese, 223 

of Lead, 325 

of Manganese, 281 

of Mercury, 246 
Green, 246 
Red, 246 

of Potassium, 257 

of Silver, 115 

of Sodium, 258 

of Sulphur, 387 

of Zinc, 411 
Iodides, 257 
Iodine, 257 
Iodism, 258 
Iodized Cotton, 591 

Phenol, 257 

Starch, 257 



INDEX. 



761 



Iodoi, 25S 
Iodoform, 258 
Iodum, 257 
Ipecacuanha, 261 
Iridin, 263 
Iris, 263 
Irish Moss, 178 
Irisin, 263 
Iritis, 611 
Iron, 220 

Dialysed, 223, 425 

Pills, 476 

and Tannic Acid, 461 
Irritability, 611 
Irritants, Cutaneous, 49 
Ischuria. — See Urinary Disorders. 
Isinglass, 255. 
Isonandra Gutta, 240 
Iso-naphthol, 293 
Itch. — See Scabies, 671 
Itching. — See Lichen, Prurigo, Pruritus, 

Pediculi, Scabies, Urticaria, etc. 
Ivy, Poison, 346 



Jaborandi, 318 

Jaborine, 318 

Jalap, 264 

Jalapin, 264, 366 

James' Powder, 103 

Jamestown Weed, 382 

Japaconitine, 77 

Jasmine, Yellow, 229 

Jateorrhiza Calumba, I49 

Jaundice, 612 

Jequirity, 55 

Jervine, 404 

Joint Affections, 613 

Juglans, 265 

Juniperin, 265 

Juniper, 265 

Juniperus communis, 265 
Sabina, 353 
Virginiana, 353 



Kairine, 184 

Kairoline, 184 

Kalium, 329 

Kalmia latifolia, 285 

Kama! a, 266 

Kavahin, 267 

Kava-kava, 267 

Kawin, 267 

Keeley's Gold Cure, 717 

Kefir, 268 

Keratitis, 613 

Kidneys, Diseases of. — See Albuminuria, 
Bright's Disease, Calculi, Diabetes, 
Dropsy, Hematuria, Lithaemia, Ne- 
phritis. 



Kino, 64, 267 

Kinoin, 267 

Kino-red, 267 

Kinovate of Calcium, 181 

Kinovin, 181 

Kombe arrow-poison, 383 

Koussin, 135 

Kousso, 135 

Krameria, 64, 268 

Kumyss, 87, 268 

Kurung Oil, 329 



Labarraque's Solution, 51, 177 
Labor, 614, 732 

Positions in, 732 

Signs of, 732 
Lac Sulphuris, 386 
Lactate of Iron, 221 
Lactation, 614 
Lactopeptine, 309 
Lactophosphate of Calcium, 312 
Lactose, 356 
Lactuca virosa, 269 
Lactucerin, 269 
Lactucin, 269 
Lactucarium, 269 
Ladies' Slipper, 202 
La Fayette's Mixture, 194 
Lallemand's Specific, 582 
Lanolin, 270 
Lanthopine, 298 
Lapathin, 352 
Lappa, 270 
Larch, 84 

European, 84, 393 
Lard, 79 

Benzoinated, 79, 132 

Oil, 79 
Larix Europaea, 393 
Laryngismus Stridulus, 615 
Laryngitis, 615 
Laryngotomy, 617 
Latin Phrases and Terms, 703 
Laudanine, 298 
Laudanosine, 298 
Laudanum, 299 
Laurel, Mountain, 285 
Laurocerasus, 67 
Lavandula, 271 
Lavender, 271 

Water, 271 
Laville's Anti-gout Remedy, 190, 667, 717 
Laxatives, 38 

Powder, 480 
Lead, 325 

Colic, 528 

Plaster, 326 

Sugar of, 325 

Water, 325 

and Laudanum, 468 

White, 325 



7 6: 



INDEX. 



Leek, 90 

Legal 's Disease, 635 

Lemon, 272 

Juice, 272 

Peel, 272 
Lentigo. — See Freckles, 573 
Leopard's Bane, 117 
Leprosy, 617 
Leptandra, 271 
Leptandrin, 271 
Lettuce, 269 
Leucocythaemia, 617 
Leucoline, 167 

Leucoma. — See Corneal Opacities, 534 
Leucorrhoea, 470, 617 
Levigation, 421 
Levulose, 355 
Lice. — See Pediculi, 646 
Lichen, 618 
Lichenin, 165 
Licoperdon giganteum, 272 
Lignum Vitse, 238 
Lily of-the-Valley, 192 
Lily, Water, 296 
Lime, 146, 147, 272 

Chlorinated, 177 

Sulphurated, 386 

Water, 147 
Limon, 272 
Limonis Cortex, 272 

Succus, 272 
Linimenta, 435, !|.68 
Liniment, Aconite, 76 

Ammonia, 94 

Anodyne, 469 

Army, 469 

Belladonna, 129 

Camphor, 150 

Cantharides, 155 

Chloroform, 173 

Compound, 173, 469 

Croton, 399 

Lead Subacetate, 325 

Lime, 147 

Mustard, Compound, 375 

Soap, 364 

Stokes', 469 
' Turpentine, 392 
Liniments, Formulae for, 469 
'Linseed, 274 
Lint, Boracic, 60 
Linum, 274 

Lips. — See Chapped Lips, 522 
Lip-salve, Red, 396 
Liquid ambar orientalis, 384 
Liquids, Normal, 432 
Liquores (See Solution of), 428 
Liquorice Root, 233 

Wild, 55 
Lithaemia, 618 
Litharge, 325 
Lithium, 274 
Lithontriptics, 45 



Liver. — See Hepatalgia, etc., 597 

Liver of Sulphur, 386 

Lixiviation, 425 

Lobelacrin, 276 

Lobelia, 275 

Lobelin, 276 

Lobeline, 276 

Lochia. — See Labor and Puerperal Disor 

ders, 614, 662 
Lock-jaw. — See Tetanus, 682 
Locomotor Ataxia, 619 
Log- wood, 64, 240 
Lotion, 468 

Black, of Mercury, 246 

Boracic, 60 

Yellow, of Mercury, 246 
Loxopterygium Lorentzii, 339 
Lozenges, 439, 477 
Lugol's Solution, 257 
Lumbago, 620 

Lumbrici. — See Worms, 700 
Lungs, Diseases of, 620 

Gangrene of, 621 
Lupulin, 244 
Lupuline, 244 
Lupus, 621 
Lycopodium, 277 
Lyctonine, 76 
Lymph angeitis, 622 



Mace, 291 

Oil of, 291 
Maceration, 425 
Macis, 291 
Macrotin, 179 
Magendie's Solution, 300 
Magenta, 227 
Magma, 423 
Magnesia, 277 

Ponderosa, 278 
Magnesium, 277 
Magnolia, 279 
Magnolin, 279 
Maize, 355, 409 
Malaria, 622 
Male Fern, 123 
Mallotus phillipinensis, 266 
Malt, 279 

Extract, Hoff's, 280 
Maltum, 279 
Mammary Abscess, 489 
Manaca, 280 
Mandrake, 328 
Manganese, 280 

Oxide, 280 
Manganum, 280 
Mangifera indica, 282 
Mango, 282 
Mango-fruit, 282 
J Mangosteen, 282 
i Mania, 623 



INDEX. 



763 



Mania, Puerperal, 663 

Manna, 282 

Mannit, 282 

Mannite, 236 

Manzanita, 40I 

Marasmus. — See Atrophy, Emaciation, 

Tabes Mesenterica. 
Marc, 431 
Margarin, 288 
Marginal Shield Fern, 123 
Marigold, 148 
Marjoram, Wild, 306 
Marrubiin, 283 
Marrubium, 283 
Marsh-mallow, 92 
Mass of Copaiba, 194 

of Ferrum Carbonate, 221 

of Mercury, 245 
Massae, 438 
Mastic, 283 
Mastiche, 283 
Mastichin, 283 
Mastitis, 623 * 
Mastodynia, 624 

Masturbation. — See Emissions, Spermator- 
rhoea, 558, 675 
Mate, 143 

Materia Medica, 17, 55 
Matico, 284 
Matricaria, 284 

Chamomilla, 284 
May Apple, 328 

McMunn's Elixir of Opium, 299 
Meadow Anemone, 336 

Saffron, 188 
Measles, 624 

Diagnosis of, 728 

False. — See Roseola, 670 
Measures, Approximate, 446 

Domestic, 446 

and Weights, 443, 739 
Meconidine, 298 
Meconoiosin, 298 
Meconin, 298 
Medicines, Administration of, 20 

Classification of, 23 
Meerschaum, 374 
Mel, 284 

Despumatum, 285 

Rosae, 285 
Melaleuca Cajuputi, 146 
Melancholia, 625 

Puerperal, 663 
Melia Azedarach, 126 
Melissa, 285 
Mellin's Food, 280 
Mellita, 429 
Meningitis, Cerebral, 625 

Cerebro-spinal, 626 

Spinal, 626 

Tubercular. — See Hydrocephalus, 602 
Menispermin, 317 
Menispermum, 285 



Menispermum, Cocculus, 317 
Menopause. — See Climacteric, 526 
Menorrhagia, 627 
Menstrual Disorders, 627 
Menstruum, 425 
Mentagra, 628 
Mentha Piperita, 286 

Viridis, 287 
Menthol, 286 
Mercurial Ointment, 245 

Plaster, 245 
Mercuric Chloride, 245 

Iodide, 246 
Mercurio-vegetal, 280 
Mercurous Chloride, 245 

Iodide, 246 
Mercury, 245 

Ammoniated, 245 

with Chalk, 245 

Vegetable, 280 
Mesenteric Diseased — See Tabes Mesen- 
terica, 682 
Metabolism, Agents affecting, 41 
Meta-dihydroxy-benzene, 183, 342 
Methane, 82 
Methene Chloride, 82 
Methyl-acetanilide, 57 
Methyl Alcohol, 82, 88 

Bromide, 82 

Chloride, 174 

Bichlorinated, 172 

Coniine, 190 

Creasol, 196 

Ether of Protocatechuic Aldehyde, 403 

Hydrate, 88 

Phenacetine, 31 1 

Salicylate, 229 

Terchloride, 172 
Methylal, 82, 170 
Methylene Bichloride, 174 
Methylene-di methyl Ether, 170 
Methylic Alcohol, 88 

Ether, 82 
Methysticin, 267 
Metric Prescriptions, 445 

System of Weights, etc., 444, 739 

Table for Converting, 740 
Metritis, Acute, 628 
Metrorrhagia, 628 
Mezereon, 287 
Mezereum, 287 
Microbe- killer, 718 
Migraine, 592 
Miliary Fever, 629 
Milk. — See Agalactia, Lactation. 
Milk Fever. — See Lactation, 614 
Mindererus, Spirit of, 95 
Mineral Waters, III 
Mint, 287 

Miscarriage. — See Abortion, 488 
Mistletoe, 408 
Misturse, 429, 461 
Mixture, Almond, 98 



764 



INDEX. 



Mixture, Ammoniac, 94 

Asafetida, 122 

Bismuth, 465 

Chalk, 147 

Chloroform, 173 

Copaiba, Compound, 194 

Coxe's Hive, 103, 367 

Ferro-saline, 223 

Gentian, Alkaline, 231 
and Senna, 231 

Glycyrrhiza Comp., 234 

Iron, Aromatic, 223 

and Ammon. Acetate, 223 

Iron, Compound, 221 

Iron, Laxative, 223 

Lafayette's, 194 

Laville's, 190, 667, 717 

Liquorice, Compound, 234 

Magnesia and Asafetida, 122, 278 

Neutral, 330 

Quinine, 463, 465 

Potassium Citrate, 330 

Rhubarb and Soda, 344 

Squibb's, 299, 524 
Mixtures, 429, 461 

Compounding of, 464 

Substances suitable to, 462 
Moccasin-plant, 202 
Molasses, 355 
Mole. — See Nsevus, 630 
Mollities Ossium. — See Bone Diseases, 505 

Rachitis, 665 
Monkshood, 76 
Monoxide of Carbon, 82 
Monsel's Solution, 222 
Moonseed, Canadian, 285 
Morbilli. — See Measles, 624 
Morphine, 298, 300 

and Atropine, 306, 714 

Habit, 639 
Morrhuse Oleum, 288 
Morrison's Pills, 150, 718 
Moschus, 290 
Mosquitoes, 678 
Motor Depressants, 24 

Excitants, 24 
Mouth Diseases. — See Aphthae, Cancrum 

Oris, Gums, Parotitis, Ptyalism, Stom- 
atitis, Toothache, Tongue. 
Mouth "Washes, Formulae, 583 
Mucilage of Acacia, 56 

of Cydonium, 201 

of Elm, 400 

of Sassafras-pith, 366 

of Tragacanth, 399 
Mucilagines, 429 
Mullein, 406 
Mumps, 645 
Muriate. — See Hydrochlorate. 

of Berberiiae, 133 

of Cocaine, 214 
Musc?e Volitantes, 629 
Muscarine, 85 



Muscular Disorders. — See Atrophy, Cho- 
rea, Hydrophobia, Laryngismus, Lum- 
bago, Myalgia, Pleurodynia, Rheum- 
atism, Tetanus, Torticollis. 

Musk, 290 

Mustard, 374 
Black, 375 
Flour of, 375 
Oil of, 375 
White, 375 

Myalgia, 629 

Mydriasis, 129 

Mydriatics, 28 

Myelitis, 629 

Mykose, 210 

Myopia, 630 

Myotics, 29 

Myrcia, 290 

Myrica, 64 

cerifera, 164 

Myricin, 164 

Myristica, 291 

Myristicol, 291 

Myronate of Potassium, 375 

Myrosin, 375 

Myroxylon toluifera, 127 
Pereirse, 127 

Myrrh, 292 

Myrrhin, 292 

Myrrhol, 292 

Myrtle, 64 

Myrtol, 511 



Nsevus, 630 
Nails, Ingrowing, 630 
Napelline, 76 
Naphthaline, 183, 292 
Naphthol, 293 
Narceine, 298 
Narcotics, 26 
Narcotine, 298 
Nasal Affections, 630 

Injections, Formulas, 548 
Natrium, 376 
Nausea, 631 
Necrosis, 631 
Nectandra, 308 
Nervous Affections, 631 

Exhaustion, 632 
Nervousness, 632 

Nervous System, Agents affecting, 24 
Neuralgia, 633 

Ovarian, 642 
Neutral Mixture, 330 
Nicotiana Tabacum, 389 
Nicotianin, 389 
Nicotine, 389 
Niemeyer's Pill, 652 
Nightshade, Black, 208 

Deadly, 128 

Woody, 208 



INDEX. 



765 



Night-mare, 636 

Night Sweats. — See Hectic Fever, Perspi- 
ration, Phthisis. 
Nipples, Sore, 636 

Fissured, 636 
Nitrate of Ammonium, 95 

of Iron, 222 

of Lead, 325 

of Mercury, 246 

of Muscarine, 85 

of Potassium, 330 

of Silver, 115 
Fused, 115 

of Sodium, 377 
Nitre, 330, 377 

Chili, 377 

Sweet Spirit of, 80 
Nitrite of Amyl, 99 

of Ethyl, 80, 100 

of Potassium, 99 

of Sodium, 99 
Nitro-benzene, 183 
Nitro-benzol, 98 
Nitro-glycerin, 99 
Nitrous Ether, 80, 8^ 

Oxide, 82 
Nodes, 636 
Normal Liquids, 432 
Norwood's Tincture, 404 
Norway Spruce, 323 
Nucin, 265 
Nutgall, 64, 223 
Nutmeg, 291 
Nux Vomica, 294 
Nyctalopia, 591 
Nymphaea, 64 

Odorata, 296 
Nymphomania, 636 



Oak-bark, 64, 340 

Black, 340 
Oak, Dyer's, 229 

Poison, 346 

White, 340 
Oat, 126 
Obesity, 6^7 

Obstetrical Memoranda, 732 
Odontalgia, 637 
GEsophagus, Affections of, 638 
Official Operations, 418 

Preparations, 427 
Officinal. — See Preface. 
Oil of Allspice, 320 

of Almond, Bitter, 98 
Expressed, 98 

of Amber, 385, 393 

of Anise, 102, 256 

of Anthemis, 102 

of Aurantium Cortex, 124 
Flores, 124 

of Bay, 290 



of Bergamot, 134 
of Cade, 266 
of Cadinum, 266 
of Cajuput, 146 
of Caraway, 160 
of Carum, 160 
Carron, 147, 274 
Castor, 348 
of Caryophyllus, 160 
of Cedar, 362 
Chamomile, 102 
Chaulmoogra, 165 
of Chenopodium, 166 
of Cinnamon, 187 
of Cloves, 160 
Cod-liver, 288 
of Copaiba, 194 
of Coriander, 195 
of Cotton-seed, 235, 297 
Croton, 398 
of Cubeb, 198 
of Erigeron, 213 
Ethereal, 80 
of Eucalyptus, 218 
of Fennel, 227 
of Gaultheria, 229 
of Gossypium-seed, 235, 297 
of Hedeoma, 242 
of Hemlock, 324 
of Juniper, 266 
Kurung, 329 
Lard, 79 

of Lavender, 271 
Flowers, 271 
of Lemon, 273 
of Linseed, 274 
of Linum, 274 
of Mace, 291 
of Mentha Piperita, 286 
of Mentha Viride, 287 
of Mirbane, 98 
of Morrhua, 288 
of Mustard, Volatile, 375 
of Myrcia, 290 
of Myristica, 291 
of Neroli, 124 
of Nutmeg, 291 
Olive, 296 

of Orange flowers, 124 
of Orange-peel, 124 
of Origanum, 306 
of Pennyroyal, 242 
of Pepper-mint, 286 
Phosphorated, 31 1 
of Pimenta, 320 
of Pinus Silvestris, 323 
of Pix Liquida, 323 
of Pongamia, 329 
of Ricinus, 348 
of Rose, 349, 350 
of Rosemary, 351 
of Rue, 353 



766 



INDEX. 



Oil of Ruta, 353 

of Sabina, 354 

Salad, 296 

of Sandalwood, 362 

of Santal, 362 

of Sassafras, 366 

of Scotch Fir, 323 

of Sesamum, 373 

of Sinapis, Volatile, 375 

of Spearmint, 287 

of Spruce, 324 

Sweet, 296 

of Succinum, 385, 393 

of Tabacum, 389 

of Tanacetum, 391 

of Tansy, 391 

of Tar, 323 

of Terebinthina, 392 

of Theobroma, 395 

of Thuja, 393, 396 

of Ihyme, 397 

of Tiglium, 398 

of Turpentine, 392 

of Valerian, 402 

of Wintergreen, 229 

Wood, 239 
Oils, Expressed, 425 

Fixed, 425 
Ointment, 164 

Basilicon, 342 

Belladonna, 129 

Boracic, 60 

Calamine, 413 

Carbolic Acid, 61 

Chrysarobin, 179 

Citrine, 246 

Diachylon, 326 

Gallic Acid, 64 

Gall, 229 

Hamamelis, 241 

Iodme, 257 

Iodoform, 258, 484 

Lead Carbonate, 326 
Iodide, 326 

Mercurial, 245 

of Mercury, Ammoniated, 245 
Nitrate, 246 

Red, 246 
Oxide, Red, 245 
Yellow, 245 

Mezereum, 287 

Nutgall, 229 

Petroleum, 310 

of Pix Liquida, 323 

of Potassium Iodide, 257 

of Rose-water, 350 

of Staphisagria, 380 

Stramonium, 382 

Sulphur, 386 

Alkaline, 386 

of Tannic Acid, 75 

Tar, 323 

Thymol, 397 



Ointment, Veratrine, 404 

White Precipitate, 245 

Witch hazel, 241 

of Zinc Oxide, 411 
Ointments, 440, 483 

Compounding, 483 

Formulae for, 484 
Olea Europsea, 296 
Oleaginous Preparations, 435 
Oleata, 71, 436 
Oleate of Aconitine, 72, 77 

of Aluminium, 72 

of Arsenic, 72 

of Atropine, 72 

of Bismuth, 72 

of Cocaine, 214 

of Copper, 72 

of Iron, 72 

of Lead, 72, 326 

of Mercury, 71, 245 

of Morphine, 72, 300 

and Mercury, 72 

of Quinine, 72 

of Silver, 72 

of Strychnine, 72 

of Veratrine, 71, 404 

of Zinc, 72 
Oleates, 71, 436 
01ein,288, 296, 374 
Oleoresina, 435 
Oleoresin of Aspidium, 123 

of Capsicum, 157 

of Cubeb, 198 

of Lupulin, 244 

of Pepper, 321 

of Zingiber, 413 
Oleoresins, 435 
Olive, 296 
Onion, 90 
Onychia, 638 
Operations, Official, 418 
Ophelia Chirata, 168 
Ophthalmia, 638 
Opisthotonos. — See Tetanus, 682 
Opium, 298 

Denarcotized, 299 

Habit, 639 
Opodeldoc, 364 
Orange, 124, 272 

Blossom, 718 
Orchitis, 641 
Ordeal Bark, 161 
Origanum, 306 
Otalgia, 641 
Otitis, 641 
Otorrhcea, 642 
Ovarian Neuralgia, 642 

Tumors. — See Cysts, 539 
Ovaritis, 642 
Ovis Aries, 374 
Oxalate of Cerium, 164 

of Iron, 222 
Oxaluria, 643 



INDEX. 



767 



Ox-gall, 220 

Oxide of Antimony, 103 

of Arsenic, 119 

of Calcium, 146 

of Ethyl, 79 

of Iron, Hydrated, 222 

with Magnesia, 222 

of Lead, 325 

of Magnebium, 277 

of Manganese, Black, 280 

of Mercury, Red, 245 

of Mercury, Yellow, 245 

of Propyl, 288 

of Silver, 115 

of Zinc, 411 
Oxidizers, 458 
Oxy-benzene, 61 
Oxymel, 285, 429 
Oxytocics, 48 
Oyster shell, 147 
Ozcena, 643 



Pagliari's Styptic, 595 
Pain, 643 

Chest, 522 

Gastric, 37 
Pains, False, 569 
Paints, 485 

Palmitate of Cetyl, 165 
Palmitin, 297 
Pancoast's Styptic, 595 
Pancreas, Agents affecting, 40 
Pancreatin, 306 
Pancreopepsin, 309 
Pannus. — See Corneal Opacities, 534 
Pansy, 407 
Papain, 307 
Papaiva, 307 

Papaver Somniferum, 298 
Papaverine, 298 
Papaw Milk, 307 
Paper of Cantharides, 155 

of Mustard, 375 

of Potassium Nitrate, 330 
Papers (Chartae), 442, 479 
Papine, 299 
Parachinamsols, 184 
Paraconiine, 191 
Paracoto Bark, 195 
Paracotoin, 195 
Paraldehyde, 170, 307 
Paralysis, 645, 677 
Paramenispermin, 317 
Paramorphine, 298 
Paraphimoses. — See Phimosis, 650 
Paraplegia. — See Paralysis, 645 
Parasiticides, 52 
Paregoric, 299 



Parigenin, 365 
Parillin, 365 



Paris Green, 1 19, 729 

Paronychia, 638 

Parotitis, 645 

Parsley, 108 

Parrish's Chemical Food, 312 

Participles, 712 

Parvule, 471 

Paste, Black, 581 

Vienna, 330 
Pastilles, 439, 477 
Pasque-flower, 336 
Patent Medicines, 716 
Paullinia curare, 200 

sorbilis, 143, 239 
Pavy's Solution, 736 
Pearson's Solution, 119 
Pectin, 340 
Pediculi, 646 
Pelletierine, 236 
Pellitory, 337 

Persian, 338 
Pelosine, 308 
Pelvic Diameters, 733' 
Pemphigus, 646 
Pencils, 482 
Penis. — See Chancre, Chancroid, Chord ee, 

Gleet, Gonorrhoea, Phimosis, Urethra. 
Pennyroyal, 241 
Pennywort, 253 
Pepo, 308 
Pepper, Black, 320 

Cayenne, 156 

Water, 329 
Peppermint, 286 
Pepsin, 309 

Liquid, 309 

Saccharated, 309 
Pepsinum, 309 

Peptogenic Milk Powder, 309 
Perchloride of Iron, 221 
Percolation, 425 
Pericarditis, 646 

Diagnosis of, 726 
Periostitis, 647 
Peritonitis, 647 

Puerperal, 663 
Permanganate of Potassium, 281 
Pernicious Fever. — See Intermittent Fever, 

Remittent Fever. 
Peroxide of Hydrogen, 393 
Perry Davis's Pain- Killer, 718 
Persimmon, 64 
Perspiration, 647 
Pertussis, 648 
Peruvian Bark, 180 
Petrolatum, 310 
Petroleum Ether, 131 

Ointment, 310 
Petroselinum sativum, 108 
Peumus Boldo, 135 
Phaeoretin, 344 
Phagedena. — See Chancre, Chancroid, 

Gangrene, Ulcers. 



;68 



INDEX. 



Pharmaceutical Incompatibility, 458 

Rules, 455 
Pharmaceutists. — Their objectionable prac- 
tices, 452 
Pharmacojogy, 17 
Pharmacopoeias, List of, 415 
Pharmacy, 17, 415 

Extemporaneous, 442 

Official, 418 

Rules for neophytes, 455, 460 
Pharyngitis, 649 
Phaseo mannit, 355 
Phenacetine, 184, 310 
Phenazone, 105 
Phenedine, 310 
Phenol, 61, 183 

Iodized, 257 

Salicyl, 357 

Sodique, 61 
Phenolid. 57 
Pheno-resorcin, 184 
Phenyl, 1 83 
Phenyl-acetamide, 57 
Phenyl-methyl acetone, 169 
Phenylic Alcohol, 61, 88 
Phimosis, 650 
Phlebitis, 650 

Phlegmasia Alba Dolens, 650 
Phlegmon, 651 
Phlorol, 196 
Phosphate of Ammonium, 95 

of Calcium, Precipitated, 312 

of Codeine, 300 

of Iron, 222 

of Iron and Manganese, 223 

of Sodium, 312 
Phosphates, 311 

Syrup of the, 312 
Phosphide of Zinc, 312 
Phosphites, 311 
Phosphorus, 311 
Photophobia, 651 
Phthisis, 651 

Diagnosis of, 728 
Physeter macrocephalus, 165 
Physiological Antagonists, 459 
Physostigma, 314 
Physostigmine, 314 
Phytolacca, 316 
Pichi, 317 

Picrsena excelsa, 338 
Picrates, 73 
Picroglycion, 208 
Picropodophyllin, 328 
Picrotoxin, 317 
Pierce's Favorite Prescription, 718 

Golden Discovery, 718 
Pigmenta, 485 
Piles, 478 
Pill of Aloes, 91 

of Aloes and Asafetida, 91, 122 

of Aloes and Iron, 91 

of Aloes and Mastic, 91 



Pill of Aloes and Myrrh, 91 

of Antimony, Compound, 103 

of Asafetida, 122 

Blue, 245 

Compound Cathartic, 190 

of Galbanum Comp., 122, 228 

of Iodide of Iron, 221 

of Iron, Compound, 221 

Lady Webster's, 91 

of Mercury, 245 

of Opium, 299 

of Phosphorus, 311 

of Rhubarb, 344 

of Rhubarb, Compound, 344 

Tanjore, 678 
Pill-masses, 438, 471 
Pills, 438, 470 

Coated, 474 

Compressed, 475 

Excipients for, 471 

Formulas for, 476 

Process of making, 471 

Official, 438 

Substances suitable for, 473 
Pilocarpine, 318 
Pilocarpus, 318 
Pilulae, 438, 470 
Pimenta, 320 
Pimpinella Anisum, 102 
Pimples. — See Acne, 490 
Pine, Prince's, 166 

Yellow, 392 
Pines, 323 
Pinipicrin, 396 
Pinites Succinifer, 385, 392 
Pink, Carolina, 380 
Pink-root, 380 
Pinus, 323 

Australis, 392 

Palustris, 323 

Sylvestris, 323 

Tseda, 393 
Piper, 320 

angustifolium, 284 

methysticum, 267 
Piperazidine, 321 
Piperazine, 321 
Piperine, 321 
Pipsissewa, 166 
Piscidia, 322 
Piscidin, 322 
Pissenlit, 391 

Pistacese Terebinthus, 392 
Pistacia Lentiscus, 283 
Pitch, 323 

Burgundy, 323 

Canada, 323 

Hemlock, 323 
Pityriasis, 654 
Pix, 323 

Pix Liquida, 323 
Planat's Tincture, 317 
Plantago, 324 



INDEX. 



769 



Plantain, 324 
Plaster, Adhesive, 342 

Ammoniac, 94 

with Mercury, 94 

Arnica, 117 

Asafetida, 122 

Belladonna, 129 

Capsicum, 157 

Carbolic Acid, 61 

Court, 255 

Diachylon, 326 

Galbanum, 228 

Ichthyocolla, 255 

Iron, 222 

Lead, 326 

Mercurial, 245 

Opium, 299 

Pitch, Burgundy, 323 

Pitch with Cantharides, 155, t,!^ 

Pitch, Canada, 323 

Resin, 342 

Soap, 364 

Strengthening, 222 

Vesicating, 484 

Warming, 323 
Plasters, 441, 484 

Formulae for, 484 

Preparation of, 441 
Plethora, 654 

Abdominal, 488 
Pleurisy, 654 

Diagnosis of, 728 
Pleurisy-root, 123 
Pleuritis, 654 
Pleurodynia, 655 
Pleuro-pneumonia, 655 
Plum, 335 
Piumbum, 325 
Plummer's Pills, 103 
Pneumonia, 655 

Diagnosis of, 728 
Podophyllin, 328 
Podophyllitoxin, 328 
Podophyllum, 328 
Poison Ivy, 346 

Oak, 346 

Sumach, 346 
Poisoning by Acids, 67 

Acid, Acetic, 720 

Arsenious, 121, 726 
Carbolic, 61, 720 
Chromic, 63 
Gallic, 65 

Hydrocyanic, 69, 720 
Mineral, 67, 720 
Oxalic, 720 
Sulphuric, 720 
Sulphurous, 74 
Tannic, 75 

Aconite, 78, 721 

Agaricus, 85 

Alcohol, 89, 721 

Alkalies, 332, 378, 721 

49 



Poisoning by Alum, 721 
Ammonia, 95, 721 
Antimony, 104, 721 
Arsenic, 121, 721 
Atropine, 130, 721 
Barium, 721 
Bees, 721 

Belladonna, 130, 721 
Bromides, 137 
Camphor, 151, 721 
Cannabis Indica, 154, 721 
Cantharis, 156, 721 
Chloral, 171, 721 
Chlorine, 177, 721 
Chloroform, 82, 175, 721 
Cinchona, 185 
Cocaine, 215 

Cocculus Indicus, 318, 723 
Colchicum, 188, 722 
Conium, 192, 722 
Copper, 199, 722 
Creasote, 722 
Curare, 201 

Cyanide of Potassium, 69 
Digitalis, 205, 722 
Duboisine, 207 
Ergot, 212 
Ether, 82, 721 
Fish, 722 
Gamboge, 722- 
Gas, Carbonic Acid, 722 

Sulphuretted Hydrogen, 7 2-2 
Gelsemium, 230, 722 
Glass, 722 
Gold Salts, 125, 722 
Hyoscyamus, 254, 722 
Insects, 721 
Iodine, 259, 722 
Ipecacuanha, 263 
Iron, 722 
Lead, 327, 722 
Lime, 148, 722 
Lobelia, 276 
Mercury, 249, 722 
Mezereum, 722 
Muscarine, 85 
Morphine, 303. 723 
Mushrooms, 723 
Nitrites, 100 
Nux Vomica, 295, 724 
Oak or Ivy, 347, 723 
Opium, 303, 723 
Phosphorus, 313, 723 
Physostigma, 314, 725 
Phytolacca, 316 
Picrotoxin, 318, 723 
Pilocarpine, 319 
Potassa, 332 

Potassium Salts, 332, 723 
Pulsatilla, 337 
Quinine, 185, 723 
Reptiles, 408, 723 
Resorcin, 343 



770 



INDEX. 



Poisoning by Rhus, 347, 723 

Sanguinaria, 361 

Silver Salts, 1 16, 723 

Snakes, 408 

Sodium, 378 

Stramonium, 382, 724 

Strychnine, 295, 724 

Sulphites, 74 

Sulphur, 388 

Sulphuretted Hydrogen, 388 

Sumach, 347 

Tin, 724 

Tobacco, 390, 724 

Turpentine, 394 

Vegetable Poisons, 724 

Veratrum Viride, 405, 724 

Wounds, 724 

Zinc Salts, 412, 724 
Poisoning, 52, 720 

Antidotes and Antagonists, 53 

Indications for Treatment, 53 

General Principles, 720 
Poisonous Compounds, 458 
Poisons, Energetic, 720 
Poke-berry, 316 
Poke, Indian, 403 
Poke-root, 316, 403 
Polygala Senega, 370 
Polygonum Hydropiperoides, 329 
Polyporus fomentarius, 84 
Polypus, 657 

Polyuria. — See Diabetes Insipidus, 543 
Pomade de Bareges, 654 
Pomegranate, 64, 236 
Pond's Extract, 241 
Pond Lily, 64 
Pongamia, 329 
Poppy, White, 298 
Porphyrization, 421 
Porphyroxine, 298, 360 
Porrigo Capitis. — Tinea Tonsurans, 685 
Porter, 87 
Port Wine, 87 
Potassa, 330 

Alum, 92 

cum Cake, 330 

Sulphurata, 386 
Potassio Cupric Tartrate, 199, 736 
Potassium, 329 
Potato, 208 

Potentilla Sarmentosa, 647 
Potus, 467 
Poultices, 485, 657 

List of Br. official, 485 
Powder of Aloes and Canella, 91 

Antimonial, 103 

Aromatic, 187 

Chalk, Compound, 147 

Dover's, 261, 299 

Effervescing. Comp., 331 

Glycyrrhiza Comp., 234 

Gray, 245 

Ipecac and Opium, 261, 299 



Powder of Jalap, Compound, 264 

James', 103 

Kino, Compound, 267 

Liquorice, Compound, 234, 372 

Morphine, Compound, 300 

Opium, 299 

Rhubarb, Compound, 344 

Seidlitz, 331 

Tully's, 300 
Powders, 439, 478 

Formulae for, 480 

Substances suitable to, 479 
Prairie Flower, 706 
Precipitant Solutions, Table of, 457 
Precipitate, White, 245 
Precipitation, 423 
Pregnancy, Disorders of, 657 

Signs of, 732 

Vomiting of, 698 
Premna tatiensis, 399 
Preparations, Acetous, 436 

Alcoholic, 431 

Aqueous, 427 

Ethereal, 435 

Extemporaneous, 461, 470 

Gaseous, 485 

Glycerin, 436 

Liquid, 427, 461 

Official, 427 

Oleaginous, 435 

Solid, 427, 436, 470 
Prepositions, 712 
Prescriptions, 447 

Analysis of, 447 

Blanks for, 451 

Filling of, 453 

Metric, 445 

Renewals, 452 

Table of Doses, 741 , 

Tonic, 492, 496 
Prescription Writing, 450 

Latin Words used in, 703 
Prickly Heat. — See Lichen, 618 
Prince's Pine, 166 
Prinos, 334 

Proctitis. — See Rectum, 665 
Prolapsus Ani, 658 

Uteri, 658 
Pronunciation, 711 
Propyl Oxide, 288 
Propylamine, 117 
Prosopalgia. — See Neuralgia, Odontalgia, 

Tic Douloureux. 
Prostate, Hypertrophied, 658 
Prostatitis, 658 
Prostatorrhcea, 659 
Protectives, 51 
Protiodide of Mercury, 246 
Protopine, 298 
Prune, 335 
Prunum, 335 
Prunus domestica, 335 

Lauroceras-us, 68 



INDEX. 



771 



Prunus serotina, 335 

Virginiana, 335 
Prurigo, 659 
Pruritus, 480, 484. 659 
Pseudaconitine, 76 
Pseudo-jervine, 404 
Pseudo-morphine, 298 
Pseudotropine, 253 
Psoriasis, 660 
Ptelea trifoliata, 346 
Pterocarpus marsupium, 267 

santalinus, 362 
Pterygium, 661 
Ptosis, 661 

Ptyalism, 35, 248, 661, 722 
Paccine, 360 
Puerperal Convulsions, 662 

Disorders, 662 

Fever, 662 

Mania, 663 

Melancholia, 663 

Peritonitis, 663 
Puff-ball, 272 
Pulmonary Sedatives, 31 
Pulsatilla, 336 
Pulse, 663 
Pulveres, 439, 478 
Pulverization, 421 
Pumpkin-seed, 308 
Punica Granatum, 236 
Purgatives, 38 
Purging Agaric, 84 

Cassia, 162 
Purpura, 664 
Pustule, Malignant, 664 
Pustules. — See Echthyma, Eruptions, Im- 
petigo, Pustule Malignant. 
Pustulants, 49 
Pyaemia, 664 
Pyreihrine, t>ZT 
Pyrethrum, 337 

Roseum, 338 
Pyridine, 183, 389 
Pyrocatechin, 183, 184, 323 
Pyrogallol, 64, 183 
Pyrol, 258 
Pyrophosphate of Iron, 222 

of Sodium, 312 
Pyrosis, 664 
Pyroxylin, 235 



Quantities, Table of, 741 
Quassia, 338 

Surinam, 338 
Quassin, 338 
Quebrachine, 339 
Quebracho, 339 
Queen's Delight, 381 

Root, 381 
Quercin, 340 
Quercitrin, 340 



Quercus Alba, 64, 340 
Lusitanica, 229, 310 
Tinctoria, 340 

Quicksilver, 245 

Quillaia, 341 

Quince-seed, 201 

Quinetum, 183 

Quinicine, 183 

Quinidine, 181 

Quinine, 181 

Mixture. 463, 4C5 

Quinoidin, 183 

Quinquinine, 183 

Quinsy. — See Tonsillitis, 685 



Rabies. — See Hydrophobia, 6c 2 
Rachitis, 665 

Radam's Microbe-killer, 718 
Radway's Ready Relief, 718 

Resolvent, 718 
Raspail's Eau Sedative, 95, 150 
Raspberry. 352 
Recamier Balm, etc., 716 
Rectum, Absorption by, 20 

Diseases of, 665 

Prolapse of, 658 

Ulceration of, 665 
Red Gum. — See Strophulus, 679 
References and Bibliography, 487 
Refrigerants, 35 
Relapsing Fever, 665 
Remittent Fever, 66*6 

Diagnosis of, 730 
Renal Depressants, 44 
Renewals of Prescription":, 45 > 
Repercolation, 426 
Resin, 341,393 

Cerate, 342 

of Copaiba, 194 

of Guaiac, 238 

of Jalap, 264 

Plaster, 342 

of Podophyllum, 328 

of Scammony, 367 
Resina, 341, 393 
Resinae, 438 
Resolvents, 42 
Resorcin, 61, 183, 342 
Respiration. — See Bronchitis, Croup, Dysp 

ncea, Emphysema, Pneumonia, etc. 
Respiration, Agents affecting, 30 

Artificial, 734 
Respiratory Depressants, 30 

Stimulants, 30 
Restoratives, 41 
Retina, Affections of, 666 
Revalenta Arabica, 718 
Rhamnoxanthin, 227 
Rhamnus Frangula, 227 

Purshiana, 162 
Rhaphidophora vitiensis, 399 
Rhatanine, 268 



772 



INDEX. 



Rhatany, 64, 268 
Rheum, 343 

Rheumatic Arthritis, 666 
Rheumatism, Acute, 667 

Chronic, 669 

Diagnosis of, 727 

Gonorrhoeal, 670 

Muscular, 670 
Rhinacanthin, 345 
Rhinacanthus, 345 
Rhinitis. — See Catarrh, Acute Nasal, also 

Nasal Affections. 
Rhceadine, 298 
Rhubarb, 343 
Rhus Aromatica, 345 

diversiloba, 346 

glabra, 346 

pumila, 346 

radicans, 346 

Toxicodendron, 346 

venenata, 346 
Ricinus communis, 348 
Rickets. — See Rachitis, 665 
Rigors. — See under Fever, 569 
Ring-worm, 684 
Roasting, 420 
Rochelle Salt, 331 
Rosa centifolia, 349 

Damascera, 350 

Gallica, 64, 350 
Rosanilin, 227 
Rose, 64, 350 

Attar of, 350 

Cabbage, 349 

Pale, 349 

Red, 64, 350 
Roseine, 227 
Rosemary, 64, 351 
Roseola, 670 
Rosin, 341 
Rosmarinus, 351 
Rottlera, 266 

tinctoria, 266 
Rottlerin, 266 
Rubefacients, 49 
Rubeola. — See Measles, 624 
Rubijervine, 404 
Rubini's Tincture, 150 
Rubus, 64, 351 

Canadensis, 351 

Idaeus, 352 

occidentalis, 352 

trivialis, 351 

strigosus, 352 

villosus, 351 
Rue, 352 
Rules for Incompatibility, 460 

for Pharmaceutists, 455, 
Rum, 87 

Bay, 291 
Rumex, 352 
Rumicin, 352 
Rupia. — See Pemphigus, 646 



Ruta, 352 
Russian Spirit, 670 
Rye, 210 



Sahadilla, 404 
Sabina, 353 
Saccharine, 354 
Saccharum, 355 

Lactis, 356 
Sacred Bark, 162 
SafBower, 197 
Saffron, 197 

American, 197 

Meadow, 188 
Saffron- tea, 197 
Sage, 359 

Sage's Catarrh Remedy, 718 
Salbromalide, 57 
Salicin, 357 
Salicylate of Antipyrine, 104 

of Cinchonidine, 183 

of Cocaine, 214 

of Lithium, 357 

of Methyl, 229 

of Phenol, 357 

of Physostigmine, 315, 357 

of Sodium, 357 

of Theobromine, 144 
Salicyl-bromalide, 57 
Saligenin, 357 
Saline Mineral Waters, 1 1 1 

Purgatives, 38 
Salipyrin, 106, 357 
Saliva, Agents affecting, 35 
Salivation, 35, 248, 661, 722 
Salix, 356 
Salol, 357, 359 
Salt, common, 377 

Epsom, 278 

Glauber's, 377 

Rochelle, 331 
Salt petre, 330 

Chili, 377 
Salt-rheum. —See Eczema, 556 
Salts, Deliquescent, List of, 474 

Efflorescent, List of, 474 

Insoluble, 457 
Salve, Red Lip, 396 
Salvia, 359 
Salviol, 359 
Sambucus, 360 
Sandal- wood Oil, 362 
White, 362 
Yellow, 362 
Sanford's Catarrh Cure, 718 
Sanguinaria, 360 
Sanguinarine, 361 
Sanitas, 393 
Santalum Album, 362 

citrinum, 362 

Rubrum, 362 



INDEX. 



773 



Santonica, 362 
Santonin, 363 

Santoninate of Sodium, 363 
Sapo, 364 

Animalis, 364 

Medicatus, 364 

Mollis, 364 

Viridis, 364 
Sapogenin, 371 
Saponification, 364 
Saponin, 163, 341 
Sarcinae, 671 

Sarcocele. — See under Cancer, Testicles. 
Sarothamnus Scoparius, 368 
SarsaDarilla, 365 
Sassafras, 366 

Medulla, 366 

Swamp, 279 
Sassy Bark, 161 
Saunders, Red, 362 
Savine, 353 

Sayre's Method for Chloroform, 176 
Scabies, 671 

Scald-head. — See Eczema, Tinea. 
Scalds, 512 
Scammonium, 366 
Scammony, 366 
Scarlet Fever, 67 1 

Diagnosis of, 728 
Scheele's Acid, 67 

Green, 119 
Sciatica, 672 
Scilla, 367 
Scillin, 367 
Scillipicrin, 367 
Scillitin, 367 
Scillitoxin, 367 
Scirrhus. — See Cancer, 515 

1 Diagnosis of, 726 
Sclererythrin, 210 
Scleroderma, 673 
Scleromucin, 210 
Scleroxanthin, 210 
Scoparin, 368 
Scoparius, 368 
Scorbutus. — See Scurvy, 674 
Screaming. — See Nightmare, 636 
Scrofulosis, 673 
Scudamore's Mixture, 582 
Scurvy, 674 
Scutellaria, 370 
Scutellarin,.370 
Sea-sickness, 674 
Seborrhcea, 675 
Sea-wrack, 228 
Secale cereale, 210 
Secaline, 410 
Sedatives, 24, 37 

Cardiac, 33 

Gastric, 37 

Pulmonary, 31 

Urinary, 45 

Uterine, 476 



Sedatives, Vascular, 34 
Vesical, 45 

Seidlitz Powder, 331 

Seigel's Syrup, 718 

Senega, 370 

Senegin, 371 

Senna, 371 

Sennacrol, 372 

Sennapicrih, 372 

Separation, 423 

Septicaemia, 664 

Sequah's Oil, 718 

Prairie Flower, 719 

Serpentaria, 373 

Serpent-bites. — See Poisoning by Reptiles, 
also Stings. 

Sesamum, Oil of, 373 

Sevum, 374 

Shampoo Mixtures, 583 

Sheep, 374 

Sherry Wine, 87 

Shingles. — See Herpes Zoster, 601 

Sialogogues, 35 

Sickness at Stomach. — See Nausea, Sea- 
sickness, Vomiting. 

Siddhi, 153 

Silicate of Magnesium, 374 
Hydrated, 374 
of Potassium, 331 
of Sodium, 374 

Silicious Mineral Waters, 112 

Sdver, 115 

Sinalbin, 375 

Sinapine, 375 

Sinapis, 374 
Alba, 375 
Nigra, 375 

Singultus. — See Hiccough, 601 

Sinigrin, 375 

Sinistrin, 367 

Skin, Agents affecting, 49 
as an Absorbent, 21 

Skin Diseases. — See Acne, Boils, Burns, 
Carbuncles, Chapped Hands and Lips, 
Chilblains, Condylomata, Ecchymosis, 
Ecthyma, Eczema, Elephantiasis, 
Eruptions, Erysipelas, Erythema, 
Freckles, Herpes, Herpes Zoster, Ich- 
thyosis, Impetigo, Intertrigo, Lichen, 
Lupus, Mentagra, Naevus, Onychia, 
Pemphigus, Phlegmon, Pityriasis, 
Prurigo, Pruritus, Psoriasis, Roseola, 
Scabies, Scleroderma, Seborrhcea, 
Strophulus, Syphilis, Tinea, Ulcer, 
Urticaria, Wart, Wen. 

Skull cap, 370 

Sleep, A bnormal. — See Delirium, Insom- 
nia, Nightmare, Somnambulism. 

Slippery Elm Bark, 400 

Smallpox, 696 

Diagnosis of, 728 

Smart weed, 329 

Smell, Agents affecting, 30 



774 



INDEX. 



Smilacin, 365 
Smilax, 365 
Snake-root, Black, 179 

Virginia, 373 
Sneezing, 675 

Agents producing, 32 

See also Catarrh, Hay Fever, Influ- 
enza. 
Soaloin, 91 
Soap, 364 

Bark, 341 

Curd, 364 

Green, 364 

Insoluble, 364 

of Lead Monoxide, 364 

of Lime, 364 

Soft, 364 
Soda, Caustic, 376 

Chlorata, 177 

Chlorinated, 177 
Soda-water, no 

Sodio-Theobromine-salicylate, 143 
Sodium, 376 
Solanine, 208 
Solanum Dulcamara, 208 
Solid Preparations, 436, 470 
Soluble Substances, 462 
Solution, 421 

Aids to, 462 

Circulatory, 422 

of Aluminium Benzoate, 94 

of Ammonium Acetate, 95 

of Arsenious Acid, 119 

of Arsenic and Mercuric Iodide, 119, 
246 

of Arsenite of Bromine, 119 

of Arsenite of Potassium, 1 J 9 

of Carbolic Acid, 61 

of Carbonic Acid, no 

Clemen's, 1 19 

Donovan's, 1 19 

Fehling's, 199, 736 

Fowler's, 119 

of Gutta-percha, 240 

of Iodine, Compound, 257 

of Iron Acetate, 221 

of Iron Citrate, 221 

of Iron Chloride, 221 

of Iron Nitrate, 222 

of Iron and Quinine Citrate, 223 

of Iron Subsulphate, 222 

of Iron Tersulphate, 222 

of Lead Subacetate, 325 

of Lead Subacet., Dilute, 325 

of Lime, 147 

of Lime, Chlorinated, 177 

of Lime, Saccharated, 147 

Labarraque's, 177 

Lugol's, 257 

Magendie's, 300 

of Magnesium Citrate, 278 

of Mercuric Nitrate, 246 

of Morphine Sulphate, 300 



Solution of Opium, Compound, 299 

Pancreatic, 306 

Pavy's, 736 

Pearson's, 1 19 

of Pepsin, 309 

of Potassa, 330 

of Potassio-cupric Tartrate, 199, 736 

of Potassium Arsenite, 119 

of Potassium Citrate, 330 

of Potassium Silicate, 374 

of Soda, 376 

of Soda Chlorinated, 147, 177 

of Sodium Arseniate, 119 

of Sodium Silicate, 374 

of Thymol, 397 

of Zinc Chloride, 411 
Solutions (Liquores), 428 

Hypodermic, 714 

Precipitant, Table of, 457 

Stock, 455 
Solvents, 422 
Somnal, 379 
Somnambulism, 675 
Sores, 689 
Sorghum, 355 
Sorrel, 352 
Sozodont, 719 
Spanish Flies, 154 
Sparteine, 368 
Spasmodic Affections, 675 
Spearmint, 287 
Specific Gravity and Volume, 447 

Table of, 738 
Spermaceti, 165 
Spermatorrhoea, 675 
Spermine, 321 
Spigelia, 380 
Spina Bifida, 676 
Spinal Concussion, 676 

Congestion, 676 

Inflammation. — See Meningitis, Mye- 
litis. 

Irritation, 676 

Paralysis, 677 

Softening, 677 
Spirit of Ammonia, 94 

of Ammonia, Aromatic, 94 

of Ammonia, Fetid, 122 

of Anise, 102 

of Camphor, 150 

of Chloroform, 173 

of Cinnamon, 187 

of Ether, So, 84 

Compound, 80, 84 

of Nitrous Ether, 80, 84 

of Gaultheria, 229 

Grain, 86, 88 

of Hedeoma, 242 

of Juniper, 266 

of Juniper, Compound, 266 

of Lavender, 271 . 

of Lemon, 273 

of Mentha Piperita, 286 



INDEX. 



775 



Spirit of Mentha Viride, 287 

of Mindererus, 95 

of Myrcia, 291 

of Myristica, 291 

of Nutmeg, 291 

of Orange, 124 

of Pennyroyal, 242 

of Peppermint, 286 

Perfumed, 87 

Potato, 88 

Proof, 87 

Rectified, 87 

Russian, 670 

of Spearmint, 287 

of Turpentine, 82, 392 

Wood, 88 
Spirits (Spiritus), 434 
Spleen, Affections of, 677 
Spongia Usta, 674 

Spotted Fever. — See Typhus Fever, Men- 
ingitis, Cere bro- spinal. 
Sprains, 677 
Spruces, 323 
Spunk, 84 

Squamse. — See Ichthyosis, Pityriasis, Pso- 
riasis. 
Squaw -root, 164 
Squibb's Mixture, 299, 524 
Squill, 367 

St. Ignatius' Bean, 255 
St. Jacob's Oil, 77, 719 
St. Mary's Thistle, 159 
Stains, 677 
Stammering, 677 
Staphisagria, 380 
Star Anise, 102, 256 
Starch, 101, 355 

Iodized, 101, 257 
Statice, 64 
Stavesacre, 380 
Sterility, 678 
Sternutatories, 32 
Stigmata Maydis, 410 
Stillingia, 381 
Stimulants, 23 

Cardiac, 33 

Hepatic, 39 

Local, 25 

Pancreatic, 40 

Respiratory, 30 

Vascular, 34 
Stings, 678 
Stock Solutions, 455 
Stomach Diseases. — See Dyspepsia, Gas- 

tralgia, Gastric Ulcer, Gastritis, etc. 
Stomachics, 35 
Stomatitis, 678 
Stone. — See Calculi, 513 
Storax, 384 
Strabismus, 679 
Straining, 422 
Stramonium, 382 
Strangury. — See Cystitis, Dysuria. 



Stricture. — See Rectum. 

of Urethra, 691 
Strophanthin, 383 
Strophanthus, 383 
Strophulus, 679 
Struma. — See Scrofulosis. 673 
Strychnine, 243, 255, 294 
Strychnos Ignatii, 255 

Gaultheriana, 243 

Nux-Vomica, 294 
Sturgeon, 255 
Stye. — See Eyelids, 568 
Styptic Collodion, 75 
Styptics, 50, 595 
Styracin, 384 
Styrax, 384 

Benzoin, 132 
Styrol, 384 

Subacetate of Lead, 325 
Subcarbonate of Bismuth, 134 , 
Subchloride of Mercury, 245 
Subiodide of Bismuth, 135 
Sublimation, 419 
Subnitrate of Bismuth, 134 
Substances best given alone, 461 

difficult to combine in pill, 473 

suitable for mixtures, 462 

suitable for pills, 473 

suitable for powders, 479 

unsuited to pill-form, 474 
Subsulphate of Iron,- 222 

of Mercury, Yellow, 246 
Succinum, 385, 393 
Sudorifics, 46 
Suet, 374 
Sugar, 355 

Beet, 355 

Cane, 355 

Diabetic, 355 

Fruit, 355 

Grape, 355 

of Lead, 325 

of Milk, 356 

Starch, 355 

in Urine, Tests for, 736 
Sulphate of Aluminium, 93 

of Aluminium and Ammonium, 9: 

of Aluminium and Potassium, 9 : 

of Ammonium, 95 

of Atropine, 129 

of Cadmium, 140. 

of Cinchoniciine, 182 

of Cinchonine, 182 

of Copper, 199 

of Duboisine, 207 

of Hyoscyamine, 253 

of Iron, 222 

of Iron, Dried, 222 

of Iron, Precipitated, 222 

of Iron and Ammonium, 222 

of Magnesium, 278 

of Manganese, 280 

of Morphine, 300 



7/6 



INDEX. 



Sulphate of Potassium, 330 

of Quinidine, 182 

of Quinine, 182 

of Sodium, 377 

of Sparteine, 368 

of Strychnine, 294 

of Tetra-hydromethyl-chinoline, 184 

of Zinc, 411 
Sulphide of Allyl, 90, 122 

of Antimony, 103 

of Antimony, Purified, 103 

of Calcium, 386 

of Hydrogen, 387 

of Mercury, Red, 246 
Sulphite of Magnesium, 74, 278 

of Potassium, 74 

of Sodium, 74 
Sulpho-carbolate of Sodium, 61, 62 
Sulpho-cyanate of Acrinyl, 375 
Sulpho cyanide of Allyl, 375 
Sulphonal, 170 
Sulphur, 385 

Liver of, 386 

Lotum, 386 

Milk of, 386 

Precipitated, 386 

Sublimed, 385 

Washed, 386 
Sulphurated Antimony, 103 

Lime, 386 

Potassa, 386 
Sulphuretted Hydrogen, 387 
Sulphurous Mineral Waters, 112 
Sumach, Poison, 346 

Smooth, 346 

Swamp, 346 

Sweet, 345 
Sumbul, 388 
Sun-dew, 207 
Sunstroke, 679 
Suppositoria, 440, 481 
Suppositories, Formulae, 483 

Official in Br. Phar., 482 

of Tannic Acid, 75 
Suppuration, 679 
Surgeon's Agaric, 84 
Surgical Fever, 679 
Svapnia, 299 

Swallowing. — See Dysphagia ; (Esopha- 
gus, Disorders of. 
Swamp Sassafras, 279 
Sweet Bay, 279 

Flag, 146 

Gum, 384 
Swift's Specific, S. S. S., 719 
Sycosis, 679 

Sydenham's Laudanum, 299 
Syncope, 680 
Synovitis, 680 
Syphilis, 680 
Syrup of Acacia, 56 

of Allium, 90 

of Almond, 98 



Syrup of Althaea, 92 

of Amygdala, 98 

of Citric Acid, 273 

of Garlic, 90 

of Ginger, 413 

of Hydriodic Acid, 258 

of Hypophosphites, 312 

of Hypophos. with Iron, 312 

of Ipecacuanha, 261 

of Iron Bromide, 136, 221 

of Iron Iodide, 221 

of Iron and Mang. Iodide, 223, 281 

of Iron and Mang. Phosphate, 223 

of Iron, Quinine, and Strychnine 
Phosphates, 312 

of Krameria, 268 

of Lactophosphate of Calcium, 312 
. of Lactucarium, 269 

of Lemon, 273 

of Lime, 147 

of Manganese Iodide, 281 

of Orange, 124 

of Orange-flowers, 124 

of Phosphates, Compound, 312 

of Prunus Virginiana, 335 

of Rhubarb, 344 

of Rhubarb, Aromatic, 344 

of Raspberry, 352 

of Rose, 350 

of Rubus, 351 

of Rubus, Aromatic, 351 

of Rubus Idaeus, 352 

of Sarsaparilla, 365 

of Sarsaparilla, Comp., 365 

of Scilla, 367 

of Squill, 367 

of Squill, Compound, 103, 367, 371 

of Senega, 371 

of Senna, 372 

of Stillingia, Comp., 381 

of Tar, 323 

of Tolu, 127 

of Wild Cherry, 335 

of Zingiber, 413 
Syrupi (Syrups), 428 



Tabacum, 389 

Tabellae Nitroglycerin!, 99 

Tabes Mesenterica, 682 

Table of Drops, etc., in f^j, 446, 739 
of Latin Words, Phrases, etc., 703 
of Metric Conversion, 740 
of Precipitant Solutions, 457 
of Prescription Doses and Quantities, 

of Specific Gravities and Volumes, 738 
Tables of Differential Diagnosis, 725 
of Weights and Measures, 443, 739 
Tablets, 439 

Compressed, List of, 478 
Hypodermic, List of, 478 



INDEX. 



777 



Tag Alder, 90 

Tamarind, 391 

Tamar-Indien, 372, 719 

Tamarindus, 391 

Tanacetin, 391 

Tanacetum, 391 

Tanjore Pill, 678 

Tannate of Cannabin, 153, 154, 169 

of Pelletierine, 236 
Tannin, 75 

and Iron, 461 
Tansy, 391 

Oil of, 391 

Tea of, 391 
Tapeworm, 124, 237, 700 
Tar, 323 
Tar-water, 323 
Taraxacerin, 391 
Taraxacin, 391 
Taraxacum, 391 
Tartar, Crude, 329 

Emetic, 103 
Tartra borate of Potassium, 60, 514 
Tartrate of Antimony and Potas., 103 

of Chinoline, 167 

of Iron and Ammonium, 223 

of Iron and Potassium, 223 

Potassio-Cupric, 199, 736 

of Potassium, 330 

of Potassium, Acid, 331 

of Potassium and Sodium, 331 
Tartrates, 76 
Taste, Agents affecting, 30 

Disordered, 682 
Taurocholate of Sodium, 220 
Taeniafuges, 40, 237 
Taeniae. — See Worms, 700 
Tea, 142 

Flaxseed, 274 

German Breast, 57 

Saffron, 197 

Tansy, 391 

Worm, 380 
Teeth, 682 

Agents affecting, 34 
Teething. — See Dentition, 542 
Temperature of the Body, 730 
Tenesmus. — See Dysentery, 550 
Terchloride of Methyl, 172 
Terebene, 393 
Terebinthene, 393 
Terebinthina, 392 

Canadensis, 392 , 

Terpine, 393 
Terpinol, 393 
Tersulphate of Iron, 222 
Testa Prseparata, 147 
Testicles, 682 
Testing, 426 
Tests for Morphine, 301 

Urinary Constituents, 735 
Tetanus, 682 
Tetrachloride of Carbon, 82, 174 



Tetra-iodo-pyrol, 258 

Tetter. — See Herpes, Pityriasis, Psoriasis. 

Thalline, 184 

Thebaine, 298 

Theine, 141, 144 

Theobroma Cacao, 143, 395 

Theobromine, 143, 395 

Therapeutical Incompatibility, 459 

Therapeutics, 17, 487 

Applied, 18, 487 

Empirical, 18 

Natural, 17 

Rational, 18 

Special, 487 
Theriaca, 355 
Thermometer, Clinical, 730 
Thimble-berry, 352 
Thirst, 683 

Agents allaying, 35 
Thistle, Blessed, 159 
Thompson's Eye-water, 719 

Tincture, 311 
Thorn-apple, 382 
Thorough- wort, 219 
Throat. — See Aphonia, Croup, Diphtheria, 

Laryngitis, Pharyngitis, Scarlet Fever, 

Tonsillitis, etc. 

Sore, 683 
1 Thrush. — See Aphthce, 499 
Thuja, 393, 396 
Thujetin, 396 
Thujin, 396 
Thus Americanum, 393 
Thyme, Garden, 397 
Thymene, 397 
Thymol, 397 
Thymus vulgaris, 397 
Tic Douloureux, 684 
Tiglii Oleum, 398 
Tincture of Aconite, 77 

of Ailanthus, 86 

of Aloes, 91 

of Aloes and Myrrh, 91 

of Arnica-flowers, 117 

of Arnica root, 1 1 7 

of Asafetida, 122 

of Aurantium Amarum, 124 

of Aurantium Dulce, 124 

of Baptisia, 128 

of Belladonna, 129 

of Benzoin, 132 

of Benzoin, Compound, 132. 3S5 

of Berberis, 133 

of Bryonia, 139 

of Calendula, 148 

of Calumba, 149 

of Camphor, 150 

of Cannabis Indica, 153 

of Cantharides, 155 

of Capsicum, 157 

of Cardamom, 159 

of Cascarilla, 162 

of Catechu, Compound, 163 



77 8 



INDEX. 



Tincture of Chirata, 168 

Chloroform and Morphine, 173, 300 

of Chloroform, Compound, 173 

of Cimicifuga, 179 

of Cinnamon, 187 

of Cinchona, 18 1 

of Cinchona, Compound, 181 

of Cocculus, 317 

of Colchicum, 188 

of Conium, 191 

of Coto, 195 

of Crocus, 197 

of Cubeb, 198 

of Digitalis, 204 

of Duboisia, 207 

of Eucalyptus, 218 

of Euphrasia, 220 

of Galls, 229 

of Gelsemium, 230 

of Gentian, Compound, 231 

of Ginger, 413 

of Guaiac, 238 

Ammoniated, 238 
Hager's, 182 
of Hemp, Indian, 153 
of Hops, 244 
of Humulus, 244 
Huxham's, 181 
of Hydrastis, 252 
of Hyoscyamus, 253 
of Ignatia, 255 
of Iodine, 257 

of Ipecac and Opium, 261, 299 
of Iron Acetate, 221 
of Iron Chloride, 221 
of Kino, 267 
of Krameria, 268 
of Lavender, Compound, 271 
of Lobelia, 276 
of Lupulin, 244 
of Matico, 284 
of Musk, 290 
of Myrrh, 292 
of Nitro-glycerin, 99 
Norwood's, 404 
of Nutgall, 229 
of Nux Vomica, 294 
of Opium, 299 
of Opium, Camphorated, 299 
of Opium, Compound, 299 
of Opium, Deodorized, 299 
of Opium and Ipecac, 299 
of Orange Peel, Bitter, 124 
of Orange Peel, Sweet, 124 
of Phosphorus, 311, 312 
of Physostigma, 314 
of Phytolacca, 316 
of Pulsatilla, 336 
of Pyrethrum, 338 
Pyrexialis, 182 
of Quassia, 338 
of Quebracho, 339 
of Rhubarb, 344 



Tincture of Rhubarb, Aromatic, 344 

of Rhubarb, Sweet, 344 

of Rhus Toxicodendron, 347 

of Sanguinaria, 361 

of Serpentaria, 373 

of Soap, Green, 364 

of Squill, 367 

of Stillingia, 381 

of Stramonium, 382 

of Strophanthus, ^8^ 

of Sumbul, 388 

of Thuja, 396 

of Tolu, 127 

of Valerian, 402 

of Valerian, Ammoniated, 402 

of Vanilla, 403 

of Veratrum Viride, 404 

of Viscum, 408 

Warburg's, 182, 186 

of Zingiber, 413 
Tincturse, 433 
Tinea Circinata, 684 

Decalvans, 684 

Favosa, 684 

Sycosis. — See Mentagra, 628 

Tonsurans, 685 
Tobacco, 389 

Indian, 275 

Symptoms. — See Nervousness, 
632 
Toe-nails. — See Nails, 630 
Tolene, 127 
Toluene, 354 
Tomato, 208 
Tonga, 399 
Tongine, 399 
Tongue, 685 
Tonics, 41 

Cardiac. 33 

Formulae, 492, 496 

Gastric, 35 

Hair, 583 

Nerve, 633, 641 

Pills for Women, 477 

Uterine, 48 

Vascular, 34 

Vesical, 45 
Tonsillitis, 685 
Tonsils, Enlarged, 686 

Ulcerated, 686 
Toothache. — See Odontalgia, 637 
Toothrash. — See Strophulus, 679 
Torrefaction, 420 
Torticollis, 686 
Torulae. — See Sarcinse, 671 
Tracheitis. — See Croup, 536 
Trachoma. — See Conjunctivitis Granular, 

530; Ophthalmia, 638 
Tragacantha, 399 
Traumaticine, 240 
Traumatic Fever, 679 
Treacle, 355 
Tree of Heaven, 86 



INDEX. 



779 



Tri-chlor-aldehyde, 1 68 
Tricophytosis Capitis. — See Tinea, 684 
Trimethylamine. 117, 1 18, 244 
Trinitrophenol, 73 
Trinitrate of Glyceryl, 99 
Trinitrin, c>9 
Trismus, 686 
Triticin, 400 
Triticum, 400 

Vulgare, 101 
Trituration, 421 

of Elaterinum, 209 
Triturationes, 440, 480 
Triturations, Advantages of, 480 

Formulae, 481 

of Mercury. 246, 481 
Troches, 439, 477 

of Ammonium Chloride, 95 

of Catechu, 163 

of Chalk, 147 

of Cubeb, 198 

of Ginger, 413 

of Glycyrrhiza and Opium, 234 

of Ipecac, 261 

of Iron, 222 

of Krameria, 268 

of Liquorice and Opium, 234, 299 

List of. 477 

of Magnesia, 278 

of Morphine and Ipecac, 261, 300 

of Peppermint, 286 

of Potassium Chlorate, 330 

of Santonin, 363 

of Sodium Bicarbonate, 377 

of Sodium Sanfoninate, 363 

of Tannic Acid, 75 

of Zingiber, 413 
Trochisci, 439, 477 
Tropeius, 129 

Tropical Fruit-Laxative, 372, 719 
Tropin, 129 
Trypsin, 306 

Tubercular Meningitis. — See Hydroceph- 
alus, Acute, 602 
Tuberculin, 653 
Tuberculosis. — See Phthisis, Scrofulosis, 

651. 673, 728 
Tully's Powder, 300 
Tumors, 687 

Diagnosis of, 726 

Uterine, 694 
Turnera aphrodisiaca, 202 
Turpentine, 392 

Canada, 392 

Chian, 392 • 

Oil of, 392 

Venice, 393 
Turpeth Mineral, 246 
Tympanites, 687 
Typhlitis, 687 
Typhoid Fever, 687 

Diagnosis of, 729 
Typho malarial Fever — See Typhoid. 



Typhus Fever, 689 
Diagnosis of, 729 



Ulcers and Sores, 689 

of Rectum, 665 

Stomach, 576 

of Tonsils, 686 

of Uterus, 695 
Ulmus, 400 
Umbelliferon, 228 
Umbrella-tree, 279 
Unguenta, 440, 483 
Unguentum, 164, 440 
Uraemia, 691 
Urea, Agents affecting, 40 

in Urine, Test for, 736 
Urethane, 170 
Urethra, Stricture of, 691 
Urethral Injections, 470 
Urethritis, 470, 691 
Urginea Scilla, 367 

Uric Acid Diathesis. — See Lithaemia, 618 
Urinary Astringents 45 

Disorders, 691 

Sedatives, 45 
Urine, Acidifiers of, 45 

Alkalinizers of, 44 

Examination of, 735 
Urticaria, 692 
Ur>one, 229, 401 
Ustilago, 410 
Uterine Alteratives, 48, 692 

Cancer, 693 

Congestion, 693 

Depressants, 48 

Diseases, 694 

Displacements, 694 

Hypertrophy, 693 

Prolapse, 658 

Tonics, 48 

Tumors, 694 

Ulceration, 695 
Uva Ursi, 400 
Uvula, 695 



Vaccination, 695 

Vaginismus, 695 

Vaginitis, 695 

Valerene, 401 

Valerian, 202, 401 

Valerianate of Ammonium, 95, 402 

of Butyl, 102 

of Iron, 222 

of Quinine, 182 

of Zinc, 403, 411 
Valerianates, 402 
Valerol, 244, 401 
Vallett's Mass, 221 
Van Buskirk's Sozodont, 719 



ySo 



INDEX. 



Vanilla, 403 
Vanillin, 403 
Vao, 200 
Vapores, 485 
Vaporization, 418 
Vapors, 485 
Varicella, 696 
Varicocele, 696 
Varicosis, 696 
Variola, 696 

Diagnosis of, 728 
Vascular Sedatives, 34 

Stimulants, 34 

Tonics, 34 
Vaseline, 310 

Vegetable Drugs, their Constituents, 416 
Veins. — See Phlebitis, Phlegmasia, Vari- 
cosis. 
Veins, Transfusion by, 20 
Velatine, 187, 213 
Vellarine, 253 
Venous Medication, 20 
Veratralbine, 404 
Veratrine, 404 
Veratroidine, 404 
Veratrum Album, 404 

Sabadilla, 404 

Viride, 403 
Verbascum, 406 
Verbs, 711 
Vermicides, 40 
Vermifuges, 40, 470 
Vertigo, 697 

Verucca. — See Warts, 699 
Vesical Tonics, 45 

Sedatives, 45 
Vesicants, 49 
Viburnin, 407 
Viburnum, 407 

Compound, 407 

Opulus, 407 

Prunifolium, 407 
Vienna Paste, 330 
Villate's Solution, 200, 517 
Vina (See also Wines), 434 « 
Vinegar, 59 

Bitters, 719 

of Lobelia, 276 

of Opium, 299 

of Sanguinaria, 361 

of Squill, 367 
Vinegars (Aceta), 436 
Vinum, 87 

Album, 87 

Aromaticum, 87 

Official (See Wine of — ) 

Portense, 87 

Rubrum, 87 

Xericum, 87 
Viola Cucullata, 408 

Tricolor, 407 
Violet, 408 
Violine, 407 



Vi?cin, 408 

Viscum, 408 

Visions, Agents producing, 29 

Vitellin, 408 

Vitellus, 408 

Vitriol, Elixir of, 73 

Volkmann's Antiseptic Fluid, 397 

Vomiting, 697 

of Pregnancy, 698 

Diagnosis of, 730 
Vulva, Eczema, etc., of, 699 
Vulvitis, 699 



Wade's Bougies, 483 
Wafers, 479 
Wahoo, 219 

Walker's Vinegar Bitters, 719 
Warburg's Tincture, 182, 186 
Warming-plaster, 323 
Warner's Safe Cure, 719 
Warts, 699 
Wash, 468 

Black, 246 

Hair, 583 

Mouth, 583 

Yellow, 246 
Washing, 422 

Waste, Agents promoting, 42 
Wasting. — See Atrophy, 502 ; Emaciati 

558 
Wasting Diseases, 558 
Water, no 

Almond, Bitter, 98 

of Ammonia, 94 

of Ammonia, Stronger, 94 

Anise, 102 

Camphor, 150 

Carbolic Acid, 61 

Carbonated, no 

Cherry-laurel, 67, 69 

Chlorine, 176 

Cinnamon, 187 

Cologne, 87 

Creasote, 196 

of Crystallization, 424 

Distilled, no 

Elder-flower, 360 

Fennel, 227 

Hunyadi, 1 12, 532 

Laurel, 67 

Lavender, 271 

Lime, 147 

Orange-flowe*. 124 

Peppermint, 280 

Rose, 350 

Soda, no 

Spearmint, 287 

Tar, 323 
Water lily, 296 
Water pepper, 329 
Waters (Aquae), 427 



INDEX. 



78, 



Waters, Mineral, ill 

Nomenclature, 1 1 1 
Wax, 164 
Wax Myrtle, 64 

Weakness. — See Adynamia, 491 ; Ex- 
haustion, 567 
Weights and Measures, 443, 739 

Apothecaries', 443, 740 

British Pharmacopoeial, 443 

Metric, 444, 740 
Wen, 700 
Whiskey, 86 

White leg. — See Phlegmasia, 650 
White-swelling. — See Joints, 613 ; Synovi- 
tis, 680 
Whitlow. — See Onychia, 638 
Whooping-cough, 648 
Willow, 356 
Wine, 87 

of Aloes, 91 

of Antimony, 103 

Aromatic, 87 

of Cocaine, 214 

of Colchicum-root, 188 

of Colchicum-seed, 188 

of Ergot, 210 

of Ipecac, 262 

of Iron, Bitter, 223 

of Iron Citrate, 221 

of Opium, 299 

Port, 87 

of Quebracho, 339 

Red, 87 

of Rhubarb, 344 

Sherry, 87 

of Tar, 323 

of Tobacco, 389 

White, 87 
Wines (Vina), 87, 434 
Winter-berry, 334 



Wintergreen, 229 

Witch-hazel, 64, 241 

Wood Oil, 239 

Woorara, 200 

Words and Phrases, Latin, 703 

Sundry, 712 
Worms, 40, 700 
Worm grass, 380 
Wormseed, 166 

Levant, 362 
Worm Tea, 380 
Wormwood, 56 
Wounds, 701 

Writer's Cramp. — See Spasmodic Affec- 
tions, 675 • 
Wry-neck. — See Torticollis, 686 



Xantho-puccine, 251 
Xanthoxyline, 409 
Xanthoxylum, 409 
Xeroderma. — See Ichthyosis, 604 



Yam, Wild, 207 
Yellow Fever, 701 

Diagnosis of, 730 
Yerba Santa, 213 
Yolk of Egg, 408 
Yvon's Hypnotic Elixir, 609 



Zea Mays, 355, 409 

Zincite, 411 

Zincum, 410 

Zingiber, 413 

Zona. — See Herpes Zoster, 601 



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MEDICAL AND SCIENTIFIC PUBLICA TIONS. ' 25 

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THERAPEUTICS. 

Napheys' Modern Therapeutics. New Revised Edi- 
tion, Enlarged and Improved. In Two Hand- 
some Volumes. 1892. 

A COMPENDIUM OF RECENT FORMULAE AND THERAPEUTICAL DIRECTIONS FROM THE 

practice of eminent contemporary physicians, American and Foreign. Edited 
by Allen J. Smith, m.d., Assistant Demonstrator of Morbid Anatomy and Patholo- 
gical Histology, Lecturer on Urinology, University of Pennsylvania ; Physician in 
the Dispensary for Diseases of Children, University Hospital, etc.; and J. Aubrey 
Davis, m.d., Assistant Demonstrator of Obstetrics, University of Pennsylvania; 
Assistant Physician Home for Crippled Children, Philadelphia, etc. 
Volume I. — Medical Therapeutics. Therapeutics of Diseases of Children. 
Octavo. 1000 pages. Handsome half Russia binding, net, $6.00 

Volume II. — Surgical Therapeutics. Therapeutics of Gynecology and Ob- 
stetrics. To be ready i?i Autumn of J8p2. 

ANNOUNCEMENT. 

The frequent demands for a new and thoroughly revised edition of 
this popular work have induced the present publishers to have one pre- 
pared in the most complete manner, representing the latest achievements 
of therapeutical science as set forth by the most distinguished teachers 
and practitioners. The same general plan and strictly practical aims have 
been observed as in former editions. The precise formulae, specific direc- 
tions, and methods of treatment recommended by the most eminent 
American and foreign practitioners are given ; and the full resources of 
the materia medidl are grouped under the various diseases to which 
they are applicable. Particular attention has been paid to describing 
the modes of employment and relative value of new remedies, including 
the latest additions to therapeutical agents. 

By a careful arrangement, all the diseases which the physician is 
likely to meet are presented systematically and discussed separately, 
including those of women and children as well as strictly medical and 
surgical complaints. It has been the aim of the editors to set forth the 
treatment of able specialists in all these departments, so that the general 
practitioner may have at his command the therapeutic resources of those 
who devote their whole attention to limited fields of disease. 

With this end in view, numerous monographs, journals, and special 
papers, both in this country and Europe, have been consulted and their 
most useful therapeutic suggestions extracted. No other work on the 
subject will be found so thoroughly and constantly useful to the practic- 
ing physician, because no other supplies so directly and with such ease 
of reference the information he desires. 

The whole work has been rearranged, the better part rewritten, 
and every page will show improvements or additions. A large number 
of new and representative prescriptions have been added to the text. 

It has been thought desirable to include Diseases of Women and 
Children in the two volumes instead of publishing separately, as before. 



THERAPEUTICS AND MATERIA MEDICA. 

Potter's Materia Medica, Pharmacy and Therapeutics. 
Third Edition, Revised and Enlarged. 1891. 

A HANDBOOK OF MATERIA MEDICA, PHARMACY AND THERAPEUTICS including the Phy- 

sioiogical Action of Drugs, Special Therapeutics of Diseases, Official and Extempo- 
raneous Pharmacy, etc. By Sam'l O. L. Potter, m.a., m.d., Professor of the 
Practice of Medicine in Cooper Medical College, San Francisco ; Late A. A. Sur- 
geon, U. 5. Army; Author of "Speech and its Defects," and the "Quiz-Compends" 
of Anatomy and Materia Medica, etc. Revised, Enlarged and Improved. Octavo. 
With Thumb Index. Leather, $5.00 

" The author has aimed to embrace in a single volume the essentials of practical materia medica and 
therapeutics, and has produced a book small enough for easy carriage and easy reference, large enough to 
contain a carefully digested, but full, clear and well-arranged mass of information. He has not adhered to 
any pharmacopoeia, as is the case of certain recent manuals, thereby limiting his work, and in this day of new 
remedies causing constant disappointment, but has brought it up to date in the most satisfactory way. No 
new remedy of any acknowledged value is omitted from this list. Under each the section on physiological 
action and therapeutics has been written with care. ... In the enumeration of drugs suited to different 
disorders a very successful effort at discrimination has been made, both in the stage of disease and in the cases 
peculiarly suited to the remedy. It is no mere list of diseases followed by a catalogue of drugs, but is a digest 
of modern therapeutics, and as such will prove of immense use to its possessor." — The Therapeutic Gazette. 

A Unique Book. — The plan of this work is new and original with Dr. Potter, and its 
contents have been combined and arranged in such a way that it offers a compact statement 
of the subjects in hand, containing more correct information in a practical, concise form 
than any other publication of the kind. 

The work commences with a section on the classification of medicines, as follows : — 

Agents acting on the Nervous System, Organs of Sense, Respiration, Circulation, 
Digestive System, on Metabolism (including Restoratives, Alteratives, Astringents, Anti- 
pyretics, Antiphlogistics and Antiperiodics, etc.) Agents acting upon Excretion, the 
Generative System, the Cutaneous Surfaces, Microbes and Ferments, and upon each other. 

Part I. — Materia Medica and Therapeutics (351 pages), the drugs being 
arranged in alphabetical order, with the synonym of each first ; then the description of 
the plant, its preparations, physiological action, and lastly its Therapeutics. 

Part II. — Pharmacy and Prescription Writing (56 pages). This is written for 
the use of physicians who desire or of necessity must put up their own prescriptions, and 
includes — Weights and Measures, English and the Metric Systems ; Specific Gravity and 
Volume; Prescriptions, their principles and combinations; proper methods of writing 
them; Abbreviations; Stock solutions and preparations, and Incompatibility, etc. 

Part III. — Special Therapeutics (211 pages) is an alphabetical List of Diseases — 
a real Index of Diseases — giving the drugs that have been found serviceable in each 
disease, and the authority recommending the use of each, a very important 
feature, as it gives an authoritative character to the book that is unusual in works on 
Therapeutics, and displays an immense amount of research on the part of the author. 
600 Prescriptions are given in this part, many being over the names of eminent men. 

The Appendix (36 pages) contains lists of Latin words, phrases and abbreviations, 
with their English equivalents, Genitive Case Endings, etc. 36 formulae for Hypodermic 
Injections; 10 of Chlorodyne; Formulae of prominent patent medicines; Poisons and 
their Antidotes; Differential Diagnosis; Temperature Notes; Obstetrical Memoranda; 
Clinical Examination of Urine ; Table of Specific Gravities and Volumes ; Table showing 
the number of drops in a fluidrachm of various liquids, the weight of one fluidrachm in 
grains, and a table for converting apothecaries' weights and measures into grams, etc., etc. 

The Index covers thirty-five pages, and will be found very elaborate. 

The whole work is a statement of known facts in terse language ; it is, in fact, the 
essentials of Practical Materia Medica and Therapeutics. Although it is to a great extent a 
compilation, as any such book must be, from the works of prominent writers and teachers, 
yet it will be found to contain much original matter and many useful suggestions not 
included in any other book. 



PRACTICE OF MEDICINE. 

Roberts' Practice of Medicine. Eighth Edition. Re- 
vised, Enlarged and Illustrated. 

A HANDBOOK OF THE THEORY AND PRACTICE OF MEDICINE. By FREDERICK T. 

Roberts, m.d., b.Sc, f.rcp., Professor of Materia Medica and Therapeutics, and 
of Clinical Medicine, at University College Hospital, London; Physician to Bromp- 
ton Hospital for Consumption and Diseases of the Chest, etc. Eighth Edition. 
Revised and Enlarged. 51 Illustrations. 1059 pages. Octavo. 

Handsome Cloth, $5.50; Full Sheep, Raised Bands, #6.50 

" The various subjects have been treated in a complete and masterly manner. . . . We heartily 
commend this handbook, not only to gentlemen preparing for the medical profession, but to those who may 
have finished their professional education; as this work contains, in a brief and concise shape, all that the 
busy general practitioner needs to know to enable him to carry on his practice with comfort to himself and 
with advantage to his patients." — British Medical Journal. r 

" It is unsurpassed by any work that has fallen into our hands as a compendium for students." — The Clinic. 

"We particularly recommend it to students about to enter upon the practice of their profession." — St. 
Louis Medical and Surgical Journal. 

" If there is a book in the whole of medical literature in which so much is said in so few words, it has 
never come within our reach." — Chicago Medical Journal. 

" The regularity with which fresh editions of this admirable text-book make their appearance, serves to 
show that it continues to maintain its favored position with the student, who finds it a safe and reliable guide. 
Apart from the clearness of style and its thoroughly practical character, a great feature of Dr. Roberts' work 
is the systematic method with which each subject is treated. The value of this kind of instruction is high, as 
it enables the student to marshal his ideas in an orderly manner, and to assign to each part its special 
importance. The author has not been unmindful of the necessity of keeping his book ' up to date,' and he 
has evidently bestowed much pains on its revision. It is enough to say that it fully merits its popularity." — 
The Lancet, London, February 7th, 189 1. 

" The arrangement of the subject is admirable, each disease is very fully considered in elegant phraseology 
without any undue verbosity, and the matter is presented in a manner which is easily grasped and retained in 
the memory. It is quite unnecessary to refer further to the pages of this valuable and reliable text-book. It 
will be found a trustworthy guide both by students and practitioners, and the latter will find much more infor- 
mation as to treatment, than is usually recorded in such works." — Liverpool Medico- Chir. Journal, Jan., 1891. 

Hughes' Compend of the Practice of Medicine. 4th 
Enlarged Edition* 

A COMPEND OF THE PRACTICE OF MEDICINE. By DANIEL E. HUGHES, M.D., late 

Demonstrator of Clinical Medicine at Jefferson Medical College, Philadelphia; now 
Physician-in-Chief, Philadelphia Hospital In two parts. 

Part I. — Continued, Eruptive and Periodical Fevers, Diseases of the Stomach, Intes- 
tines, Peritoneum, Biliary Passages, Liver, Kidneys, etc., and General Diseases, etc. 

Part II. — Diseases of the Respiratory System, Circulatory System and Nervous 
System; Diseases of the Blood, etc. Price of each Part, strongly bound in cloth, $1.00 

Interleaved for the addition of notes, 1.25 

*^* These books are a complete set of notes upon the practice of medicine. The 
synonyms,' definition, causes, symptoms, pathology, prognosis, diagnosis, treatment, etc., 
of each disease being given. The treatment is especially full and a number of valuable 
prescriptions have been incorporated. Reference has been made to the latest writings 
and teachings of Drs. Flint, Roberts, Loomis, Bartholow, DaCosta, etc. Dr. Hughes' 
long experience as demonstrator of clinical medicine under the last named famous pro- 
fessors gave him unrivaled opportunities for the preparation of a book of this character. 

Physicians' Edition. Fourth Edition. Same as above, but in one volume, 
and including a section on Skin Diseases and a very complete index. 

Full Morocco, Gilt Edges, $2.50 
" The best condensation of the essentials of Practice I have yet seen. ... It will be an admirable 
review book for students after a solid course of study, and it will be scarcely less useful to the busy practi- 
tioner as a ready means of refreshing his memory." — C. A. Lindsley, M.D., Professor of Theory and Prac- 
tice of Medicine, Yale College, New Haven. 



NEW AND REVISED EDITIONS. 

PQUIZ-COMPENDS.? 

A SERIES OF PRACTICAL MANUALS FOR THE PHYSICIAN AND STUDENT. 

Compiled in accordance with the latest teachings of prominent lecturers 
and the most popular Text-books. 

Bound in Cloth, each $1.00. Interleaved, for the Addition of Notes, $1.25. 

They form a most complete, practical and exhaustive set of manuals, containing information nowhere else 
collected in Such a practical shape. Thoroughly up to the times in every respect, containing many new pre- 
scriptions and formulae, and over 300 illustrations, many of which have been drawn and engraved specially for 
this series. The authors have had large experience as quiz-masters and attaches of colleges, with exceptional 
opportunities for noting the most recent advances and methods. The arrangement of the subjects, illustrations, 
types, etc., are all of the most approved form. They are constantly being revised, so as to include the latest 
and best teachings, and can be used by students of any college of medicine, dentistry and pharmacy. 

No. 1. Human Anatomy. Fifth Edition (1891), including Visceral Anatomy, formerly pub- 
lished separately. 16 Lithograph Plates, Tables, and 117 Illustrations. By Samuel O. L. 
Potter, m.a., m.d., late A. A. Surgeon, U. S. Army. Professor of Practice, Cooper Med. College, 
San Francisco. 

Nos. 2 and 3. Practice of Medicine. Fourth Edition, Enlarged (1890). By Daniel E. Hughfs, 
M.d., late Demonstrator of Clinical Medicine in Jefferson Med. College, Phila. ; Physician-in Chief, Phila- 
delphia Hospital. In two parts. 

Part I. — Continued, Eruptive and Periodical Fevers, Diseases of the Stomach, Intestines, Peritoneum, Biliary Passages, 
Liver, Kidneys, etc. (including Tests for Urine), General Diseases, etc. 

Part II. — Diseases of the Respiratory System (including Physical Diagnosis), Circulatory System and Nervous System; 
Diseases of the Blood, etc. 

*** These little books can be regarded as a full set of notes upon the Practice of Medicine, containing the Synonyms, 
Definitions, Causes, Symptoms, Prognosis, Diagnosis, Treatment, etc., of each disease, and including a number of prescrip- 
tions hitherto unpublished. 

No. 4. Physiology, including Embryology. Sixth Edition (1891). By Albert P. Brubaker, m.d., 
Prof, of Physiology, Penn'a College of Dental Surgery; Demonstrator of Physiology in Jefferson Med. 
College, Phila. Revised, Enlarged and Illustrated. In Press. 

No. 5. Obstetrics. Illustrated. Fourth Edition (1889). For Physicians and Students. By Henry 
G. Landis, m.d., Prof, of Obstetrics and Diseases of Women, in Starling Medical College, Columbus. 
Revised Edition. New Illustrations. 

No. 6. Materia Medica, Therapeutics and Prescription Writing. Fifth Revised Edition (1891). 
With especial Reference to the Physiological Action Of Drugs, and a complete article on Prescription 
Writing. Based on the Last Revision (Sixth) of the U. S. Pharmacopoeia, and including many unofficinal 
remedies. By Samuel O. L. Potter, m.a., m.d., late A. A. Surg. U. S. Army; Prof, of Practice, 
Cooper Med. College, San Francisco. 5th Edition. Improved and Enlarged. 

No. 7. Gynaecology. (1891.) A Compend of Diseases of Women. By Henry Morris, m.d., Demon- 
strator of Obstetrics, Jefferson Medical College, Philadelphia. Many Illustrations. 

No. 8. Diseases of the Eye and Refraction. Second Edition (1888). Including Treatment and 
Surgery. By L. Webster Fox, m.d., Chief Clinical Assistant Opthalmological Dept., Jefferson Medical 
College, etc., and Geo. M. Gould, m d. 71 Illustrations, 39 Formulae. 

No. 9. Surgery, Minor Surgery and Bandaging. Illustrated. Fourth Edition (1890). Including 
Fractures, Wounds, Dislocations, Sprains, Amputations another operations ; Inflammation. Suppuration, 
Ulcers, Syphilis, Tumors, Shock, etc. Diseases of the Spine, Ear, Bladder, Testicles, Anus, and other 
Surgical Diseases. By Orville Horwitz, a.m., m.d., Demonstrator of Surgery, Jefferson Medical 
College. 84 Formulae and 136 Illustrations. 

No. 10. Medical Chemistry. Third Edition (1890). Inorganic and Organic, including Urine Analysis. 
For Medical and Dental Students. By Henry Leffmann, m.d., Prof, of Chemistry in Penn'a College 
of Dental Surgery, Phila. Third Edition. Revised and Enlarged. 

No. 11. Pharmacy. Third Edition (1890). Based upon " Remington's Text-Book of Pharmacy." By 
F. E. Stewart, m.d., ph.g., Professor of Pharmacy, Powers College of Pharmacy; late Quiz-Master at 
Philadelphia College of Pharmacy. Third Edition. Revised. 

No. 12. Veterinary Anatomy and Physiology. Illustrated. (1890.) By Wm. R. Ballou, m.d., Prof, 
of Equine Anatomy, New York College of Veterinary Surgeons, etc. 29 Illustrations. 

No. 13. Dental Pathology and Dental Medicine. (1890.) Containing all the most noteworthy points 
of interest to the Dental Student. By Geo. W. Warren, d.d.s., Clinical Chief, Penn'a College of 
Dental Surgery, Philadelphia. Illus. 

No, 14. Diseases of Children. (1890.) By Marcus P. Hatfield, Professor of Diseases of Children, 
Chicago Medical College. With Colored Plate. 

These books are constantly revised to keep up with the latest teachings and discoveries. 



From The Southern Clinic. — " We know of no series of books issued by a?iy house that so 
fully meets our approval as these ? Quiz- Compends f They are well arranged, full and concise, 
and are really the best line of text-books that could be found for either student or practitioner \" 



Potter. A Compend of Anatomy. Fifth Edition. 
1 6 Lithograph Plates. 117 other Illus. 

including the viscera. (Based on Gray.) By Saml. O. L. Potter, m.a., m.d., 
late A. A. Surg. U. S. Army ; Professor of the Practice of Medicine, Cooper Medical 
College, San Francisco. Revised and Enlarged. i2mo. Being No. i ? Quiz- 
Compend ? Series. See page 29. Strongly bound in cloth, #1.00 

Interleaved, for the addition of notes, 1.25 

*^*An Appendix has been added to this edition, containing 16 Lithographic Plates of the Arterial and 
Nervous Systems, with explanatory tables that will be found exceedingly useful and practical. We would 
call special attention to these tables, as being entirely original in design and arrangement, giving graphic 
views of the most difficult part of Human Anatomy, and including anastomoses (the arteries) and distri- 
bution (the arteries and nerves) ; a thing never before shown completely in tabular form. The different types 
are so arranged as to grade the branches according to relative importance, and by the systematic and ingenious 
use of brackets with various types, the tables are veritable pictures themselves of their objects. 

Dr. Potter's power of condensation and arrangement, have never been displayed to such advantage as in 
these tables, which must take their proper place as the best of all attempts of the kind, even in the restricted 
spase of pages the size of which was previously determined, and to which the tables had to conform. 

The plates are equally original, having been made from new drawings by Dr. Potter's own hand ; they 
are graphic delineations, and being diagrammatic, do not represent the exact forms or proportions of the parts 
thus shown. If colored by hand, by the student, as may be done with very little trouble, their value will be 
greatly increased. 

" In the particular line to which it belongs, and as one of the pioneers, this work of the indefatigable Dr. 
Potter stands in the list of the very best. This is particularly conspicuous in view of the many failures tc 
render the subject of anatomy attractive when presented in compends." — American Practitioner and News, 
January, 1891. 

" This is ? Quiz-Compend No. I, based on Gray principally, and is a book that to a student is almost 
necessity, and to the practicing physician a great aid as a ready reference work, enabling him, at almost 
glance, to keep in mind a great many valuable points in anatomy that otherwise he would forget." — The Cin- 
cinnati Medical Journal, February 15th, i8gi. 

" Of all the studies in a medical course, anatomy is the most important. To wade through a < Gray,' for 
review, is very irksome, and by having an Anatomy in an epitomized form and thoroughly reliable, both time 
and labor will be saved. Dr. Potter has thus conferred a boon on both the student and practitioner alike, bj 
publishing his Compend of Anatomy. The tables and plates of the nerves and arteries are excellent ; these 
constitute the Appendix, and by their aid one can review this important part of the work in a short space of 
time." — Canada Lancet, Toronto, February, i8gi. 



Robinson. The Latin Grammar of Pharmacy an 
Medicine. 

By H. D. Robinson, ph.d., Professor of Latin Language and Literature, University 
of Kansas, Lawrence. With an Introduction by L. E. Sayre, ph.g., Professor of 
Pharmacy, and Dean of the Dep«. of Pharmacy, in the University of Kansas. 121110. 
275 Pages. Cloth, $2.00 

" It is a work that meets with my hearty approval There is great need of just such a book in our 
American schools of pharmacy and medicine."— E. S. B as tin, Professor of Botany, Depl. of Pharmacy, 
Northwestern University, Chicago. 

" The object of this useful book is a very laudable one, namely, to improve, if possible, the Latin used by 
both physicians and druggists, chiefly in the prescribing of drugs. While it is true that many of the profession 
find it unnecessary to remember the genitive endings of words used in medicine, because of the customary 
abbreviations in prescribing-writing, there are others who frequently desire to write their directions to the 
druggist in Latin, in order that the patient may not learn of facts about which it is often necessary for him to 
remain in ignorance. We hope that the book will prove a success, and by its general employment in both 
pharmaceutical and medical schools, improve the knowledge of Latin in both professions."— 7 he Medical 
A r ews, Philadelphia, January loth, 1891. 

" The plan of the book is excellent, the field new, as it fills a long-felt want. All medical students 
should have it, both the collegian, as it will give a practical turn to his knowledge of Latin, and the non- 
graduate, as it will give him a direct and useful acquaintance with that language. The country doctor who 
has not had the advantages of the younger men will find it a great help in overcoming this defect, and may 
speedily acquire a familiarity with this language that will surprise his classical confrere:'— Southern Cat. 
Practitioner, December, 1890. 




NURSING, MASSAGE, ETC. 

Ostrom. Massage and the Original Swedish Move- 
ments. Illustrated. Second Edition. 

AND THEIR APPLICATION TO VARIOUS 

diseases of the body. A Manual for 
Students, Nurses, and Physicians. By 
Kurre W. Ostrom, from the Royal 
University of Upsala, Sweden ; In- 
structor in Massage and Swedish Move- 
ments in the Hospital of the University 
of Pennsylvania and in the Philadel- 
phia Polyclinic and College for Gradu- 
ates in Medicine, etc. Illustrated by 87 
explanatory Wood Engravings, drawn 
specially for this purpose. 121110. Sec- 
ond Edition. Cloth, #1.00 

" This book, which is well written and carefully illustrated, will be of service both to physicians and 
nurses as well as to manipulators. Mr. Ostrom, who came to this country from Sweden, has proven himself 
a capable teacher as well as a good Masseur, his instructions being careful, accurate, and complete." — 
University Medical Magazine, Philadelphia, March, 1890. 

Parvin. Obstetric Nursing. 

LECTURES DELIVERED AT THE TRAINING SCHOOL FOR NURSES OF THE PHILADELPHIA 

hospital. By Theophilus Parvin, m.d., Professor of Obstetrics and Diseases of 
Women and Children in the Jefferson Medical College ; Obstetrician to the Phila- 
delphia Hospital. Revised and Enlarged. 121110. Cloth, $ .75 

Humphrey. A Manual for Nurses, 4th Edition, 

including general anatomy and physiology, Management of the Sick-Room, etc. 
By Laurence Humphrey, m.d., m.r.c.s., Ass't Physician to, and Lecturer at, Adden- 
brook's Hospital, Cambridge, England. i2mo. 79 Illustrations. Cloth, $1.25 

" That a work of such a character should be addressed to nurses at all is in itself a significant indication 
of the high standard to which the art of nursing has risen in recent years, and also a good proof of the 
estimation in which really good nursing is held alike by the public and by medical men. To the intelligent 
and often well educated women who now take up nursing either as an occupation or as a profession, some 
theoretical training in the elements of anatomy and physiology is very generally recognized as necessary by 
all hospital authorities. . . ." — The Practitioner, London, April, /890. 

Fullerton. Obstetrical Nursing. Illustrated. 

A HANDBOOK FOR NURSES, STUDENTS, AND MOTHERS. By ANNA M. FULLERTON, M.D., 

Demonstrator of Obstetrics in the Women's Medical College; Physician in charge 
of, and Obstetrician and Gynaecologist to, the Woman's Hospital, Philadelphia, etc. 
34 Illustrations, several of which are original. Second Edition, Revised and Enlarged. 
121110. 222 pages. Cloth, #1.25 

BY THE SAME AUTHOR. 

Nursing in Abdominal Surgery and Diseases of 
Women. 

COMPRISING THE REGULAR COURSE OF INSTRUCTION AT THE TRAINING SCHOOL OF THE 

woman's hospital, Philadelphia. 70 Illustrations, urao. 284 pages. Cloth, $1.50 



Published Annually for 42 Years. 



The Physician's Visiting List. 

(LINDSAY & BLAKISTON'S. ) 

Contents.— Special Revised Edition for 1893. 



CALENDAR, 1893-1894. 

TABLE OF SIGNS, to be used in keeping records. 

THE METRIC OR FRENCH DECIMAL SYSTEM OF 
WEIGHTS AND MEASURES. 

TABLE FOR CONVERTING APOTHECARIES' 
WEIGHTS AND MEASURES INTO GRAMS. 

POSOLOGICAL TABLE (Meadows). 

DOSE TABLE, giving the doses of official and unofficial drugs 
in both the English and Metric Systems. Completely re- 
written and rearranged for 1893 by Dr. George M. Gould. 

LIST OF NEW REMEDIES. 

INCOMPATIBILITY (Dr. S. O. L. Potter). 



POISONS AND ANTIDOTES. 

DISINFECTANTS. 

EXAMINATION OF URINE (Dr. J. Daland, based upon 

Tyson). « 

BRIGHT'S DISEASE, Differential Diagnosis of. 
DIAGNOSIS AND TREATMENT OF THE SIMPLER 

DISEASES OF THE EYE (Dr. George M. Gould). 
THE ERUPTIVE FEVERS, Table of. 
ASPHYXIA AND APNCEA. 
A NEW COM PLETE TABLE FOR CALCULATING THE 

PERIOD OF UTERO-GESTATION. 
COMPARISON OF THERMOMETERS. 



AND THE USUAL BLANK LEAVES FOR KEEPING ACCOUNTS, RECORDS, ENGAGEMENTS, ETC. 



SIZES AND PRICES. 



REGULAR EDITION. 

For 25 Patients weekly. Tucks, Pockets and Pencil, 

50 



75 
100 



Vols.{jJP- to I une 



ily to Dec. 

Vols i J an * t0 J une 
Vols *tjuly to Dec. 

INTERLEAVED EDITION. 

For 25 Patients weekly. Interleaved, Tucks and Pencil, 



2 Vols. 



Jan. to June I 
July to Dec. J 



551.00 
1.25 
1.50 
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2.50 

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PERPETUAL EDITION, without Dates. 

No. I. Containing space for over 1300 names, with blank 
page opposite each Visiting List page. Bound 
in Red Leather cover, with Pocket and 
Pencil, 

No. 2. Containing space for 2600 names, with blank 
page opposite each Visiting List page. Bound 
like No. 1, with Pocket and Pencil, 
MONTHLY EDITION, without Dates. 

No. 1. Bound, Seal leather, without Hap or Pencil, 
gilt edges, ..... 

No. 2. Bound, Seal leather, with Tucks, Pencil, etc., 
gilt edges. . 



$1.25 



SPECIAL SIZES AND BINDINGS MADE TO ORDER. 



" The fact that this Visiting List has been published annually for forty years is suffi- 
cient guarantee of its excellence and popularity. In addition to the visiting list proper, 
it contains easily-accessible suggestions upon many of the emergencies that may arise in 
a physician's practice, as when he is too far from home to learn from his text-books the 
antidote for a poison that may have been swallowed, or the proper method of resuscitating 
a half-drowned person. True, he should know these things, but who does not occasion- 
ally forget, when he most wishes to remember ? There are also dose-tables, tables of the 
metric system, a list of new remedies, rules for examining urine, a table for calculating 
the period of pregnancy, and other equally useful information. The arrangement for 
entering patients, visits, consultations, etc., is exceeding simple, and the whole makes a 
thin, compact, and easily-carried volume." — Medical News, P hi la da., January 3 , i8gi. 

Jgg^The Perpetual and Monthly Editions can be commenced at any time and 
used until full. 

J^iT'This is a plain, systematic method of keeping a record of visits ; well printed, 
strongly bound, durable, convenient, and small. 

This Visiting List is published in November of each year. 






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